Morbidity and mortality

rj i -/ wu 1- i z/ I





Morbidity and Mortal



U. S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFtA

PUBLIC HEALTH SERVICE


Prepared by the


For release May 1, 1964


I COMMUNICABDS E


ATLANTA. GEORGIA 30333


PROVISIONAL INFORMATION ON SFLECTED) NOTIFIABLE [)DIS AS-s IN THI LINI1
DEATHS IN SELfCTID CITIFS FOR W FFK ENDID APRIL 25, 1964


POST-MEASLES
Of the 27 cases of post-infectious encephalitis re-
ported this week 14 are attributed to measles infections.
The accompanying graph depicts the secular trend of
reported measles and post-measles encephalitis for 1964
by week of reporting.
As previously reported (MMWR, Vol. 13, pp. 46 and
102) and as shown elsewhere in this issue most of the
post-infectious encephalitis cases reported in January,
February, and March were attributed to mumps infections.
That measles accounts for over half of the post-infectious
encephalitis cases reported this week may be attributed to
the striking increase in reported cases of measles within
the past month. This week, with a oral of 29,899 cases of
measles reported, constitutes the third straight week
wherein reported measles cases have exceeded 25,000, a


ENCEPHALITIS
figure well in excess of the median figure for measles
cases reported during the same weeks of 1959 to 1963.


RI REPORTED MEASLES 5 964
50.000
?5.000
CDOOG--
.5 .CiC.)

?0Q.O
Ri.


carRsEPOP TED PCST ME ASL E E%1CEP**AL.TIc .964


.EE. LID.hi


Table I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES


(Cumulative totals include revised and de


played reports through previous weeks)


17 th Week Ended Cumulative. First 17 Weeks
Disease April 25, April 27, Median Med ian
~~____~~________ ___ 1964 1963 1959 1963 1964 1963 1959 1963

Aseptic meningitis ................ 20 19 --- 459 370 ---
Brucellosis ....................... 5 5 9 125 111 177
Diphtheria ........................ 3 5 5 68 104 235
Encephalitis, primary infectious .. 24 1--- 540 1 ---
Encephalitis, post-infectious ..... 27 --- 248 461 -

Hepatitis, infectious including
serum hepatitis .................. 821 824 875 15,388 17,158 17,158
Measles ............................. 29,899 16,295 18,177 226,977 212,000 221,585
Meningococcal infections .......... 76 62 43 1,046 1,006 945
Poliomyelitis, Total .............. I 3 4 23 47 131
Paralytic ........................ 1 3 3 17 42 85
Nonparalytic ................... --- 5 2 ---
Unspecified .................. --- 1 3 ---

Streptococcal Sore Throat and
Scarlet fever ..................... 10,632 7,921 --- 183,686 162,304 ---
Tetanus ............................ ... 4 2 --- 64 57 ---
Tularemla .......................... ... 3 3 --- 81 4 ---
Typhoid fever ...................... .. 7 3 9 111 116 162

Rabies in Animals .................. 127 132 95 1,488 1,282 1,384


Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY

Cum. Cum.
Anthrax: 2 Psittacosis: 13
Botulism* 6 Rabies in Man.
Leptospirosis: 7 Smallpox;
Halaria:Nebr.-1 30 Typhus-
Plague: Murine! Ky.-l 4
____I____ _________ Rky Mt. Spotted: 7


4 ii i






Morlility and Mortality rcekly HRport


Figure I/
CASES OF INFECTIOUS HEPATITIS BY
SITKA, ALASKA


NUMBER
OF CASES
a
.7


5




2



WEE$ 'fI ': c .-. ..' U 5
ENDED


APRIL MAY JUNE JULY AUGUST


EPIDEMIOLOGICAL REPORTS


HEPATITIS Alaska
An outbreak of infectious hepatitis, involving 66
individuals, occurred in Sitka, Alaska, between April and
late September 1963. Six cases occurred in April and May.
After a hiatus of 3 weeks, 60 additional cases became
clinically manifest between June and October ISee
Figure 1).
The epidemic appears to be the sum of 2 smaller
outbreaks among Alaskan Indians and non-native Cauca-
sians. The Indian outbreak appears to have reached its
peak during late July-early August. The Caucasian out-
break had its peak about I month later.
The distribution of the cases from April through
October by age, sex. and ethnic group can be seen in
Table 1. There were 11 cases in individuals 30 years or
older. All 11 were Caucasian, 10 of the 11 were white
females. The dates of onset among these 10 women ranged
from the extremes of the epidemic. Two had a history of
contact with a previous case during the 10 to 50 days
prior to onset. In both instances, this contact was with a
patient outside the home. Of the remaining 8 women, 4 had
children in schools in which hepatitis had occurred; an
additional patient worked as a baby-sirrer. Three of the
%omen, however, had no close contact with children.
Of 28 adult contacts in Indian households, 4 gave a
history of a previous episode of jaundice. Three recalled
an icteric illness approximately 30 years earlier, which
would suggest that infectious hepatitis mav have been
prevalent among the Indian population of Sitka at that
time and would help explain the absence of cases in
natives Vl years of age and over.
Cases among white adults 10 years of age and over
were not confined to persons who had recently arrived in
itrka. Of the 10 women in this group who became ill. 8
had resided in the town for at least 5 years and 3 of these


WEEK OF ONSET




* CASE IN AN
ALASKAN INDIAN
O CASE IN A
CAUCASIAN


.* ?1 Ze 1 '. *.
SEPT. OCT.


TABLE 1
DISTRIBUTION OF INFECTIOUS HEPATITIS BY AGE, SEX.
AND ETHNIC GROUP
SITKA, ALASKA. APRIL OCTOBER 1963

Indian Coucasian
Age Group Male Female Male Female Total
0-4 1 1 2
5-9 4 4 5 3 16
10-14 6 4 5 5 20
15-19 2 2 1 5
20-29 2 1 5 4 12
30-39 4 4
40-49 1 2 3
50-59 3 3
60o 1 1
Total 15 11 1 17 23 66



had lived there more than a quarter-century.
The duration of the outbreak, the age distribution of
the cases, and the history of contact elicited from 32
percent of the cases are evidence that the mode of trans-
mission of infectious hepatitis in Sitka was by the person-
to-person route. Possible common sources such as food,
water, milk, and parenteral introduction were investigated;
they could not explain the epidemiological pattern. Simi-
larly, there was no evidence to incriminate schools or
social gatherings as contributing significantly to the
total spread of hepatitis through the community.
Immune globulin administration 0.01 cc Ilb) to family
contacts was successful in preventing secondary house-
hold cases.
Ri p.'retd by I.. P. Sprnccr. ,M.P.. rilka jiealth Offircer
Miss .Mlar Rou/, %. pP .\. Sirka. I dr im 0. ircks. Al.o..
Pirrccor. nir sieon of pubhlre iruth. lark K. Lesh. ,M.D..
Chief, Maternal and CI'rld Iealth, and a team from the
C PC.)


142








Morbidity and Mortality Weekly Report


ENCEPHALITIS
A. total of ni cases of post-infectious encephalitis
were reported during March (see table right. This figure
compares with the- S1 and 25 cases reported for February
and january respectively (See MMWR, Vol. 13, pp. 46 and
102).
Mumps continued to be the chief inciting cause,
accounting for i' cases in March. The table below com-
pares the monthly incidence of mumps during the first
quarter of 19L4:

Mumps Percent of Total Cases

January 22 88
February 39 76
March 37 59

There were 15 cases of measles post-infectious
encephalitis in March, compared with 6 in February and
2 in January.
No case of vaccinia encephalitis has been reported
thus far in 1964.


143


REPORTED CASES OF POST-INFECTIOUS ENCEPHALITIS
FOR MARCH
4 Weeks Ending 3 7, 3 14, 3 21, 3 28

Inciting Cause
Gerar.n Herpes
Reporting Area Mumps Chickenpon Measles Measles Influenza Simplaei
New England
Connectic.u 1
Middle Atlontic
New York Up-State 1 4 2
Pennsylvan.a 3 2 1
East North Central
Ohio 3 2
Illinois 10 1 2
Michigan 3 1
South Atlantic
Virgin 2 1
East South Central
Tennessee 3
West South Cenlral
Arkansas 1 1
Texas 1
Paciic
Washington
California 8 1 6 1
Hawai. 1
U. S. TOTAL 37 6 15 3 1 1
(Stoates not reporting a case not listed).


TOTAL DEATHS REPORTED IN 108 CITIES




The weekly average number of total deaths in 108
cities for the four-week period ending April 25 was 11,9%0
as compared with an expected weekly average of 11,902.


Week Ending
Week Ending 4 Week Weekly
4 4 4 11 4 18 4. 25 Total Average

Observed 12,286 12,140 11,614 11,761 47,801 11,950
Expected 12,018 11,945 11,865 11,780 47,608 11,902

Excess 268 195 251 19 193 48


TOTAL DEATHS RECORDED IN 108 U.S. CITIES
Average Number per Week by Four Week Periods


*eBV LACE OF OCCLURRENCE *CA.LCuErED FROM 19954 IO FCPfRirAiCE


l' 1.iii/id-' pOi,'< 1 -4 1









I II lrliid ii, and Mortality reeklv Reliorl



I.,hlI ( AMS OF() SP IFIMI) N()TIFIABLI [)ISF[A.SF I NITfU [3 ATES

FOR W IK -K ENI)Dl)

APRIl. 2i. 19 '( AN A APRIL 2 196 ( Ih WIIK)


E ne rpia I l I t
A 'ept i
1 nin1.r tl Pr ima r P.- l nl P. I IL'myI el t T t'al Cal ies P..1 1.... Ii t Paralytic
Art .1
A nri.1 ---- ------ ------- --------- ---- ------------- ------------
Cunulativ Curnmulative

1964 1461 196b 19 b- 1964 1963 1964 1963 ]h6 Ib3 1964 1963
I'NITED TATE ... 20 19 26 27 1 3 23 47 1 3 17 42

TEW FNC(IAND .......... I -
i .. ...
i Hs- LHap-hl r ......- -
V r, i ............- -
Ma-- 1 hu -. 1 t I -...... -
RIh ,i. ] l L I d ....... -
C nrint : ILL ........ ----

MIDDLE ATLANTIC ...... 2 3 4 5 4 S
., r lty ...... I I -
... -r Up-State. I 1 2 4 2 4
J r y......... -
PL nn-w, Il nl in ....... 2 1 -

EA I NORH CENTRAL ... 2 2 7 1 1 3 13 1 1 3 11
Ohi .................. 1 1 1 2 4 1 2 3
Indiana .............. .
Illin i ..............- 1 5 1 6 1 5
Michi ,an........... I 2 1 1 1 3 1 3
S~ C,.-n1s i n .. .. .

'T NORTH CENTRAL... 1 7 I
nnc. ........ 1 4 1 1
1., ............... 1 .
l .I l ...... .
N *rlh Dak ta..... .. .
'u h Dak. .
b I ara, k.a ........... .- .
ln 4 i ........ .... -

,1I-.TH ATLANTIC. ..... 5 2 3 1 11 5 1 8
D awire ........... I -
MAr\ land........... 1 .
D iL t. 1' C.lumbia.. -
V tir in ld .... I
r4-t Virpinia...... 2 -- 1 -
rth Carolina...... 5 2 2 2
'-uth Carolina..... 1 1 -
C..or ta ............ 1 1 1 -
Flirida ... .. ..... 3 2 1 3 2 1 3 2

[E' SlLIITH CENTRAL... I 3 I 1 3 2
r.tucky ........... I 1
Ti nn- e .......... .1 -
Ala .imn ............ 2 -
"i4l;tpi............. 3 -

ECI .'T CENTRAL... 3 I 2 1 2 10 1 1 10
'r[.. 'u ...........
% I .8. 8
f'k I a h.,'u a ........... .
Tx. a ................. 3 2 1 2 2 1 1 2

M 'NS TAI ...;...... ...... .1 2 1 1 1
.',n 1 rla. . ..
int i m ............... -
h.V ". n .............


I r.. .
*A I ar ...........
A I r' i ........... .. -


i t 1 . .-


P : IF .............. 8 10 9 8
-hl n'l n ... .... I I 1 -
,r, ... .
S i rr, . 7 9 2 15 7 6
41 i.............


P.ri .- -
____ "*_________ ________________ 1____ ____ 2 _____- ____ 2_







Morbidity and Morialiyv Weekly Report 145


Table 3 CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

APRIL 25, 1964 AND APRIL 2', 1963 ( 17th WEEK) Continurd


Infectious Hepatltis
Brucellosis Diphtheria including Serum Hepatitis Typhoid Fever

Area Under 20 years Age
Cum. Cum. Total 20 years and over Unknown Cumulative Cum.

1964 1964 1964 1964 196. 1964 1964 196- 1964 1963 1964 1964

UNITED STATES... 5 125 3 68 821 410 353 58 15,388 17,158 7 111

NEW ENGLAND.......... 1 1 5 77 34 40 3 1,640 2,022 7
Maine............. 1 2 24 11 12 1 577 944 -
New Hampshire...... 5 3 2 128 139 -
Vermont............. 12 8 2 2 205 28 -
Massachusetts...... I 3 13 6 7 323 588 4
Rhode Island....... 7 1 6 76 48 3
Connecticut ........ 16 5 11 331 275 -

MIDDLE ATLANTIC...... 2 4 205 111 94 3,519 3,330 18
New York City...... 1 37 13 24 509 428 6
New York, Up-State. 1 92 62 30 1,558 1,477 4
New Jersey......... 2 39 13 26 639 519 -
Pennsylvania....... 1 1 37 23 14 813 906 8

EAST NORTH CENTRAL... 1 17 6 136 64 54 18 2,312 2,698 3 25
Ohio............... 22 9 10 3 611 808 1 16
Indiana............ 16 9 6 1 200 244 1 4
Illinois........... 1 12 6 24 11 10 3 360 576 3
Michigan........... 2 54 30 24 982 933 1 2
Wisconsin.......... 2 20 5 4 11 159 137 -

WEST NORTH CENTRAL... 2 70 10 45 24 20 1 900 759 10
Minnesota.......... 2 2 5 3 2 73 127 -
Iowa............... I 40 8 5 3 132 126 3
Missouri........... 4 17 7 10 225 308 3
North Dakota....... 2 1 1 37 20 -
South Dakota....... I 11 1 6 2 4 92 30 I
Nebraska........... 10 1 I 19 56 -
Kansas............. 1 7 7 6 1 322 92 3

SOUTH ATLANTIC....... 6 1 18 50 30 20 1,494 1,841 1 25
Delaware.......... 2 2 33 26 -
Maryland........... 12 9 3 284 209 1
Dist. of Columbia.. 26 57 -
Virginia............ 2 6 1 5 222 407 1 6
West Virginia ...... 9 5 4 265 271 -
North Carolina..... 7 5 2 281 493 9
South Carolina..... 3 5 4 1 54 77 2
Georgia............ 2 1 13 2 2 35 75 l
Florida............ I 2 7 4 3 294 226 6

EAST SOUTH CENTRAL... 1 7 4 41 22 15 4 1,055 1,757 1 13
Kentucky........... 1 3 20 12 8 466 528 1 8
Tennessee.......... 1 16 9 7 364 693 4
Alabama............ 3 2 141 256 1
Mississippi ........ I 1 5 1 4 84 280 -

WEST SOUTH CENTRAL... 5 13 72 40 29 3 1,118 1,169 1 7
Arkansas........... 1 6 3 3 127 143 3
Louisiana......... 1 3 12 9 3 228 211
Oklahoma............ 1 I 1 68 63 3
Texas.............. 2 10 53 28 22 3 695 752 1 1

MOUNTAIN ............. 1) 1 50 16 5 29 1,021 1,189 1 1
Montana............. 8 5 1 2 99 180 -
Idaho............... 8 8 81 175 -
Wyoming.............. 33 20 -
Colorado........... 12 2 1 9 315 249 -
New Mexico........ 1 1 6 5 1 160 146 -
Arizona............. I 10 10 215 261 1 1
Utah............... 7 6 4 2 90 148 -
Nevada............. 1 28 10 -

PACIFIC............. 1 7 7 1 7 145 69 76 2,329 2,393 5
Washington........ 6 16 8 8 245 396 I
Oregon.............. I 24 17 7 259 342 -
California......... 1 6 1 I 96 38 58 1,701 1,590 4
Alaska............. 8 6 2 75 52 -
Hawaii............. -- -- 1 1 49 13 -

Puerto Rico 3 31 24 7 246 235 6








1 6 t Morbidity and Mortality Wpeekl Report


Tahlc 4 CASES OF SPECIFIED NOTIFIABLE DISEASES UNITED STATES

FOR WEEKS ENDED

APRIL 2S 196-1 AND APRIL 2. 19,6 ( I'th WEEK) Coniinud


Strept aoccal
Meningococcal Sore Throat and Rabies in
M-Il'.c Mrninglir Scarlet Fever Tetanus Tularemia Animals
Are.i
Cumult ive Curm. Curn. Cum.
1i64 196u 196. 1963 1964 1963 1964 1964 1964 1964 1964 1964

UNITED STATES... 29,899 76 1,046 1,006 10,632 7,921 4 64 3 81 127 1,488

%EF ENCGIAND.......... 576 2 31 69 1,278 829 7
aine ................ 91 1 3 10 102 103 5
Nei Hlmpshir ...... 3 2 9 1
,'rmnt ............ 65 -1 2 26 45 1
Maj -ichusett4 ...... 163 13 33 115 122 -
Rh.-., Il.anl ....... 112 2 6 68 64 -
C .nnect i Lut........ I.. 1 12 16 963 486 -

MIDDLE ATLANTIC...... 2,658 5 98 133 693 507 3 1 30
New Y.rk Citv...... 695 2 19 16 34 39 -
Ne6 Y,-rl. Up-State. 686 1 35 .7 502 256 1 29
New Jer-ey ......... 607 14 21 54 9 2 -
Pennsylvania....... 670 2 30 .9 103 120 1

EAST NORTH CENTRAL... 7,778 10 164 165 1,523 759 5 8 32 174
Oh .................. 1,485 48 45 275 118 1 1 25 93
Indiana............ 2,272 28 21 149 97 1 8
Illinois........... 1,267 1 35 25 267 103 2 5 6 39
Michigan............. 1,864 5 39 53 548 259 1 I 12
Wisconsin.......... 890 1 14 21 284 182 I 1 22

WEST NORTH CENTRAL... 1,806 6 61 61 313 332 3 21 36 474
Minnesota.......... 7 2 12 11 24 35 1 10 141
1.wa ............... 1,-55 3 3 100 89 1 1 15 167
Missouri ........... 24 3 33 25 37 2 13 7 86
North Dakota........ 311 1 4 1 101 153 1 21
South Dakota ....... 41 10 2 41
Nebraska........... 9 4 14 1 1 10
Kansas ............. NN 5 3 10 44 6 8

SOUTH ATLANTIC....... 2,847 13 233 203 1,032 615 3 27 1 15 17 231
Delaware........... 19 1 3 1 17 4 -
Maryland........... 120 17 29 131 56 2 -
Dist. of Columbia.. 5 7 3 14 1 -
Virginia........... 1,035 4 26 51 248 176 2 4 3 4 153
West Virginia...... 912 17 10 504 231 1 12
North Carolina..... 77 3 40 32 10 26 7 4 2
South Carolina..... 168 2 36 12 36 42 3 -
Georgia............ 18 11 5 4 1 1 8 9 35
Florida............. 511 3 69 54 67 75 1 10 3 29

EAST SOUTH CENTRAL... 3,3.9 7 106 82 1,721 1,195 9 16 19 233
Kentucky............ 1,155 4 35 20 313 130 1 1 4 32
Tennessee.......... 1,281 2 38 35 1,277 936 4 11 13 191
Alabama............. 11 1 18 13 37 3 3 2 10
Mississippi........ 902 15 14 131 92 1 -

WEST SOUTH CENTRAL... 6,161 9 96 107 954 792 8 I 16 9 223
Arkansas............ 68 1 9 5 2 2 1 4 4 57
Louisiana .......... 4 6 77 46 2 5 3 22
Oklahoma............ 91 3 21 49 29 11 5 29
Texas............... 5,998 2 7 35 901 758 3 1 115

MOUNTAIN............. 1,043 2 39 33 1,770 1,708 2 1 5 4 54
Montana............ 130 2 45 59 1 -
Idaho.............. 92 1 1 103 209 -
Wyoming............ 16 I 2 1 42 53 1 1 2- -
Colorado........... 189 8 7 838 758 -
New Mexico ........ 16 18 2 360 266 1 25
Arizona ............. 353 1 3 6 119 131 4 29
Utah............... 131 1 11 263 231 2 -
Nevada.............. 116 6 3 -

PACIFIC .............. 3,681 22 218 153 1,348 1,184 1 7 9 62
Washington......... 1,311 2 18 12 356 508 -
Oregon.............. 410 3 15 7 25 26 1 1
California......... 1,886 15 172 126 766 578 1 7 8 61
Alaska.............. 60 6 4 109 32 -
Hawaii ............. 14 2 7 4 92 40 -

Puerto Rico 467 2 14 4 30 28 3 24 3 9







M1orbidit and Moorlaliti Weekl Report




TahlI 4 (A) TOTAL DEATHS IN REPORTING CITIESS


147


(Tables 4(A), 4(B), 4(C), and 4(D) will be published in sequence covering a four-week period.)o

For weeks ending For weeks ending
Area Area
4/4 1 4/11 4/18 4/25 4/4 4/11 4/18 4/25


NEW ENGLAND:
Boston, Mass. .............
Bridgeport, Conn .........
Cambridge, Mass. ..........
Fall River, Mass .........
Hartford, Conn. ...........
Lowell, Mass .............
Lynn, Mass. ...............
New Bedford, Mass. ........
New Haven, Conn. ..........
Providence, R.I ..........
Somerville, Mass. .........
Springfield, Mass. ........
Waterbury, Conn. ..........
Worcester, Mass .........

MIDDLE ATLANTIC:
Albany, N.Y. .............
Allentown, Pa. ...........
Buffalo, N.Y. ............
Camden, N.J .............
Elizabeth, N.J. ..... ......
Erie, Pa. .................
Jersey City, N.J. .........
Newark, N.J. .............
New York City, N.Y. .......
Paterson, N.J ............
Philadelphia, Pa. ........
Pittsburgh, Pa. ...........
Reading, Pa .............
Rochester, N.Y. ...........
Schenectady, N.Y. .........
Scranton, Pa. .............
Syracuse, N.Y ............
Trenton, N.J .............
Utica, N.Y. ..............
Yonkers, N.Y. .............

EAST NORTH CENTRAL:
Akron, Ohio.................
Canton, Ohio...............
Chicago, Ill. ............
Cincinnati, Ohio............
Cleveland, Ohio............
Columbus, Ohio..............
Dayton, Ohio ................
Detroit, Mich ............
Evansville, Ind. ..........
Flint, Mich. ...............
Fort Vlayne, Ind. ..........
Gary, Ind. ................
Grand Rapids, Mich .......
Indianapolis, Ind .........
Madison, WL i .............
Milwaukee, Wis. ............
Peoria, Ill. ..............
Rockford, Ill. .............
South Bend, Ind. ..........
Toledo, Ohio...............
Youngstown, Ohio ............

WEST NORTH CENTRAL:
Des Moines, Iowa ...........
Duluth, M nn. ......... .....
Kansas City, Kans. ........
Kansas City, Mo. ..........
Lincoln, Nebr. ...........
Minneapolis, Minn. ........
Omaha, llebr. ..............
St. Louis, ll ...........
St. Paul, Minn ...........
Wichita, Kans. ............


279
36
34
34
59
17
23
28
52
62
12
65
33
50


40
47
167
41
24
56
78
102
1,594
49
593
176
67
96
56
33
64
54
17
38


58
36
849
173
201
127
87
396
35
44
55
47
45
148
43
128
23
33
48
113
48


66
17
33
122
40
169
88
247
100
46


259
40
30
33
58
34
27
24
50
63
13
34
22
61


50
39
160
40
33
36
83
89
1,858
43
601
155
50
82
35
30
66
51
28
45


58
30
755
161
205
136
83
357
49
40
42
19
60
158
24
138
47
40
40
104
64


58
26
37
136
27
127
63
243
93
61


267
47
24
24
66
26
26
28
63
65
12
40
27
55


45
28
166
49
34
37
88
87
1,681
54
512
191
46
102
23
37
59
42
38
26


41
39
680
169
235
112
73
332
39
47
44
34
44
156
53
124
21
24
36
98
62


55
38
35
93
26
158
82
244
69
57


285
37
26
28
53
22
25
25
36
74
15
62
25
42


40
35
153
41
30
35
85
89
1,706
44
587
184
42
109
26
46
61
48
22
33


64
42
716
172
186
111
84
380
28
36
39
35
46
154
27
96
27
45
32
101
55


80
32
55
16,
22
131
92
272
60
55


SOUTH ATLANTIC:
Atlanta, Ga. .............
Baltimore, Md. ............
Charlotte, N.C. ...........
Jacksonville, Fla. ........
Miami, Fla. ...............
Norfolk, Va. .............
Richmond, Va. ............
Savannah, Ga ....... .....
St. Petersburg, Fla ......
Tampa, Fla. ...............
Washington, D.C. ..........
Wilmington, Del. ..........

EAST SOUTH CENTRAL:
Birmingham, Ala. ..........
Chattanooga, Tenn ......
Knorville, Tenn. .. .......
Louisville, Ky. ..........
Memphis, Tcnn. ............
Mobile, Ala. ..............
Montgomery, Ala. ..........
Nashville, Tenn. ..........

WEST SOUTH CENTRAL:
Austin, Tex. .............
Baton Rouge, La. ..........
Corpus Chrietl, Tex. ......
Dallas, Tex. ...............
El Paso, Tex ..............
Fort Worth, lex. .........
Houston, Te ............
Little Rock, Ark.. ........
New Orleans, L3. ..........
Oklahoma City, Okla ......
San Antonio, Tex .........
Shreveport, La ............
TulZa, Okla. .............

MOUNTAIN:
Albuquerque, N. Mex ......
Colorado Springs, Cole. ..
Denver, Colo ............
Ogden, Utah...............
Phoenix, Ar ...........
Pueblo. Colo. .............
Salt Lake City, Utsh .......
Tucson, Ariz. .............

PACIFIC:
Berlele5, Calif .. ..........
Fresno, Calif. .............
Glendale, Calif. ..........
Honolulu. Hawj i ...........
Long Beach, C lif. .........
Los Angelcs, Calif. ........
Oakiand, C ltif .. ...........
Pasadena, C lif. ...........
Portland, Oreg.......... ..
Sacrai.m ncr. Calif. ........
San Diego, Calif. ....... ..
ian Francisco, Calif. ....
San Jose, Calif ..........
Seattle, Wash. ...........
Spokane, Wash. ...........
T3ac ma, Wa;h. .............

San Juan, P.R. ...............


OCurrent Week Ilortalitv for 108 Selected Cities

4(A) Total Mortality, all apes...................
4(B) Pneumonia-Influenza Deaths, all ages........
4(C) Tctal Deaths under 1 Year of Age............
-fD) Total Deaths, Persons 65 years and over.....


11,761
490
737
6,522


NOTF 411 deaih. b. place or or:urren e.


18 12 22
59 47 37
50 31 31
54 43 54
68 68 1 57
498 449 1 611
83 99 67
38 34 37
149 104 125
84 60 52
99 103 105
224 198 i 189
57 55 44
137 139 121
60 59 51
31 42 35

S29 20 21


*Estimate based on average percent of divisional total.
Totals for previous weeks include reported corrections.


-- '-~







Morbidity and Mortality Weekly Report


INTERNATIONAL NOTES QUARANTINE MEASURES

Immunization Inlormarion for international Travel
'li, i--.. edition Public Health Ser ice Publei attirri Vn. S4
The following information should be added to the list
of Yellow Fever Vaccination Centers in Section 6:
Page 76
City: Philadelphia, Pennsylvania
Center: Temple University Hospital


Broad and Ontario Streets
Tel: BA 1-8000
Monday, 10-12 a.m.
Yes


In addition to the established procedures for reporting morbidity
and mortality, the Communicable Disease Center welcomes
accounts of interesting outbreaks or cases. Such accounts should
be addressed to:

Lawrence K. Alrman, M.D., Editor
Morbidity and Mortality Weekly Report
Communicable Disease Center
Atlanta, Georgia 30333



Notes- Thoe provisional doto are based on *wekly telegramn t he ComiiunI
cable Diseose Cente by the Individual Strae eoflrh departments.
Symbol Data noe avoilable
*Quantity eor
Proceduwes for consiruc lon of vwtious monrtolity curve may be sobIned kf
Statritlcs Section, Communicable Disease Center Public Helth Seavice,
U. 5. Department of Health. Educoaton, iad Welfare, Atlalte, Georgae 3033.


U S DEPOSITORY


The Morbidity and Mortalty Weekly Report, with a circuloron
of 10,500 is published by the Communicable Disease Center,
Atlanta, Georga.
Chief, Communicable Disease Center James L. Goddard, M.D.
Chief. Epdemiology Branch A. D. Langmuir. M.D.
Chief. Statistics Section R E. Serfling, Ph.D.
Asst. Chief, Stlaistics Section I. L. Sherman, M.S.
Chief, Surveillance Section D. A. Henderson, M.D.
Editor, MMWR L. K. Altmon, M.D


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