Morbidity and mortality

COMMUNICABLE DISEASE CENTER


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND


Vol. 14, No. 4




s R[PFUR


_ Week Ending
January 30, 1965



IBLIC HEALTH SERVICE


EPIDEMIOLOGIC NOTES C.\ E i-s


INFLUENZA
Group A influenza infections have been demonstrated
by serological conversions in 4 States during the past few
weeks. In addition to confirmations in New Jersey, Con-
necticut, Massachusetts, and Penns l\ ania.(some reported
in MMWtR, Vol. 14, No. 3), focal outbreak of influenza in
Missouri has presumptively been ascribed to Type A virus
by fluorescent antibody study of nasal secretions from
typical cases. An outbreak of influenza-like disease has
been reported from northern Maine but laboratory tests are


Epidemiologic Reports .................. .. 34
Influenza State Reports ............ ..... 34
New Jersey; Missouri; Maine; Pennsylvania 34
International . . ... 40

as yet incomplete and the cliological agent not identified.
The only virus isolate yet typed is an influenza A2 strain
recovered in Allegphtn County, Pennsylvania.
The outbreaks occurring in these States continue to
be sporadic and scattered. In gcnoral, children principally
appear to be affected at times resulting in marked school


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)

4th Week Ended Cumulative, First 4 Weeks
Disease Median
January 30, January 25, 1960 1964 Median
1965 1964 1965 1964 1960- 1964

Aseptic meningitis .......... 26 27 26 126 117 105
Brucellosis ....... ........ 4 9 7 21 19 22
Diphtheria ................ .1 7 20 13 18 60
Encephalitis, primary infectious.. 31 30 *-- 123 110 --
Encephalitis, post-infectious .... 18 4 --- 52 23 ---
Hepatitis, infectious including
serum hepatitis ........ .. 851 1,116 1,129 3,104 3,482 4,096
Measles ................. 7,639 7,060 8,908 26,393 21,879 30,927
Meningococcal infections ...... 60 50 50 258 205 205
Poliomyelitis, Total ......... 1 4 7 1 5 31
Paralytic .............. 1 3 5 1 3 19
Nonparalytic ......... .. 1 ~ R DA 2
Unspecified ...... ........ .. 14 _
Streptococcal Sore Throat and
Scarlet fever ............ 11,335 10,177 9,470 39,517 33,016
Tetanus .................1 5 --- 12 ---
Tularemia ................ 5 7 .-. 29 .
Typhoid fever .... ......... 14 2 9 I 181 24
Rabies in Animals .. .. 95 81 57 368 /Jst4 228

Table 2. NOTIFIABLE DISEASES OF LOW F J4ENCY
Cum. -- Cum.
Anthrax: 1 Rabies in Man:
Botulism: Smallpox:
Leptospirosis: Hawaii 1, Texas 1 2 Trichinosis: Minn. 16 17
Malaria: Conn. 1 1 Typhus -
Plague: Murine: -
Psittacosis: 2 Rky. Mt. Spotted: 3




~-T
K~----


Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES
INFLUENZA Continued

absenteeism. Extension of the illness into adult and older
age populations is not being generally observed although
in some areas cases are being identified among all age
groups.
Attention is called to the charted influenza and pneu-
monia mortality data reported to CDC from 122 United
States cities (page 35). In the United States as a whole,
influenza and pneumonia deaths are below the epidemic
threshold. In the Middle Atlantic Division, irregular ex-
cursions above the "epidemic threshold" have been evi-
dent in past weeks. Several cities within the Eastern
Divisions have reported fluctuations in numbers of deaths,
at times well above seasonal expectations. Although some
of the increases may reflect already identified influenza
activity in the area, others cannot yet be explained.


EPIDEMIOLOGIC REPORTS
INFLUENZA State Reports
New Jersey
Since early January 1965, health workers, physicians
and other paramedical personnel have been aware of an
increased incidence of acute febrile respiratory disease
throughout the State. Influenza activity was first confirmed
ata State school forboys, 9 to 16 years of age, near James-
burg in Middlesex County. On January 1, 1965, older boys
returning from vacations in the Newark, New Brunswick,
and Paterson areas, developed acute febrile respiratory
illnesses. During the following week, the daily number of
new cases reached a peak. The over-all attack rate in the
ensuing epidemic was 22 percent among the 700 inmates
and 5 percent among school employees. The illness was
characterized as an acute systemic febrile respiratory
disease with temperatures up to 1040 F. Serologic con-
firmation of group A influenza was performed by the State
Laboratory; virus isolation attempts are under way.
Subsequent outbreaks of clinically similar illness
were noted in 3 institutions in the Middlesex-Somerset
County areas: a psychiatric hospital, a chronic disease
hospital, and a State university. Attack rates within these
institutions have been uniformly low (10 percent); no
laboratory confirmations have been made to date.
From a survey of physicians, it would appear that in-
creased respiratory illness is occurring in scattered areas
throughout the State. There has been no widespread school
or industrial absenteeism to support this sureyv to date.
(Reported by William J. Dougherty, M.D., Director, Divi-
sion of Preventable Disease Control, Martin Goldfirld,
M.d)., Director of Laboratories, New Jersey State Depart-
ment of Health, and an EIS officer assisting in the investi-
yation).


Missouri

A consolidated school in Princeton. Missouri, with
about 700 students experienced a sudden increase in its
daily absentee rate to more than 25 percent early in the
week of January 24. Because of continuing high absen-
teeism, the school was closed on January 27. Clinically
the accountable illness was characterized as being
influenza-like but of only moderate severity.
,Epidemiological and laboratory studies are under wa\
in the State Health Department and the CDC Field Station,
Kansas City, Kansas. Employing fluorescein labeled A2
influenza antiserum, presumptive diagnosis were made in
four of seven school children whose nasal epithelial cells
demonstrated specific fluorescent staining. Additional
confirmatory tests are pending.
Retrospectively, it appears likely that a similar
illness was present in towns east of Princeton earlier
in January and was responsible for the brief closing of
schools in one of them.
(Reported by Dr. E.A. Belden, Communicable Disease
Consultant, Missouri Department of Public Health and
Welfare. and the CDC Kansas City Field Station).


Maine

In northern Aroostook Counts, near the Canadian
border, outbreaks of febrile respirator\ disease were
observed beginning in early to middle Januar Affecting
only moderate numbers of individuals, the illness appears
tohave spread in a diffuse pattern through parts of central
Maine in more recent weeks. Augurta is noted, however,
to be the only urban area in the State %where there are
evidences of modest increases in absenteeism in scattered
schools and in ph.iicians' descriptions of the heightened
occurrence of re-piratory diseases. The syndrome has
been observed primarily in younger age groups and has
not made an impact on baseline industrial absenteeism.
Laboratory processing of specimens i presently under
way at CDC.
(Reported by Dr. Dean H. Fisher. Commissioner, I aint
Department of Health and Welfare J.


Pennsylvania

Influenza virus Type A2 has been recovered h\ the
Allegheny County Laboratory from a case involved in an
outbreak recently recognized in the Counts. Some increa-e
in school absenteeism is now being recognized in
Pitt.-burgh.

(Reported by Dr. Edwin Brown, Epidemiioloqi.t. an EIS
Officer, and Mr. Joseph Sarandria, Laboratory Director,
Allegheny County Department of Health).


(Continued on ba k page









Morbidity and Mortality a weekly Report


PNEUMONIA-INFLUENZA DEATHS IN


122 UNITED STATES CITIES


40 44 48 52 4 8 12 16 20 24 28 32 36 40 44 48 52 4 8 12 16 20 24 28 32 36 40 44 48 53 4 8 12 16 20 24 28 32 36
6 3 1 29 26 23 23 20 18 15 13 10 7 5 2 30 28 25 22 21 18 16 13 11 8 5 3 31 28 2 30 2727 24 22 19 17 14 11
ON D J F M A M J A S O N N J F M A M J J A S O N D J F M A M J J A S
1962 11963 1963 1964 1964 11965


W.N.
CENTRAL
10 CITIES


WK. NO. 40 44 48 4 8 12 16 20 24 28 32
1964 1965


NEW
ENGLAND
14 CITIES







40 44 48 53 4 8 12 16 20 24 28 32 36
1964 1965


MOUNTAIN
8 CITIES


40 44 48 53 4 8 12 16 20 24 28 32
1964 '1965


PACIFIC
16 CITIES


E.S.
CENTRAL
8 CITIES


O'"'""""'""I'"""'""'"'"""""""** nean
ts..1minalinin inst at ni **I at at


40 44 48 4 8 12 16 20 24 28 32
1964 1965


W.S.
CENTRAL
13 CITIES


MIDDLE
ATLANTIC
20 CITIES


SOUTH
ATLANTIC
12 CITIES


40 44 48 4 8 12 16 20 24 2832 36
1964 1965


("
WEEK NO
WK ENDED
S MONTH
Q --


WK. NO
200-1


nl~~, I,, 1~~ ~1~1~~1~ ~11~~~1~ ~~r,~~ 1,,,rl ,I,,,l,,~r


' '


WK











36 Morbidity and Mortality Weekly Report



Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 30, 1965 AND JANUARY 25, 1964 (4TH WEEK)



SEncephalitis Poliomyelitis Diphtheria
Aseptic
Meningitis Primary Post-Inf. Total Cases Paralytic
Area
Cumulative Cumulative Cum.
1965 1964 1965 1965 1965 1965 1964 1965 1965 1964 1965 1965
UNITED STATES... 26 27 31 18 1 1 5 1 1 3 1 13

NEW ENGLAND........... 1 1 2 -
Maine.............. -
New Hampshire...... -
Vermont............ -
Massachusetts...... 1 -
Rhode Island....... 2 -
Connecticut........ -

MIDDLE ATLANTIC...... 1 1 15 7 -
New York City...... 2 -
New York, Up-State. 1 2 5 -
New Jersey.......... 7 -
Pennsylvania....... 1 4 2 -

EAST NORTH CENTRAL... 5 5 4 1 1
Ohio............... 1 3 -
Indiana............. I
Illinois............ 3 1 -
Michigan........... 1 5 1
Wisconsin.......... -- -

WEST NORTH CENTRAL... 3 2 3
Minnesota.......... 3 -
Iowa............... -- -
Missouri........... 1
North Dakota....... -
South Dakota....... 1 -
Nebraska............ i
Kansas............. 1 -

SOUTH ATLANTIC....... 4 5 1 3 2 1 4
Delaware........... -
Maryland............ 1 -
Dist. of Columbia.. -- -
Virginia........... 2 3 1 -
West Virginia...... -- -
North Carolina..... 1 1 -
South Carolina..... -- -
Georgia............. 1 I
Florida............. 2 2 2 2

EAST SOUTH CENTRAL... 1 1 1
Kentucky............ 2 1 -- -
Tennessee.......... 1 -
Alabama.............. -- -
Mississippi........ -

WEST SOUTH CENTRAL... 2 1 1 1 1 1 3
Arkansas............ 1 1 1 -
Louisiana.......... -
Oklahoma........... -
Texas............... 1 1 3

MOUNTAIN............. 2 3 -
Montana............ -
Idaho............... -
Wyoming..............-
Colorado........... 2 3 -
New Mexico ......... -
Arizona............ -
Utah................ --
Nevada............. -

PACIFIC.............. 13 9 4 7 1 1 -
Washington ......... 1 3 -
Oregon............... -
California......... 10 4 4 7 1 1 -
Alaska.............. -
Hawaii.............. 1 2

Puerto Rico -










11M rlidilI and Mortality Weekly Report 37


Tahbl 3. CASES OF %PI (f1I1) N(II VIABLE DISEASES: UNITED STATES

IOR U I I ks INI)II)

JANI'ARY 30, 1965 AND JANI'ARY 25, 1964 ( 4TH WEEK) (ON'INUED


Brucel- Infectious Hepatitis MIningacottal
loss including Serum Hepatitis Infc tions Tt tnu
Area Total Under 20 years Cumulative
incl. unk. 20 years and over Totals Cumulative Cum.
1965 1965 1965 1965 1965 1964 1965 1965 1964 1965 1965

UNITED STATES... 4 85: 454 353 3,104 3,482 60 258 205 1 12

NEW ENGLAND.......... 51 20 25 188 471 7 15 6 1
Maine............... 15 10 5 44 194 3 4
New Hampshire...... 4 3 15 5 -- 1
Vermont............ 8 4 1 20 51
Massachusetts...... 10 2 6 5 : 2 7 1
Rhode Island....... 6 2 4 18 18 1 -
Connecticut........ 8 2 6 34 70 2 3 5

MIDDLE ATLANTIC...... 188 8 01 630 793 9 36 30 1
New York City...... 32 10 22 105 113 2 9 6 -
New York, Up-State. 83 44 39 294 389 2 8 12 1
New Jersey......... 25 5 20 82 114 4 12 4
Pnn.l...ana ....... 48 28 20 149 17/ 1 7 8 -

EAST NORTH CENTRAL... 1 176 115 56 558 464 11 33 26
Ohio................ 68 44 22 190 136 3 13 10
Indiana............ 21 15 5 29 27 3 5 3
Illinois........... 17 12 4 91 51 2 8 5
Michigan........... 62 39 23 210 228 3 4 7 -
Wisconsin.......... 1 8 5 2 38 22 3 1

WEST NORTH CENTRAL... 1 72 47 21 233 203 1 14 7 2
Minnesota.......... 4 1 2 18 9 1 3 2 1
Iowa................ 1 30 19 9 116 29 -
Missouri........... 14 12 2 40 48 6 3 1
North Dakota....... 1 1 2 13 3 1
South Dakota....... 2 2 4 13
Nebraska............ 2 1 5 7
Kansas............. 19 14 5 48 84 2 1

SOUTH ATLANTIC....... 90 46 &1 324 320 16 61 51 5
Delaware........... 1 1 5 2 2 -
Maryland........... 13 6 7 58 56 : 3 5
Dist. of Columbia.. 1 1 3 8 1 1
Virginia........... 15 7 6 59 37 3 9 5 1
West Virginia...... 26 20 6 74 52 3 6 4
North Carolina..... 17 7 10 40 64 4 9 8
South Carolina .... 2 2 11 8 2 5 7
Georgia............. 1 1 20 6 1 12 6 3
Florida............ 14 5 8 54 87 1 14 16 1

EAST SOUTH CENTRAL... 1 41 27 13 172 255 1 15 14 1 1
Kentucky............ 1 17 11 5 61 126 7 4
Tennessee.......... 17 11 6 65 79 4 7 1 1
Alabama............ 1 1 28 35 1 4 2
Mississippi........ 6 5 1 18 15 I

WEST SOUTH CENTRAL... 1 83 50 29 322 198 5 29 30 1
Arkansas........... 11 6 5 36 24 2 3
Louisiana.......... 11 6 5 -7 22 6 10
Oklahoma........... 1 12 10 2 21 15 1 6 2
Texas............... 49 28 17 218 137 4 15 15 1

MOUNTAIN ............. 32 7 4 166 241 2 8 14
Montana............ 5 4 1 15 19 -
Idaho.............. 8 36 16 -
Wyoming............ 1 1 14 3 1 -
Colorado............ 9 51 1 6 -
New Mexico.......... 3 2 1 31 59 5 5
Arizona............ 10 41 49 2 2
Utah............... 4 1 19 38 1
Nevada............. 1 1 1 6

PACIFIC.............. 118 55 63 511 537 8 47 27 1
Washington.......... 15 7 8 48 75 2
Oregon............. 6 4 2 53 51 1 2
California.......... 92 43 49 369 380 7 44 23 1
Alaska.............. 36 21 1
Hawaii.............. 5 1 4 5 10 2

Puerto Rico 16 13 3 27 15 1










38 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 30, 1965 AND JANUARY 25, 1964 (4TH WEEK) CONTINUED


Strept.
Measles Sore Th. & Tularemia Typhoid Fever Rabies in .
Scarlet Fev. Animals
Area
Cumulative Cum. Cum. Cum.
1965 1965 1964 1965 1965 1965 1965 1965 1965 1965
UNITED STATES... 7,639 26,393 21,879 11,335 5 29 14 26 95 368

NEW ENGLAND.......... 1,778 7,109 1,157 1,044 1 6
Maine .............. 206 904 114 107 -
New Hampshire...... 20 135 8 -
Vermont............ 8 28 311 25 1 5
Massachusetts...... 1,152 4,109 254 169 -
Rhode Island....... 260 831 68 51 -
Connecticut........ 132 1,102 402 691 I

MIDDLE ATLANTIC...... 299 959 4,309 447 2 3 13
New York City...... 21 120 1,629 27 1
New York, Up-State. 135 342 1,013 299 1 3 11
New Jersey......... 53 166 716 65 -
Pennsylvania....... 90 331 951 56 2

EAST NORTH CENTRAL... 1,530 4,547 4,285 1,452 1 1 4 17
Ohio................ 343 1,001 658 256 -
Indiana............. 67 209 852 189 4
Illinois........... 55 147 1,489 269 2 2
Michigan........... 778 2,304 913 483 4
Wisconsin.......... 287 886 373 255 1 1 2 7

WEST NORTH CENTRAL... 689 1,927 522 459 2 1 1 15 70
Minnesota.......... 18 33 7 7 6 19
Iowa................ 506 1,079 134 103 7 24
Missouri........... 46 175 66 5 1 1 1 1 11
North Dakota....... 115 542 308 72 6
South Dakota....... 4 20 3 63 3
Nebraska........... 78 4 4
Kansas............. NN NN NN 209 1 1 3

SOUTH ATLANTIC....... 993 3,879 2,525 1,509 2 11 4 9 15 54
Delaware........... 66 27 9 1 1 -
Maryland........... 26 55 404 305 3 1 2
Dist. of Columbia.. 3 3 46 8 -
Virginia........... 100 585 538 296 3 9 42
West Virginia...... 716 2,818 833 569 1 1 I
North Carolina..... 14 70 62 17 2 2 2 4 -
South Carolina..... 17 38 401 96 2 -
Georgia............. 66 94 64 23 4 3 4
Florida............. 51 150 150 186 2 5

EAST SOUTH CENTRAL... 372 1,371 3,069 1,458 2 7 1 2 39 137
Kentucky............ 25 84 1,703 149 1 1 6
Tennessee.......... 277 936 1,219 1,189 2 5 1 1 38 126
Alabama............ 54 223 96 47 I 1 5
Mississippi........ 16 128 51 73 -

WEST SOUTH CENTRAL... 617 2,124 1,323 966 6 6 8 11 49
Arkansas........... 19 25 65 4 3 2 3 2 7
Louisiana.......... 4 5 1 17 1 1 6 17
Oklahoma............ 4 21 16 72 3 1 8
Texas............. 590 2,073 1,241 873 3 3 3 17

MOUNTAIN............. 584 2,306 943 1,938 1 3 1 2 2 7
Montana............. 255 825 268 90 1 1
Idaho............... 65 360 140 161 -
Wyoming.............. 56 12 23 1
Colorado............ 57 302 91 878 -
New Mexico......... 2 53 53 296 1 1 -
Arizona............ 14 57 255 223 1 6
Utah................ 191 650 88 267 1 3 -
Nevada............. 3 36 -

PACIFIC.............. 777 2,171 3,746 2,062 1 5 15
Washington.......... 298 623 1,455 539 -
Oregon.............. 108 473 447 36 -
California.......... 282 808 1,417 1,413 5 15
Alaska.............. 25 400 18 -
Hawaii.............. 89 242 27 56 1 -

Puerto Rico 21 105 272 6 -











Morbidity and mortality Weekly Report


Table 4. 1)FATHS IN 122 UINITFD STATES ( ITIN FO)R WEEK INI) N ) JANUARY 30, 1965


ti\ place of occurrence and week of filing certificate. Excludes fetal deaths)


Area


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----------
Chicag,, Ill.---------
Cincinnati, Ohio------
Cleveland, Ohio-------
Columbus, Ohio--------
Dayton, Ohio----------
Detroit, Mich.--------
Evansville, Ind.------
Flint, Mich.----------
Fort Wayne, Ind.------
Gary, Ind.------------
Grand Rapids, Mich.---
Indianapolis, Ind.----
Madison, Wis.---------
Milwaukee, Wis.-------
Peoria, Ill.----------
Rockford, Ill.---------
South Bend, Ind.-------
Toledo, Ohio----------
Youngstown, Ohio------

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


I t- ft I---


Al I ( ui ,


All
Ages


65 years
and over


Pni urr, -ni a
and
Influenza
All Ages


1'nl r
1 year
All
Causes


I .. r


All
Ages


65 years
and over


41 I I I I $ --


95'
350
52
44
32
71
30
22
27
56
85
13
49
59
65

3,710
42
43
173
44
43
49
91
123
1,940
41
480
227
56
102
24
35
60
53
42
42

2,889
62
43
8:.
160
210
138
73
431
39
53
49
37
47
180
31
176
40
35
45
112
73

86
54
26
39
138
27
113
85
259
68
55


6&'2
215
39
29
21
35
17
17
21
31
48
7
35
46
41

2,199
22
31
109
24
28
38
50
75
1,135
26
250
129
34
68
15
21
45
29
32
29

1,609
42
27
456
91
121
77
46
224
29
24
23
11
30
98
19
110
21
26
27
60
47

523
37
16
23
84
21
72
46
144
48
32


*Estimate based on average percent of divisional total.


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

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

WEST SOUTH CENTRAL:
Austin, Tex.-----------
Baton Rcu o, La.-------
Corpus Christi, Tex.---
Dallas, Tex.-----------
El Paso, Tex.----------
Fort Worth, Tex.-------
Houston, Tex.----------
Little Rock, Ark.------
New Orleans, La.-------
Oklahoma City, Okla.---
San Antonio, Tex.------
Shreveport, La.--------
Tulsa, Okla.-----------

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

PACIFIC:
Berkeley, Calif.-------
Fresno, Calif.---------
Glendale, Calif.--------
Honolulu, Hawaii-------
Long Beach, Calif.-----
Los Angeles, Calif.----
Oakland, Calif.--------
Pasadena, Calif.-------
Portland, Oreg.--------
Sacramento, Calif.-----
San Diego, Calif -----
San Francisco, Calif.--
San Jose, Calif.-------
Seattle, Wash.---------
Spokane, Wash.---------
Tacoma, Wash.----------


1,223
127
272
44
77
83
59
95
35
81
91
208
51

634
118
47
34
130
126
56
40
83

1,169
51
39
37
'49
50
74
200
64
194
79
119
54
59

460
41
21
124
21
126
20
48
59

1,591
17
49
45
51
84
499
85
37
119
72
95
219
32
110
38
39


and
Influenza
All Ages


1 year
All
Causes


Total 13,495 7,739 651 755

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages -------------------------55,356
All Causes, Age 65 and over------------------- 31,515
Pneumonia and Influenza, All Ages------------- 2,595
All Causes, Under 1 Year of Age--------------- 3,272


Week No.
4




UNIVERSITY OF FLORIDA

II 1 26lli I 8ll lll llllll6lllI l11111
3 1262 08864 2656


Morbidity and Mortality Weekly Report


(Continued from page 34)

EPIDEMIOLOGIC REPORTS
INFLUENZA International


Outbreaks of influenza in Russia and East Germany
have recently been observed. The following information is
from a summary prepared in late January by the World
Health Organization:
The epidemic of influenza in Leningrad began about
January 1, 1965, peaked on January 18th, and declined
thereafter. Several thousand people were reportedly
involved, not as many as in the influenza epidemic occur-
ing there three years ago. The illness is described as
being generally mild, affecting predominately children.
During recent days the epidemic has been reported in
cities in the north and east of Russia and from Tallinn,
Riga, and Moscow. A2 viruses have been isolated in
Leningrad and Moscow. Tests to determine the antigenic
characteristics of these viruses have not been completed.
Four A2 viruses have been isolated from scattered
outbreaks in the Baltic Sea area of East Germany.
There are no outbreaks of influenza reported presently
from other countries in Europe.


(Reported by W. Charles Cockburn, M.D., Chief, Medical
Officer, Virus Unit, World Health Organization, Geneva).


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA-
TION OF 13,000 IS PUBLISHED BY THE COMMUNICABLE DISEASE
CENTER, ATLANTA, GEORGIA 30333.
CHIEF. COMMUNICABLE DISEASE CENTER JAMES L. GODDARD. M.D.
CHIEF, EPIDEMIOLOGY BRANCH A. D. LANGMUIR, M.D.
CHIEF, STATISTICS SECTION R. E. SERFLING, PH.D.
ASST. CHIEF, STATISTICS SECTION IDA L. SHERMAN, MS
CHIEF. SURVEILLANCE SECTION D. A. HENDERSON, M.D.
ASSISTANT EDITOR, MMWR PAUL D. STOLLEY. M.D.
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:
THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
COMMUNICABLE DISEASE CENTER
ATLANTA, GEORGIA 30333
NOTE: THESE PROVISIONAL DATA ARE BASED ON WEEKLY TELE-
GRAMS TO THE CDC BY THE INDIVIDUAL STATE HEALTH DEPART-
MENTS. THE REPORTING WEEK CONCLUDES ON SATURDAY: COMPILED
DATA ON A NATIONAL BASIS ARE RELEASED ON THE SUCCEEDING
FRIDAY.
SYMBOLS:-:-DATA NOT AVAILABLE
QUANTITY ZERO
THE CONSTRUCTION OF THE MORTALITY CURVES IS DESCRIBED IN
VOL. 14, NO. 1, JANUARY 15. 1965.


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