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COMMUNICABLE DISEASE CENTER Vol 14, No. 52 WFFKIY U.S. DEPARTMENT OF 0- Week Ending = January 1, 1966 N, AND WELFARE PUBLIC HEALTH SERVICE HUMAN RABIES California On December 8, 1965, a 35-month-old Mexican girl died at the Children's Hospital, San Diego, California, with symptoms indicative of rabies. This diagnosis was confirmed on December 10 by the California State Depart- ment of Public Health Viral and Rickettsial Laboratory. The onset of the illness was after an apparent incubation period of only 10 days. The child came from Ensenada, Baja California, Mexico, where she had been bitten above the right ear by a presumed rabid dog on November 18. This dog subse- quently bit other dogs and all the animals involved were destroyed; none of these dogs was examined for rabies. However, because of the history the child was started on Human Rabies California . Current Trends Poliomyelitis 1965 . . International Notes Quarantine Measures . . Index Volume 14 1965 ........ . . 440 . . 441 . . 445 .. .. ... .. .. 446 a course of treatment, using an unspecified rabies vac- cine, on November 19, the day after she was bitten. No rabies vaccine was given on November 20 and 21. How- ever, the course of treatment was resumed on November 22 and the rabies vaccine was administered daily thereafter through November 30, when the tenth and last dose was (Continued on page 44) CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES (Cumulative totals include revised and delayed reports through previous weeks) 52nd WEEK ENDED CUMULATIVE, FIRST 52 WEEKS MEDIAN DISEASE JANUARY 1, DECEMBER 26, 1960- 1964 MEDIAN 1966 1964 1960- 1964 Aseptic meningitis .... 49 20 24 2.126 2,135 2,537 Brucellosis ............... 9 4 15 258 400 412 Diphtheria ................ 3 5 14 160 293 463 Encephalitis, primary infectious 25 36 --- 1,877 3,206 --- Encephalitis, post-infectious 12 10 --- 653 781 --- Hepatitis, infectious including serum hepatitis ........... 699 515 842 33,658 37,673 42,891 Measles .............. ... 4,150 2,800 4,278 266,222 487,819 429,840 Meningococcal infections .... 73 51 51 3,039 2,813 2,197 Poliomyelitis, Total ......... 1 21 59 116 902 Paralytic ............... 1 16 43 91 717 Nonparalytic ..... --- 10 14 --- Unspecified ...........* --- 6 11 - Streptococcal Sore Throat and Scarlet fever ......... ** 7,203 6,037 6,092 388,993 393,846 317,079 Tetanus ***.........**** 2 1 --- 276 267 --- Tularemia ................ 8 11 --- 246 332 --- Typhoid fever... .* '...* 18 13 13 459 460 632 Rabies in Animals .......... 81 57 61 4,236 4,515 3,556 NOTIFIABLE DISEASES OF LOW FREQUENCY Cum. Cum. Anthrax: .... ................................ 7 Rabies in Man: Calif.- ........................ 2 Botulism: ................. ............... 18 Smallpox: .... ............... .............. Leptospirosis:La.-1, Tenn.- ................... 66 Trichinosis: Pa. -1 ......................... 108 Malana:Md.- I. NC.- 1, Pa. -4, Ark.-1, Colo.-1, N.Y.C.-1 93 Typhus- Plague: ................................. 6 Murine: ............................... 26 Psittacosis: Ark. -1, Wisc. -1 ................... 52 Rky. Mt. Spotted: ........................ 261 Cholera: .. .......................... .... .. 2 _ I ~ CO.\rt Trs Morbidity and Mortality Weekly Report JANUARY 1. 1966 HUMAN RABIES California (Continued from front page) given. There is no history of hyperimmune serum being given after the child had been bitten. On November 28 the child began to show evidence of cerebral irritation; on November 29 and 30 her temperature began to rise and she became stuporous. On December 6 she was admitted to San Diego Children's Hospital at the request of officials of the Tijuana Health Department. On admission she was totally unresponsive with a rising temperature, which was 1040 F on December 7 shortly before death. A white cell count on admission was 10,500 with 75 percent neutrophils and 20 percent lymphocytes; the hemocrit was 37. Cerebrospinal fluid pressure was slightly increased; the fluid was clear with a cell count of 24 polymorphs and one lymphocyte. Culture of the fluid for organisms gave negative results. After the death of the child on December 8 an au- topsy was performed and specimens of the brain, using the fluorescent antibody technique, were positive for rabies. Infant mice were inoculated with the brain tissue and on the 5th day one mouse began to show suspicious symptoms. It was sacrificed and was positive for rabies by the fluorescent antibody technique. Thereafter it was not until the 17th day that other mice began to show symptoms of rabies. One mouse was sacrificed on that day and another on the 19th day. Both of these mice were also fluorescent antibody positive for rabies. Laboratory studies of other tissues obtained at the autopsy are proceeding. (Reported by Dr. J. B. Askew, Health Officer, San Diego California; Dr. Philip K. Condit, Chief, Bureau of Com- municable Disease; and Dr. George L. Humphrey, Public Health Veterinarian, State of California Department of Public Health.) CURRENT TRENDS POLIOMYELITIS 1965 Weekly poliomyelitis case reports are received at the Communicable Disease Center from State and local health departments through the National Morbidity Reporting System. Poliomyelitis Surveillance forms are later com- pleted on individual patients and forwarded to CDC; when all of these forms have been received they provide the data for the annual Poliomyelitis Surveillance Report. The following summary has been compiled from the weekly telegraphic reports to CDC and from such Poliomyelitis Surveillance data as are presently available. Through the 52nd week of 1965, a provisional total of 59 cases of poliomyelitis has been reported in the United States; of these, 43 are classified as paralytic cases. This provisional total of paralytic cases is less than one-half of that reported during 1964, the previous record low year. The dramatic decline in the annual incidence of poliomyelitis is illustrated in Figure 1. The peak of re- corded incidence was in 1952 when an estimated total of 21,000 cases of paralytic disease was reported, a rate of 37.2 per 100,000 population. The comparative rate for 1965 is 0.025 per 100,000. The occurrence of paralytic poliomyelitis by 4-week periods during the last 5 years is shown in Figure 2. The seasonal pattern of increased incidence during the early summer is evident in 1961 through 1963; in 1964 this was not a feature. However, during 1965 this early summer incidence is again discernible in very slight degree. Preliminary information about 34 of the 43 paralytic cases reported in 1965 is available from the Poliomyelitis Surveillance forms submitted by the State Health Depart- ments. The geographic distribution of the 34 cases through - out the U.S. is shown in Figure 3 (page 444); 32 percent of them were reported from nine counties in Texas. The only counties to report two cases of paralytic polio in any one month were Scottsbluff County, Nebraska, Cameron County, Texas, and Yuma County, Arizona. The CommOnicable Disease Center epidemic reserve oral polio vaccine type I was used in mass vaccination campaigns in children in Pinal and Yuma Counties, Arizona, in February and May 1965 respectively. Two deaths from bulbar poliomyelitis occurred. One was of a child aged 1% years from Wise County, Texas, and the other of a child of 11 years from Scottsbluff County, Nebraska; neither had received any polio vaccine. The paralytic status of the other 32 cases, as assessed after 60 days, was that 8 cases are so severely disabled as to be confined to bed or wheel chair; a further 12 cases have significant disability and 6 cases have only minor residual motor involvement. Data regarding the 60- day status of the remaining six cases are not yet available. There are two major points of interest and importance illustrated in Table 1 which shows the age and vaccina- tion status of the 34 paralytic cases. The first is that 56 (Continued on page J,4) 442 JANUARY 1, 1966 Morbidity and Mortality Weekly Report Figure 1 ANNUAL POLIOMYELITIS INCIDENCE RATES United States, 1935-1965 INACTIVATED VACCINE TOTAL ORAL VACCINE PARALYTIC CASES PRIOR TO 1951 ASSUMED TO BE 50% OF TOTAL. SINCE 1951, CASES REPORTED AS UNSPECIFIED WERE PRORATED AMONG PARALYTIC AND NONPARALYTIC CASES. SOURCE: Notional Morbidity Reports Figure 2 PARALYTIC POLIOMYELITIS CASES By Date of Onset, 1961-1964 By Date of Report, 1965 SOURCE, Polianylitis Surveillonce Unit 443 160- o 140- a: ILU 0. 120 w LJ LU *100 0 80 w 6,) 1961 1962 1963 1964 1965 444 Morbidity and Moi percent of them are 4 years of age or younger; the second is that 59 percent had received no polio vaccine what- soever. Of the 34 paralytic cases, stool specimens were available for laboratory examination from 29 patients and poliovirus was present in specimens from 24 of them (Table 2, page 445). In one case from New York both type I and type III poliovirus were isolated from the same specimen; in another case from Michigan, type II poliovirus and coxsackie virus type A4 were also isolated from one specimen. Isolations of poliovirus during 1965 are compared with those in previous years in Table 2. The relative in- crease in the frequency of recovery of type II poliovirus is believed to be associated with a wider distribution of oral poliovaccine. According to the Poliomyelitis Surveillance Reports received thus far at CDC, there were no paralytic cases reported during 1965 in persons who had received oral polio vaccine less than 30 days before the onset of paral- ysis. In four individuals, however, paralytic poliomyelitis reality I Veekly Report JANUARY 1, 1966 Table 1 PARALYTIC POLIOMYELITIS, UNITED STATES 1965 By Age Group and Vaccination Status Doses Inactivated Doses Oral Vaccine Total Vaccine Age Group Cases Cases 0 1 2 3 4 0 1 2 3 Trivalent 0-4 19 13 1 0 4 1 16 1 0 0 2 5-9 3 2 0 0 0 1 2 0 0 1 0 10-14 5 0 2 0 3 0 5 0 0 0 0 15-19 2 1 0 0 0 1 2 0 0 0 0 20-29 3 2 0 0 0 1 3 0 0 0 0 30-39 0 0 0 0 0 0 0 0 0 0 0 40+ 2 2 0 0 0 0 2 0 0 0 0 Total 34' 20 3 0 7 4 30 1 0 1 2 *Cases reported to the Poliomyelitis Surveillance Unit, CDC, through December 30, 1965. occurred within 30 days of known contact with persons recently vaccinated with trivalent oral polio vaccine. (Reported by the Polio Surveillance Unit, CDC.) Figure 3. PARALYTIC POLIOMYELITIS, 1965 GEOGRAPHIC DISTRIBUTION OF CASES REPORTED TO POLIO SURVEILLANCE UNIT THROUGH DECEMBER 30, 1965 JANtI RY 1, 1966 Morbidity and Mortality Weekly Report Table 2 POLIO( IRI' ISOLATIONS from PARALYTIC CASES United States, 1958-1965 Percent of Numbers of Cases Viruses Identified Total Specified P e Total Specified Percent Year of Cases Residual Specimens Studied Type Type Paralysis Submitted* I II III Unk. I II III 1958 3301 1479 44.8 898 29 194 10 80.1 2.6 17.3 1959 5472 2775 50.7 1881 10 228 23 88.8 0.5 10.8 1960 2218 1072 48.3 603 1 219 2 73.3 0.1 26.6 1961 829 481 58.0 231 6 145 0 60.5 1.6 37.9 1962 691 472 68.3 300 8 100 0 73.5 2.0 24.5 1963 336 242 72.0 160 6 31 0 81.2 3.0 15.7 1964 91 77 84.6 21 6 24 0 41.2 11.8 47.0 1965 34 29 85.2 15 6 4 0 60.0 24.0 16.0 *Includes all paralytic cases on which one or more fecal specimens were examined for virus isolation. State meant laboratories and laboratories in academic centers reported these results through veillance Unit. and local health depart- State epidemiologists to the Poliomyelitis Sur- INTERNATIONAL NOTES QUARANTINE MEASURES Immunization Information for International Travel 1965-66 edition-Public Health Service Publication No. 384 SECTION 5 AFRICA Algeria, Page 21 Under yellow fever delete vaccination required from arrivals from endemic zones. All other information remains the same. Sudan, Page 32 Delete previous information under yellow fever and insert: "Travelers who have been in that part of Sudan south of 15 N Latitude and are proceeding to a receptive area (see P. 90) are required to possess a vaccination certificate. Travelers who have not been south of that parallel and leave Sudan for the United Arab Republic are advised that, on arrival in the UAR, they will be required to possess a location certificate." ASIA India, Page 47 Under yellow fever, delete the first paragraph starting with, "Any person (including infants) arriving by air or sea ." Delete the first paragraph on page 48 starting with, "A certificate is not regarded as valid until 12 days after vaccination in an infected area ." and insert: "Any person (including infants), arriving by air or sea without a certificate, is detained in isolation for a period up to 9 days if he arrives within 9 days of departure from an infected area or has been in an infected area and has not been disinfected in accordance with the procedure and formulation laid down in Schedule IV of the Indian Aircraft (Public Health) Rules, 1954, or those recommended by WHO." (Continued on page 456) 445 Morbidity and Mortality Weekly Report JANUARY 1. 1966 INDEX VOLUME 14 1965 ANTHRAX Epidemic Reports Massachusetts, 160 New Jersey, 238, 304 North Dakota, 270 Pennsylvania, 104 South Carolina, 265, 270 Virginia, 99 BOTULISM Epidemic Reports Alabama, 115 California, 345, 427 Idaho, 225, 339 Washington, 170 CHICKENPOX Epidemic Reports Washington, D.C., 277 CHOLERA Epidemic Reports Washington, D.C., 193, 237 CLOSTRIDIUM PERFRINGENS Epidemic Reports Arkansas, 385 Georgia, 187 COCCIDIOIDOMYCOSIS Epidemic Reports California, 302 DIPHTHERIA Epidemic Reports Nebraska, 386 Summary Current, 209 ENCEPHALITIS, POST-INFECTIOUS Summary Annual, 246 Current (Tables) 7, 114, 147, 163, 219, 311, 371 ENCEPHALITIS, PRIMARY ARTHROPOD-BORNE Epidemic Reports Colorado, 293, 258, 245 Delaware, 387 New Jersey, 387 North Carolina, 264 Texas, 251 Summary Current, 247, 334, 360 GASTROENTERITIS Epidemic Reports California, 178, 318 Indiana, 401 Ohio, 411 New York, 353 Washington, D.C., 211 Washington, 369 GENERAL Recommendations of the PHS Advisory Committee on Immunization Practices, 64 (Measles, Rubella, Smallpox, Yellow Fever) Reported Deaths in 122 U.S. Cities, 10, 47, 179 Statistical Methods,,8 HEPATITIS Epidemic Reports Colorado, 258 New Jersey, 294 Summary Annual, 259 Current, 75, 153 INFLUENZA Epidemic Reports State: 26, 34, 42, 54, 61, 82 Intern'l: 26, 40, 42, 45, 62, 72, 82, 88, 90 Summary Current, 1, 25, 34, 41, 53, 61, 73, 81, 89, 97, 115, 370 Recommendations for Influenza Immunization and Control in the Civilian Population-1965-66, 203 MALARIA Epidemic Reports Georgia, 287 Nevada, 433 Pennsylvania, 19, 74 Summary Annual, 286 Current, 434 MEASLES Epidemic Reports California, 352 Kentucky, 377, 409 New Jersey, 368, 410 Rhode Island, 432 Summary Current, 202, 346, 379, 417 Recommendations of the PHS Advisory Committee on Measles Immunization Practice, 310 MENINGITIS, ASEPTIC Epidemic Reports Tennessee, 327 MENINGOCOCCAL INFECTIONS Summary Current, 80, 121, 145, 187, 218, 418 MUMPS Epidemic Reports Alaska, 278 MYIASIS Epidemic Reports Puerto Rico, 402 446 JANUARY 1. 1966 Morbidity and Mortality Weekly Report INDEX VOLUME 14 1965 (Continued) PLAGUE Epidemic Reports California, .12-':. 392 New Mexico, ~57. '.h:., 301 Intern'l, 104. 128 PNEUMONIA Epidemic Reports Ha-hingpon. D.C., 265 POISONING Metallic Antimony Virginia. 27 POLIOMYELITIS Epidemic Reports Arizona, 10o. 216 Florida, 74 (primates) Nebraska, 171, 195 Texas, 224 Intern'l, 128, 324 Summary Annual, 226 Current, 98, 113, 201, 217, 442 RABIES Epidemic Reports California, 441 Iowa, 270 Military personnel, overseas, 106 Tennessee, 162 West Virginia. 195 Summary Annual, 266 Current, 17, 55, 161 RUBELLA Epidemic Reports New York, 44 Summary Annual, 137 Current, 354 SALMONELLOSIS Epidemic Reports California, 19, 178, 185, 194 Colorado, 162 Florida, 287 Michigan, 171 New Jersey, 435 Rhode Island, 251 Washington, D.C., 211, 238 Washington, 333 Summary Annual, 279, 393 Current, 7, 107, 146, 210, 279, 327, 379 SHIGELLOSIS Epidemic Reports Georgia, 24 Kansas, 361 North Carolina, 18 Summary Current, 363, 426 SMALLPOX Epidemic Reports Wa-hington, D.C., 169, 177, 194 Change of Diagnosis of Smallpox to Chickenpox, 277 Kulmbach, Germany, 419 Sudan, Africa, 136 STAPHYLOCOCCAL INFECTIONS Epidemic Reports Ohio, 411 Virginia, 211 SYPHILIS Current (Tables), 8, 46, 99, 147, 155, 219, 239, 271, 311, 403, 435 TETANUS Summary Annual, 129 TICK PARALYSIS Epidemic Reports Oregon, 319 TRICHINOSIS Epidemic Reports Iowa, 200 Minnesota, 96 TUBERCULOSIS Epidemic Reports Wisconsin, 400 Summary Current, 395 TYPHOID FEVER Epidemic Reports New York City, 112 Rhode Island, 251 YELLOW FEVER Epidemic Reports Senegal, West Africa, 411 VESICULAR STOMATITIS VIRUS Epidemic Reports Colorado, 309 New Mexico, 309 VIBRIO FETUS Epidemic Reports Oregon, 425 (human) 447 448 Morbidity and Mortality Weekly Report CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED JANUARY 1, 1966 AND DECEMBER 26. 1964 (52nd WEEK) Aseptic Encephalitis 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... 49 20 25 12 59 116 43 91 3 160 NEW ENGLAND............ 2 2 2 2 Maine............. 1 1 - New Hampshire...... - Vermont............ - Massachusetts...... 2 2 Rhode Island....... - Connecticut........ 1 1 MIDDLE ATLANTIC...... 11 1 13 1 5 15 4 13 6 New York City...... 9 8 1 2 2 3 New York, Up-State. 1 1 1 1 10 1 9 1 New Jersey......... 1 4 3 3 3 2 - Pennsylvania....... 1 2 EAST NORTH CENTRAL... 6 2 3 2 24 2 17 7 Ohio............... 3 2 2 Indiana............ 5 9 6 2 Illinois........... 1 3 1 6 1 5 2 Michigan........... 1 1 1 3 1 2 - Wisconsin .......... 3 2 1 WEST NORTH CENTRAL.. 3 2 12 10 8 8 21 Minnesota.......... 1 3 1 2 7 Iowa............... 3 5 1 2 1 1 Missouri........... 2 1 4 3 I North Dakota....... - South Dakota....... 9 Nebraska........... 4 4 2 Kansas............. 1 1 1 1 SOUTH ATLANTIC....... 4 2 2 2 1 32 1 25 40 Delaware........... - Maryland........... 1 1 1 1- - Dist. of Columbia.. 3 Virginia........... 1 2 4 4 - West Virginia...... 1 1 - North Carolina..... 3 1 12 7 4 South Carolina..... 1 2 Georgia............ 3 3 3 22 Florida............ 1 1 1 10 8 9 EAST SOUTH CENTRAL.. 1 3 4 6 2 5 32 Kentucky............ - Tennessee........... 1 2 3 1 2 2 Alabama............. 2 2 2 28 Mississippi........ 1 1 1 1 2 WEST SOUTH CENTRAL .. 2 1 21 13 18 12 1 40 Arkansas............ 1 1 1 1 2 Louisiana.......... 1 2 1 1 1 1 12 Oklahoma ........... 2 3 2 2 1 Texas.............. 2 16 8 14 8 25 MOUNTAIN............. 4 3 5 11 3 6 1 2 Montana ............ 1 1 Idaho.............. 1 1 - Wyoming............ 2 2 - Colorado........... I 3 2 2 - New Mexico ......... 1 5 1 - Arizona............ 4 1 2 - Utah............... - Nevada............ . PACIFIC.............. 16 12 4 6 9 3 5 3 1 10 Washington......... 4 1 1 3 3 1 4 Oregon ............ 1 1 1 1 1 California.......... 12 11 3 5 5 2 1 2 5 Alaska............. . Hawaii............. 1 - Puerto Rico 16 Morbidity and Mortality Weekly Report 449 CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDFD JANUARY 1, 1966 AND DE(EMBFR 26, 1964 (52nd WEEK) Continued Brucel- Infectious Hepatitis Meningococcal loss including Serum Hepatitis Infections Tetanus 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... 9 699 293 302 33,658 37,673 73 3,039 2,813 2 276 NEW ENGLAND.......... 30 13 15 1,874 3,363 7 161 98 7 Maine.............. 8 4 3 336 1,018 18 9 - New Hampshire...... 3 2 172 268 1 10 2 2 Vermont............ 1 1 92 386 1 9 4 - Massachusetts...... 15 7 8 746 779 3 62 41 4 Rhode Island....... 1 1 207 237 18 12 - Connecticut........ 2 1 1 321 675 2 44 30 1 MIDDLE ATLANTIC ..... 210 78 132 6,104 8,176 17 411 356 22 New York City...... 127 33 94 1,351 1,293 8 73 48 4 New York, Up-State. 36 24 12 2,240 3,548 1 118 110 7 New Jersey......... 21 11 10 1,084 1,333 4 107 110 2 Pennsylvania....... 26 10 16 1,429 2,002 4 113 88 9 EAST NORTH CENTRAL... 125 72 43 6,567 6,100 9 457 376 1 37 Ohio............... 27 11 13 1,775 1,606 3 126 99 3 Indiana............. 12 7 4 549 495 2 52 59 1 10 Illinois........... 10 4 5 1,205 1,156 2 121 100 17 Michigan............ 65 44 21 2,612 2,435 2 109 82 3 Wisconsin ........... 11 6 426 408 49 36 4 WEST NORTH CENTRAL... 5 21 7 6 1,849 2,134 1 146 160 1 26 Minnesota.......... 1 3 1 2 227 233 33 35 1 11 Iowa............... 4 4 2 1 593 456 1 14 9 4 Missouri........... 4 409 506 58 75 6 North Dakota....... 1 35 64 13 20 1 South Dakota....... 2 24 135 4 3 - Nebraska........... 1 1 100 85 11 7 2 Kansas............... 6 3 3 461 655 13 11 2 SOUTH ATLANTIC....... 3 54 28 14 3,424 3,467 9 567 534 63 Delaware............ 93 78 11 7 - Maryland........... 15 10 5 625 643 1 56 44 3 Dist. of Columbia.. 4 54 72 1 12 17 - Virginia........... 1 10 5 1 790 565 2 76 67 6 West Virginia...... 3 2 1 461 491 30 36 1 North Carolina..... 6 5 1 348 556 2 121 94 11 South Carolina..... 3 1 144 155 1 70 59 7 Georgia............. 1 120 114 63 88 10 Florida............ 1 13 5 6 789 793 2 128 122 25 EAST SOUTH CENTRAL... 35 22 5 2,382 2,535 1 231 215 35 Kentucky............ 17 9 2 870 880 88 72 8 Tennessee.......... 13 11 2 812 904 1 73 67 12 Alabama............. 2 409 487 43 47 13 Mississippi........ 3 2 1 291 264 27 29 2 WEST SOUTH CENTRAL... 1 48 6 11 2,767 2,924 5 377 314 59 Arkansas........... 5 5 347 295 19 35 13 Louisiana.......... 7 2 5 468 690 3 203 133 11 Oklahoma............ 1 5 4 1 60 135 22 16 1 Texas.............. 31 1,892 1,804 2 133 130 34 MOUNTAIN............. 28 13 4 1,823 2,333 5 113 109 3 Montana............ 1 157 194 3 1 - Idaho............... 4 203 356 14 5 - Wyoming............ 3 3 58 97 1 7 5 - Colorado........... 1 379 604 30 22 2 New Mexico......... 7 7 398 341 11 49 - Arizona............. 5 384 497 3 24 8 1 Utah............... 6 3 3 227 193 1 19 8 - Nevada.............. 1 17 51 5 11 - PACIFIC............... 148 54 72 6,868 6,641 19 576 651 24 Washington......... 12 3 7 527 666 2 49 48 - Oregon............. 11 608 654 1 38 28 4 California......... 115 50 65 5,399 4,879 13 460 553 19 Alaska............. 9 244 317 2 20 7 - Hawaii............. 1 1 90 125 1 9 15 1 Puerto Rico 21 17 4 1,399 1,007 11 37 59 450 Morbidity and Mortality Weekly Report CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED JANUARY 1, 1966 AND DECEMBER 26, 1964 (52nd WEEK) Continued Strept. Measlet 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... 4,150 266,222 487,819 7,203 8 246 18 459 81 4,236 NEW ENGLAND.......... 61 37,488 22,666 1,159 2 7 48 Maine.............. 15 2,949 3,828 2-15 4 New Hampshire...... 383 907 3 5 Vermont............. 19 1,457 2,432 46 32 Massachusetts...... 20 19,505 7,548 172 2 3 .- 2 Rhode Island....... 2 3,972 2,575 66 1 1 Connecticut.. ...... 5 9,222 5,376 657 3 4 MIDDLE ATLANTIC....... 1,709 20,174 53,663 410 1 2 2 70 15 273 New York City...... 1,199 4,910 15,582 58 1 31- - New York, up-State. 19 4,480 13,223 242 1 16 15 257 New Jersey......... 266 4,140 12,372 42 7 - Pennsylvania....... 225 6,644 12,486 68 1 1 1 16 16 EAST NORTH CENTRAL... 1,354 64,776 106,986 477 2 19 5 59 4 641 Ohio............... 31 9,277 20,308 72 4 16 3 342 Indiana............. 15 2,366 23,232 22 1 8 1 18 75 Illinois........... 368 4,565 16,794 91 1 8 12 1 92 Michigan........... 376 28,161 30,595 223 2 7 66 Wisconsin.......... 564 20,407 16,057 69 1 6 66 WEST NORTH CENTRAL... 63 17,578 31,709 273 30 2 19 22 847 Minnesota.......... 44 950 348 3 I 1 5 187 Iowa............... 2 9,309 23,818 54 2 5 232 Missouri........... 7 2,688 1,130 4 20 2 13 7 134 North Dakota....... 10 4,045 5,500 62 50 South Dakota....... 116 69 14 3 61 Nebraska.......... 470 844 2 3 1 37 Kansas............ NN NN NN 136 4 4 146 SOUTH ATLANTIC....... 264 27,276 40,599 730 2 37 81 13 551 Delaware............ 3 519 420 11 5 - Maryland............ 66 1,359 3,457 33 2 2 21 27 Dist. of Columbia.. 17 157 358 15 - Virginia........... 31 4,325 13,085 196 9 9 9 336 West Virginia...... 45 14,872 9,991 268 3 2 29 North Carolina..... 3 419 1,288 30 8 16 3 South Carolina..... 43 1,262 4,302 39 3 9 3 Georgia............ 655 215 2 15 12 1 73 Florida............ 56 3,708 7,483 136 6 1 80 EAST SOUTH CENTRAL... 324 16,356 69,391 1,286 2 28 2 49 10 838 Kentucky............ 109 3,805 18,854 113 4 10 4 100 Tennessee.......... 213 9,043 25,213 1,085 2 23 19 6 680 Alabama............ 1 2,358 18,546 76 1 10 16 Mississippi........ 1 1,150 6,778 12 2 10 42 WEST SOUTH CENTRAL... 96 32,207 73,998 422 1 98 2 62 15 698 Arkansas........... 1 1,195 1,155 3 66 1 16 1 99 Louisiana.......... 3 134 122 13 1 9 1 12 1 89 Oklahoma............ 6 244 1,072 10 11 10 1 140 Texas.............. 86 30,634 71,649 396 12 24 12 370 MOUNTAIN............ 127 21,095 21,966 1,284 16 33 96 Montana............ 17 3,928 4,262 44 4 1 6 Idaho.............. 40 3,119 2,340 138 - Wyoming............ 1 874 296 14 4 1 - Colorado............ 2 6,009 3,461 694 1 9 New Mexico.......... 1 694 1,137 151 13 21 Arizona............ 51 1,588 6,771 94 14 57 Utah............... 15 4,658 2,668 149 8 1 2 Nevada.............. 225 1,031 2 1 PACIFIC .............. 152 29,272 66,841 1,162 14 5 79 2 244 Washington.......... 48 7,619 21,361 425 7 8 Oregon............. 18 3,520 9,042 27 5 8 9 California.......... 79 13,864 34,346 538 9 5 63 2 225 Alaska.............. 7 215 1,162 84 2 Hawaii............. 4,054 930 88 1 - Puerto Rico 28 3,009 7,378 2 16 3 17 451 Morbidity and Mortality e ekly Report Week No. Table 4. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JANIrARY 1, 1966 52 (By place of occurrence and week of filing certificate. Excludes fetal deaths) All Causes Pneumonia Under All Causes Pneumonia Under Area All 65 years and 1 year Area All 65 years and I year Influenza All Ages and over Influenza All Ages and over All Ages Causes Age and over Ages causes All Ages Causes Al Ages C~auses 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.------ IDDLE 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 Wayne, Ind.------ Gary, Ind.----------- Grand Rapids, Mich.--- Indianapolis, Ind.---- Madison, Wis.-------- Milwaukee, Wis.------- Peoria, Ill.--------- Rockford, III*-------- 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, Ho.-------- St. Paul, Minn.------- Wichita, Kans.-------- 803 281 30 35 40 47 29 27 32 54 66 18 54 36 54 3,570 44 31 150 41 43 55 95 117 1,814 43 538 193 60 107 28 40 59 43 37 32 2,738 56 43 774 184 214 159 99 339 31 49 49 35 55 174 24 130 43 30 36 126 88 939 63 26 56 146 11 121 104 291 71 50 *Estimate based on average percent of divisional total. 477 159 18 25 24 24 17 15 24 29 35 12 39 22 34 2,030 22 21 86 19 27 32 55 56 1,021 29 302 105 35 69 18 31 37 20 24 21 1,490 38 22 399 108 117 85 55 173 19 21 25 12 40 95 13 84 21 18 26 69 50 556 47 16 29 92 8 69 58 167 43 27 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.----- Knoxville, Tenn.------- Louisville, Ky.-------- Memphis, Tenn.*-------- Mobile, Ala.---------- Montgomery, Ala.------- Nashville, Tenn.------- WEST SOUTH CENTRAL: Austin, Tex.---------- Baton Rouge, 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.--------- 1,753 19 51 40 53 93 527 134 32 133 58 97 213 61 143 63 36 1,056 44 103 14 1 31 2 3 27 2 23 3 7 50 6 311 16 37 77 3 8 25 - 84 4 37 2 1 57 5 9 131 6 12 38 1 - 90 3 9 35 2 2 26 1 2 Total 13,158 7,402 601 697 Cumulative Totals including reported corrections for previous weeks All Causes, All Ages ------------------------- All Causes, Age 65 and over------------------- Pneumonia and Influenza, All Ages------------- All Causes, Under 1 Year of Age--------------- 640,803 361,960 25,982 37,543 1,255 123 278 52 98 78 63 107 40 73 86 198 59 569 82 33 43 114 122 52 30 93 1,074 34 35 21 172 37 69 177 53 179 86 116 43 52 457 42 20 111 11 135 16 59 63 452 Morbidity and Mor INTERNATIONAL NOTES QUARANTINE MEASURES (Continued from page 445) Pakistan, Page 51 Delete previous information under smallpox and insert: Smallpox \accination is required for arrivals from infected areas and for persons departing. - Delete previous information under cholera and insert: Cholera vaccination is required for all arrivals from infected areas, one year of age and over. Travelers leaving Pakistan are required to possess a certificate if they hate been in an infected local area. Under Yellow Fever, page 52. delete the third para- graph starting with, "The validity of the certificate shall extend .. ." Delete the third paragraph (page 53) starting with,"Arrivals by Sea " Union of Soviet Socialist Republics, Pages 57 & 65 Undersmallpox add: Certificate required from arri als from the Federal Republic of Germany. Delete previous information under cholera and insert: "Cholera vaccination is required of all arrivals from infected local areas, 2 years of age and over. Certificate required from arrivals from Afghanistan, Brunei, Burma, India, Iran, Malaysia, Nepal, Pakistan, Philippines, Thailand, Republic of Viet-Nam. Bulgaria, Page 58 Under smallpox add "Certificate required from arrivals from the Federal Republic of Germany." ERRATUM, Vol. 14, No. 51, p. 434. The footnote to the article "A Cryptic Case of Malaria Nev ada" should read: *World Health Organization Technical Report Series No. 272. 10th Report of the WHO Expert Committee on Malaria. World Health Organization, Geneva, 1964, p. 34. NOTIFICATIONS OF CHANGE OF ADDRESS Please notify the Communicable Disease Center, Atlanta, Georgia 30333 of any change of address. In doing so, please give your old address and the code numbers as shown on the back page of the MMWR copies you have re- ceived in the past as well as your new address, including the zip code number, with a note of the number of copies now desired. It will also be appreciated if you will notify us when Sour need for the publication has ceased or if a change in the number of copies is desired. Please mark any such communication: Attn: Distribution Sub-Unit, Communications tali ity Weekly Report JANUAR 1. 1966 THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA- TION OF 15 300. IS PUBLISHED AT THE COMMUNICABLE DISEASE CENTER, ATLANTA. GEORGIA. CHIEF. COMMUNICABLE DISEASE CENTER JAMES L. GODDARD. M.D. CHIEF, EPIDEMIOLOGY BRANCH A.D. LANGMUIR. M.O. ACTING CHIEF. STATISTICS SECTION IDA L. SHERMAN. M.S. CHIEF. SURVEILLANCE SECTION D.A. HENDERSON. M.D. EDITOR: MMWR D.J.M. MACKENZIE, M.B.. F.R.C.P.E. IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING MORBIDITY AND MORTALITY. THE COMMUNICABLE DISEASE CENTER WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE IN- VESTIGATIONS WHICH' ARE OF CURRENT INTEREST TO HEALTH OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL OF COMMUNICABLE DISEASES. SuCH COMMUNICATIONS SHOULD BE AD- DRESSED TO: THE EDITOR MORBIDITY AND MORTALITY WEEKLY REPORT COMMUNICABLE DISEASE CENTER ATLANTA, GEORGIA 30333 NOTE: THE DATA IN THIS REPORT ARE PROVISIONAL AND ARE BASED ON WEEKLY TELEGRAMS TO THE CDC BY THE INDIVIDUAL STATE HEALTH DEPARTMENTS. THE REPORTING WEEK CONCLUDES ON SAT- URDAY: COMPILED DATA ON A NATIONAL BASIS ARE RELEASED ON THE SUCCEEDING FRIDAY. m In -- n . Sg g Zg w n S O -n S m i ONIV OF L - S-DOCMENITO , U S. DEPOSITORY 0 Im -o mc Om "m n -- -- -- - 0 c u.J i ( |
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