Morbidity and mortality

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 (

xml version 1.0 encoding UTF-8
REPORT xmlns http:www.fcla.edudlsmddaitss xmlns:xsi http:www.w3.org2001XMLSchema-instance xsi:schemaLocation http:www.fcla.edudlsmddaitssdaitssReport.xsd
INGEST IEID EEHMOG0M1_GY9KCL INGEST_TIME 2013-02-07T18:54:47Z PACKAGE AA00010654_00448
AGREEMENT_INFO ACCOUNT UF PROJECT UFDC
FILES