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COMMUNICABLE DISEASE CENTER . U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE BOTULISM Fullerton, California Vol. 14, No. 40 Week Ending October 9, 1965 SERVICE Two cases of suspected botulism were reported by the Orange County Health Department on October 1, 1965. The patients were a 4:3-year-old woman and her daughter of 18 years. Both had eaten some home-canned albacore. This tuna fish had been brought home from a fishing trip by the father of the family on September 10. On September 13 parts of the fish were cooked in a pressure cooker for 1'" hours at 220 F and then placed in Mason jars which were stored at room temperature. The rest of the fish was frozen or given away as fillets. On September 19 the daughter ate two small pieces of albacore from one of the Mason jars. Three days later she developed symptoms of blurred vision and diplopia Botulism Full,.rrlJ Epidemiology Notes WMasivh ( urrvn. ,ea. I.'' in Orn *ag- which continued until So onl mild di-- ability resulting. On that day the mother and daughter prepared a salad containing some of the canned fi;h, pickles, mayonnaise and olives. The father was away from home when the salad was served for lunch on the same day it was prepared. The two sons of the family tasted the salad, complained of the taste and did not eat any of it. The mother and the daughter ate quantities which have not been determined. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES (Cumulative totals include revised and delayed reports through previous weeks) 40th WEEK ENDED CUMULATIVE, FIRST 40 WEEKS MEDIAN DISEASE OCTOBER 9, OCTOBER 3, 1960- 1964 MEDIAN 1965 1964 1965 1964 1960-1964 Aseptic meningitis 76 52 89 1,572 1,564 1,945 Brucellosis ............... 4 8 8 197 326 326 Diphtheria ....... .......*. 3 7 10 116 192 323 Encephalitis, primary infectious- 39 86 --- 1,388 2,460 Encephalitis, post-infectious 9 4 --- 567 703 Hepatitis, infectious including serum hepatitis .......... 561 735 884 26,090 29,773 33,519 Measles .. ....... .. ..... 830 718 888 242,096 463,650 398,286 Meningococcal infections *..... 48 37 37 2,424 2,149 1,688 Poliomyelitis, Total ......... 2 3 37 45 87 645 Paralytic **............. 2 34 35 71 507 Nonparalytic *......* ...... --- 6 10 --- Unspecified .............. 2 1 --- 4 6 --- Streptococcal Sore Throat and Scarlet fever ....... 5487 5,565 4,406 304.085 310,111 249,989 Tetanus *.......******* 6 4 --- 205 214 --- Tularemia ........... 5 8 --- 197 262 --- Typhoid fever .....* ...... 18 12 15 332 328 489 Rabies in Animals ..... 52 104 60 3,428 3.591 1 2.955 NOTIFIABLE DISEASES OF LOW FREQUENCY Cum. Cum. Anthrax: ....... ........ ... ..... ........ 7 Rabies in Man: ............................. 1 Botulism: Calif:-2 ................ ......... 13 Smallpox: ...................... ......... - Leptospirosis: La.-2, Hawaii-2 .................. 39 Trichinosis: ............................... 78 Malaria: Conn.-1 ............................ 63 Typhus - Plague: ................................. 6 Murine: ...................... ........ 22 Psittacosis: ................. ............... 36 Rky. Mt. Spotted: NJ-1, Ill.-l, Ga.-4, Va.-1 ........ 240 Cholera: ................................. 2 ___ F:, . .. 345 :)1 .4'.3 Morbidity and Mortality Weekly Report BOTULISM Fullerton, California (Continued from front page) The same night, September 26, the daughter's symptoms became worse and over the next few days she developed dysphagia, dysphonia and postural hypotension. The mother also became ill that same night with weakness-, difficulty in talking and parasthesias, later developing dysphagia and nausea without vomiting. Her symptoms continued to increase in se% erity, she became progressively weaker and by September 30 had developed frank dysphonia and inability to swallow. She was admitted to the hospital that day. Meantime the daughter had begun to have dif- ficulty in respiration and she in turn was taken to the hospital on October 1. On October 1, the State Bureau of Communicable Diseases was notified that these were two suspected cases of botulism; antitoxin, polyvalent for types A, B, E and F was obtained from the CDC San Francisco Field Station. The mother and daughter were each given one dose of antitoxin on the night of October 1 and one dose on the morning of October 2. The daughter has since made an uninterrupted recovery. The mother, however, required four additional doses of antitoxin. One was given on the night of October 2 but after some improvement the next morning, she developed respiratory difficulty which required tracheostomy to maintain breathing. Two further doses were given on October 3 and one on October 4. The mother is recovering slowly and it will be some time before she is well enough to leave the hospital. Serum was obtained from both patients before anti- toxin was given. Aliquots of the serum, the remainder of the salad, the unopened jars of albacore and the frozen fillet are being examined concurrently at each of the California Department of Public Health Laboratory, the Hooper Foundation, and the CDC Laboratory. (Reported by Dr. Henry A. Renteln, Head, Special Sur- veillance Section, Bureau of Communicable Diseases, California Department of Public Health; Dr. Russell Watson, Orange County Community Disease Control Officer; Dr. William Cohen, the Attending Physician, and an EIS Officer.) EPIDEMIOLOGIC NOTES AND REPORTS MEASLES Current Trends A total of 242,096 cases of measles has been reported from January 1 through October 9, 1965. The relationship of this total to the years of highest and lowest incidence during the past decade is shown in Figure 1. The seasonal occurrence of measles by 4-week periods during the past 10 years and its distribution through the geographic divisions of the United States are shown in Figure 2 and Table 1 respectively. Figure / REPORTED MEASLES BY FOUR-WEEK PERIODS, UNITED STATES 1965 COMPARED WITH II YEAR PERIOD, 1954-1964 ----HIGHEST NUMBER, 1954-64 ---- LOWEST NUMBER, 1954-64 -1965 Week Number For 10 years past, the lowest incidence of measles has occurred during the 37th to 40th weeks. This year scattered outbreaks in various parts of the United States, particularly in ruralareas, have given rise to a higher total for this 4-week period than for the one immediately preceding. Five counties in Colorado, Kentucky and Tennessee, with a combined population of 54,000, have reported more than 250 cases in the past 4 weeks. According to mortality data for measles for the past 10 years, an average of 434 deaths occur each year. Preliminary data, based on a 10 percent sampling of T4BLE I REPORTED CASES OF MEASLES BY GEOGRAPHIC DIVISION, WEEKS 1-10. 1960-65 Geographic Dission 1960 1961 196' 1961 1964 1965" Neu England ....... 40.097 37.362 56.6 7 14.202 17.062 36,876 Middle 4tlantir .... .6,127 9.343 %5.795 41.2%6 5*,263 14,945 East North Central 123.08 106,9.3s 64,111 ,l.l330 10..101 56,104 Hves Norlh Central .. 6.334 13.6b0 15,955 20,026 30,301 16,646 South Allantr ..... 20,246 40.36 *28,;327 32.551 3b.499 25,026 East South Central 3.026 2s.It 3 35.070 1i.12b 67,877 13.978 Host South Crntral .51.. 5 16.257 69.632 21.,031 72.194 31,026 Mounlann ........ ..21.903 17.570 27,025 2b,603 18,;b4 19.i85 Pacif . 50.5 1 19.569 62.402 36,730 63.569 27.641 Total ... 403.95 389,283 445.691 360.667 463.650 242,096 *PrOs i.-onsi drt(; 346 OCTOBER 9. 1965 OCTOB:R 9, 1965 Morbidity and Mortality Weekly Report Figure 2 REPORTED MEASLES BY FOUR-WEEK PERIODS UNITED STATES, 1956-1965 death certificates, indicate that there were 440 measles deaths in 1964 (Monthly Vital Statistics Report, National Center for Health Statistics.) Since the live attenuated measles virus vaccine was licensed for general use in 1962, seven million doses had been distributed by January 1965; an additional four million doses have been distributed since. This is enough vaccine to immunize nearly all children born in the United States in 3 years, although the proportion of the 11 million doses used to immunize children actually susceptible to measles is unknown. Major epidemics of measles are to be expected during the next 6 months in areas of the United States where vaccine is not being used extensively to immunize sus- ceptible age groups, particularly among pre-school children. Accordingly, the experience of measles during the coming winter among both well vaccinated and in- adequately vaccinated groups of children is confidently expected to demonstrate the preventive impact of the currently used measles vaccine both on reported incidence and on mortality. (Reported by the Childhood Virus Disease Unit of CDC.) Figure 3 CASES OF MEASLES -- BY MONTHS AND YEARS ORANGE COUNTY, CALIFORNIA 347 700 19 1959 1960 1961 1965 (See back page for text) 348 Morbidity and Mortality Weekly Report CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED OCTOBER 9, 1965 AND OCTOBER 3, 1964 (40th 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... 76 52 39 9 2 45 87 35 71 3 116 NEW ENGLAND.......... 4 1 2 2 2 2 Maine....... ....... 1 1 - New Hampshire...... --- --- --- --- - Vermont............ - Massachusetts...... 2 2 2 Rhode Island....... 2 1 - Connecticut........ 1 1 - MIDDLE ATLANTIC...... 6 6 12 1 4 13 3 12 5 New York City...... 1 8 1 1 1 3 New York, Up-State. 1 3 10 9 - New Jersey......... 3 5 1 3 2 3 2 - Pennsylvania....... 2 1 2 EAST NORTH CENTRAL... 16 7 6 2 2 19 2 15 1 5 Ohio............... 3 2 3 2 2 1 Indiana............. 2 6 5 2 Illinois........... 8 3 1 2 1 6 1 5 1 1 Michigan............ 4 2 1 3 1 2 - Wisconsin.......... 1 2 1 1 WEST NORTH CENTRAL... 9 1 5 10 9 7 7 18 Minnesota.......... 9 1 1 3 1 2 7 Iowa............... 4 2 1 Missouri............ 1 4 3 1 North Dakota....... 1 -- 1 - South Dakota....... 7 Nebraska........... 1 3 3 I Kansas............. 3 1 1 1 1 1 SOUTH ATLANTIC....... 2 5 4 3 1 21 1 16 1 30 Delaware........... - Maryland............ 1 1 1 -1 1 - Dist. of Columbia.. 3 Virginia........... 4 3 - West Virginia...... 1 - North Carolina..... 10 16 2 South Carolina...... 1 1 Georgia.......... ....... 1 1 1 15 Florida............ 1 1 3 8 7 9 EAST SOUTH CENTRAL... 1 3 1 6 1 5 1 18 Kentucky ........... . Tennessee........... 1 3 1 3 1 2 1 1 Alabama............. 2 2 15 Mississippi........ 1 1 2 WEST SOUTH CENTRAL... 12 3 16 8 14 8 29 Arkansas........... -- 2 Louisiana.......... 1 1 1 6 Oklahoma........... 1 2 1 2 - Texas............... 12 2 14 6 12 6 21 MOUNTAIN............. 3 6 5 6 3 3 - Montana............ 1 - Idaho.............. - Wyoming............. 2 2 - Colorado........... 3 1 1 - New Mexico............. 5 1 3 1 - Arizona............ 4 2 - Utah................. -- - Nevada.............. -. - PACIFIC.............. 26 23 4 3 2 6 3 4 3 9 Washington........ --- --- --- --- 2 2 --- 3 Oregon ............. -- 1 1 1 1 1 California......... 25 23 3 3 2 3 2 1 2 5 Alaska.............. - Hawaii.............. - Puerto Rico 12 *Reports for 40th week not received. Morbidity and Mortality Weekly Report 3 t1 CASES OF PlI( IIlI) NOTIFIABLE DISEASES: UNITED STATES t)R WEEKS 1NIDI D OCTOII K 9, 1965 AND OCTOHB R 3. 1964 (40th II Kl ) Continucd Brucel- Infectious Hepatitis Mi u. I 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... 4 561 275 261 26,090 29,773 48 2,424 2,149 6 205 EW ENGLAND.......... 29 13 15 1,522 2,734 3 123 61 5 Maine.............. 4 3 1 269 868 16 5 - New Hampshire .... --- --- --- --- 153 212 --- 7 1 --- 1 Vermont............ 3 1 2 83 342 7 4 - Massachusetts...... 12 6 6 601 599 3 43 24 3 Rhode Island....... 3 1 2 171 153 14 10 - Connecticut........ 7 2 4 245 560 36 17 1 MIDDLE ATLANTIC...... 107 46 61 4,648 6,605 3 314 272 13 New York City...... 30 11 19 925 1,011 54 36 - New York, Up-State. 28 12 16 1,774 2,884 1 91 75 5 New Jersey......... 19 7 12 877 1,128 1 81 93 1 Pennsylvania....... 30 16 14 1,072 1,582 1 88 68 7 EAST NORTH CENTRAL... 116 67 45 5,021 4,665 7 347 293 1 29 Ohio............... 28 12 14 1,379 1,234 1 93 75 2 Indiana............ 15 10 4 440 407 2 45 46 7 Illinois........... 25 14 11 956 859 1 94 75 1 14 Michigan........... 39 24 15 1,923 1,833 2 76 67 3 Wisconsin.......... 9 7 1 323 332 1 39 30 3 WEST NORTH CENTRAL... 4 27 12 13 1,497 1,598 123 128 18 Minnesota.......... 2 1 1 155 183 27 29 8 Iowa............... 3 6 4 1 525 246 9 7 4 Missouri........... 9 3 5 318 394 52 57 2 North Dakota....... 27 58 11 18 - South Dakota....... 20 126 3 3 Nebraska........... 5 3 2 69 42 10 6 2 Kansas.............. 1 5 1 4 383 549 11 8 2 SOUTH ATLANTIC...... 49 22 19 2,698 2,803 6 462 421 1 47 Delaware........... 1 1 65 55 1 8 6 - Maryland............ 9 3 4 473 524 44 31 1 Dist. of Columbia.. 1 39 51 9 13 - Virginia........... 20 8 7 642 439 2 56 49 7 West Virginia...... 3 1 2 376 407 1 25 33 1 North Carolina..... 2 1 1 256 469 1 94 72 1 7 South Carolina..... 122 104 1 60 50 6 Georgia............ 93 85 57 62 5 Florida............ 13 9 4 632 669 109 105 20 EAST SOUTH CENTRAL... 16 6 10 1,849 2,068 5 190 173 3 27 Kentucky........... 4 3 1 659 755 2 73 57 6 Tennessee.......... 5 2 3 621 719 60 55 2 9 Alabama............ 5 5 336 388 1 35 37 1 10 Mississippi ....... 2 1 1 233 206 2 22 24 2 WEST SOUTH CENTRAL... 45 18 24 2,275 2,332 4 315 246 1 45 Arkansas........... 3 1 2 293 220 15 23 1 11 Louisiana.......... 5 2 3 368 573 3 174 119 5 Oklahoma........... 49 110 20 10 1 Texas.............. 37 15 19 1,565 1,429 1 106 94 28 MOUNTAIN.............. 22 11 4 1,457 1,785 12 86 73 i- 3 Montana............ 9 4 2 118 158 2 - Idaho.............. 183 252 1 9 3 Wyoming............ 40 57 5 5 - Colorado............. 6 6 311 476 9 24 12 2 New Mexico......... 2 2 309 250 11 29 - Arizona............ 4 307 395 16 7 1 Utah............... 1 1 180 146 2 16 7 - Nevada............. 9 51 3 10 - PACIFIC.............. 150 80 70 5,123 5,183 8 464 482 18 Washington*....... -- --- -- -- 387 538 --- 34 33 --- Oregon............. 13 8 5 436 553 33 21 4 California.......... 125 69 56 4,061 3,807 7 371 409 14 Alaska............. 4 2 2 192 181 18 7 - Hawaii............. 8 1 7 47 104 1 8 12 Puerto Rico 5 5 1,117 805 2 9 31 2 44 *Reports for 40th week not received. 350 Morbidity and Mortality Weekly Report CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED OCTOBER 9, 1965 AND OCTOBER 3, 1964 (40th 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... 830 242,096 463,650 5,487 5 197 18 332 52 3,428 NEW ENGLAND.......... 37 36,876 17,062 506 1 2 6 39 Maine.............. 14 2,816 3,028 37 4 New Hampshire ..... --- 381 255 --- -- --- -- 1 Vermont............ 15 1,283 2,332 36 31 Massachusetts...... 5 19,303 5,375 103 1 3 2 Rhode Island....... 3,938 1,938 16 1 Connecticut........ 3 9,155 4,134 314 2 2 1 MIDDLE ATLANTIC...... 102 14,945 52,263 230 5 60 4 143 New York City...... 23 2,439 15,360 4 2 29 -- New York, Up-State. 14 4,157 12,727 180 2 15 4 130 New Jersey......... 45 2,622 12,223 34 7 -- Pennsylvania....... 20 5,727 11,953 12 1 9 13 EAST NORTH CENTRAL... 213 56,104 103,101 367 13 39 14 529 Ohio............... 7 8,902 19,643 24 9 10 272 Indiana............. 41 1,888 22,817 88 5 8 64 Illinois........... 13 2,777 16,644 63 5 10 1 82 Michigan........... 106 26,579 28,969 146 2 7 2 53 Wisconsin.......... 46 15,958 15,028 46 1 5 1 58 WEST NORTH CENTRAL... 68 16,646 30,301 192 2 25 11 8 695 Minnesota.......... 2 690 334 9 1 1 1 140 Iowa................ 49 9,050 23,332 47 2 3 198 Missouri........... 3 2,594 1,019 23 18 7 1 97 North Dakota....... 14 3,745 4,772 101 1 44 South Dakota....... 115 32 10 2 52 Nebraska........... 452 812 1 1 36 Kansas............. NN NN NN 2 2 4 1 128 SOUTH ATLANTIC....... 145 25,028 38,499 953 31 2 66 4 464 Delaware........... 505 411 18 4 - Maryland............. 3 1,166 3,408 83 1 20 22 Dist. of Columbia.. 1 78 354 21 - Virginia........... 23 3,895 12,717 197 8 8 1 285 West Virginia...... 58 13,897 8,730 230 3 21 North Carolina..... 390 1,161 19 6 15 3 South Carolina .... 34 1,052 4,261 171 3 8 2 Georgia............ 617 198 1 14 1 4 1 59 Florida............. 26 3,428 7,259 213 4 2 72 EAST SOUTH CENTRAL... 30 13,978 67,877 947 1 21 1 33 6 734 Kentucky........... 2,586 18,476 28 3 9 2 78 Tennessee.......... 27 7,937 24,340 839 1 17 1 12 4 603 Alabama............ 2,335 18,372 56 1 7 16 Mississippi........ 3 1,120 6,689 24 5 37 WEST SOUTH CENTRAL... 68 31,026 72,194 551 2 82 5 48 7 549 Arkansas........... 1,084 1,124 2 2 56 13 1 80 Louisiana.......... 1 108 115 2 5 1 7 70 Oklahoma........... 3 206 1,019 20 10 6 3 120 Texas.............. 64 29,628 69,936 527 11 4 22 3 279 MOUNTAIN ............. 35 19,852 18,784 746 15 1 28 1 75 Montana............ 8 3,739 3,122 22 4 1 5 Idaho.........l.... 4 2,798 1,943 78 - Wyoming............ 1 849 262 12 3 1 - Colorado........... 12 5,690 3,239 345 9 New Mexico......... 677 457 197 11 14 Arizona............ 7 1,339 6,684 69 12 1 45 Utah............... 3 4,556 2,085 23 8 1 1 I Nevada................. 204 992 2 I PACIFIC.............. 132 27,641 63,569 995 9 2 41 8 200 Washington ........ -- 7,245 20,068 --- -- --- 4 --- 7 Oregon............. 16 3,277 8,681 25 5 1 8 7 California......... 52 13,055 33,123 727 4 1 28 8 184 Alaska............. 186 1,112 16 2 Hawaii............. 64 3,878 585 227 - Puerto Rico 28 2,463 6,454 16 9 13 *Reports for 40th week not received. 11orlbidity and MortaliNt W'eklI Relport l)tATH' IN 122 I'NITI' ) STATI-E (l ItS Fi)R WEEK I NI) I) OCTOBER 9. 1965 (By place of occurrence and week of filing certificate. Excludes fetal deaths) All I u c Area All 65 years Ages and over NEW ENGLAND: Boston, Mass.--------- Bridgfport, Conn.--- CambhridK. 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, Il1.--------- 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.-------- P in 1 .1,. r.1 I. and Influenza All Ages rn~l, r 1 year All Causes A I ,-,,, ,1 All Ages and I 65 years Infl an r AInfluenza and over All Ages I II It- I_ I -t_ 691 231 39 20 26 57 25 24 38 45 60 14 34 28 50 3,191 45 35 148 41 26 36 59 83 1,628 37 495 201 42 101 27 40 60 40 23 24 2,416 78 40 729 162 168 114 73 290 39 45 35 25 48 164 50 110 30 27 40 92 57 762 64 21 38 125 33 101 55 201 85 39 436 135 26 14 16 27 19 20 28 25 37 8 23 20 38 1,856 24 21 89 23 18 19 36 37 941 28 279 107 20 73 18 30 37 20 18 18 1,344 32 26 377 102 97 56 47 171 25 21 20 12 29 82 26 66 16 16 24 63 36 477 42 16 19 87 22 66 31 118 51 25 *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.------------ 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.---------- 125 266 53 67 84 47 78 28 62 67 174 46 538 89 47 23 114 94 50 26 95 1,076 36 28 17 149 24 78 211 54 186 74 98 62 59 343 38 12 107 17 64 16 45 44 1,601 18 43 34 48 69 491 124 43 88 71 108 222 27 145 28 42 1 year All Causes Total 11,715 6,638 383 653 Cumulative Totals including reported corrections for previous weeks All Causes, All Ages ------------------------ 492,210 All Causes, Age 65 and over------------------- 277,616 Pneumonia and Influenza, All Ages------------- 19,938 All Causes, Under 1 Year of Age--------------- 29,251 Week No. 351 I Morbidity and Mortality Weekly Report OCTOBER 9, 1965 o-- o or a -- -- e O- S- S=. 40 z -- o, C4Y THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA- TION OF 14 000 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.D. ACTING CHIEF. ST ATISTC S 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 MORB.DITr AND MORTALITY THE COMMUNICABLE DISEASE CENTER WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE IN- 'E.TIGATIONS WHIC*m- 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. URDA. COMPILED DATA ON A NATIONAL BASIS ARE RELEASED ON THE SUCCEEDING FRIDAY. MEASLES Orange County, California Records of measles morbidity in Orange County, California, from 1958 through September 1965 are depicted in Figure 3. Between January 1 and the end of the 40th week of 1963, the County had experienced an epidemic of 2,737 reported cases. In the State of California as a whole, however, it was not until the comparable period of 1964 that an epidemic was recorded. During this time a total of 33,065 cases was reported in the State compared to the total of 20,904 cases during 1963. In Orange County a total of 221 cases was recorded at the end of the 40th week of this year, compared to 168 cases in 1964. The next epidemic peak in the County would normally be predicted for the coming winter, following the cyclic pattern of the past. However, the increasing level in the County of immunization with measles vaccine may be expected to modify the pattern, assuming that the active immunization measures already undertaken among pre-school children can be intensified. (Reported by Dr. Edward Lee Russell, Health Officer, Orange County Health Department, California; and Dr. Henry A. Renteln, Head Special Surveillance Section, Bureau of Communicable Disease, California Department of Public Health.) Editorial Note: The recommendations of the Public Health Service Advisory Committee on Immunization Practice regarding the dosage schedule for measles vaccine are in the MMWR, Vol. 14, No. 7. A statement prepared by the same Committee on the importance of measles and methods for achieving high levels of measles immunization in the community is in the MMWR, Vol. 14, No. 36. C (*03 aa o!n 5 3i > -h m nc? am 352 I n O a - s- a >m A- U S S DEPOSI ORY r- ma UNIV OF FL Li1 DOCUMENTS DEPTH * I DFPOSIlTORY |
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