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COMMUNICABLE DISEASE CENTER , Vt Iis ILI 4^E oww# Us^ Vol. 14, No. 50 Week Ending December 18, 1965 U.S. DEPARTMENT OF HEALTH _______ ^ ^ __ * I WELFARE PUBLIC HEALTH SERVICE VIBRIO FETUS INFECTIONS IN HUM ~jOREGON S JAN I During No\ember 1965. two tn Oregon State Board of Health by the Ba.t ologN oratory of the Pediatrics Department of the --it\ of Oregon Medical School. The first case reported was in a -24 to 28 week premature baby born in the Medical School Hospital on August 25, 1965. At delivery, the lower extremities, back and abdomen of the infant showed extensive petechiae and the body surface was covered by a foul smelling oily film. A few hours after birth the baby developed respiratory distress with rales noted in the chest; it died after 14 < (tN I ]:N I S '.. I ,i In n i n n.rn- ()r L.I. l nit Lc i u iltim.n r . i- lo. Ju l, I .. rnil r 1 I' .',, -m Full,' rt..ri d if rni.1 .- in N ho,- Il .-I .liiti frm 1, 1k I'_1.1t, hours. Spinal fluid and blood from the baby were positive on culture for Vibrio fetus at the Pediatrics Department Laboratory; these findings were later confirmed by the by the Laboratory Branch of CDC. Blood cultures from the mother were negative but her serum at 1: 120 agglutinated the vibrios cultured from the baby. (Continued on page 426) CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES (Cumulative totals include revised and delayed reports through previous weeks) 50th WEEK ENDED CUMULATIVE, FIRST 50 WEEKS MEDIAN DISEASE DECEMBER 18, DECEMBER 12, 1960- 1964 MEDIAN 1965 1964 1965 1964 1960- 1964 Aseptic meningitis .......... 38 35 34 2,052 2,076 2,475 Brucellosis ... ............... 5 3 6 240 383 388 Diphtheria ...... ........*. 3 11 12 154 286 444 Encephalitis, primary infectious 30 50 --- 1,828 3,120 - Encephalitis, post-infectious 9 3 --- 634 763 --- Hepatitis, infectious including serum hepatitis .......... 609 747 945 32,430 36,415 41,385 Measles ...... ........... ... 2,866 3,249 3,939 259,309 481,767 421,463 Meningococcal infections ..... 66 64 45 2,918 2,683 2,116 Poliomyelitis, Total ... 2 6 57 114 862 Paralytic .............. 2 5 41 89 683 Nonparalytic .* *.* --- 10 14 --- Unspecified ************ --- 6 11 --- Streptococcal Sore Throat and Scarlet fever ............. 7,917 8,887 7,711 375,078 377,392 304,988 Tetanus ........ ....3 5 --- 269 266 --- Tularc A * .3 3 --- 236 313-- Typhoid fever ......... 4 8 9 435 436 611 Rabies in Animals ** ...... 67 120 51 4,115 4,356 3,470 NOTIFIABLE DISEASES OF LOW FREQUENCY Cum. Cum. Anthrax: .. .................................. 7 Rabies in Man: ** .. ..................... .... 1 Botulism: ............................... 18 Smallpox: .............................. - Leptospirosis: Mass.-1, Hawaii-3, Iowa-4, Calif.-2 6 4 Trichinosis: ............................... 107 Malaria: Pa -2 ................... .......... 81 Typhus- Plague: ................................. 6 Murine: ............................... 26 Psittacosis: .............................. 48 Rky. Mt. Spotted: ........ ..... .. 260 Cholera: ................................. 2 426 The mother gave no history of recent illness. In the past she had had two miscarriages but during this pregnancy the only unusual event until the premature birth had been a temporary heavy blood-stained discharge during, the fourth month. At the time of the delivery there had been a low grade temperature which soon returned to normal without any treatment being given. The family lives on a farm which has a few cattle and swine but the mother gave no history of direct contact with the animals. However, in view of the serological findings associated with a premature birth she is presumed to have been a subclinical case of Vibrio fetus infection. The second case reported was in a 2%-year-old child admitted to the same hospital on September 1 of this year. The history prior to admission was of a 3 weeks-fever of inconstant pattern, the highest temperature noted being 1020 F. There had been an increasing anorexia for 3 or 4 days with rhinorrhea and mild joint and muscle pains. This was followed by the appearance of several small swellings in the left side of the neck. When examined on entry to the hospital there was a large, soft submandibular swelling associated with a few discrete and firm nodules in the left side of the neck. There was no general adenopathy and no other abnormal findings were noted. The child's temperature later rose to 1040F and there was an increase in the white count to 24,000 with a 29 percent lymphocytosis. Skin tests were tuberculin negative and were also negative for brucellosis, coccidiomycosis and histoplasmosis. Four blood cultures were also made and the fourth proved positive for Vibrio fetus after 6 days. The child was then given penicillin intramuscularly in daily doses of 600,000 units. The fever quickly resolved, there was a gradual decrease in the size of the lymph nodes and the child made a good recovery. DECEMBER 18, 1965 This child's family also lived on a farm and there was a history of drinking raw milk for some time prior to the illness. Epidemiological investigations at the two farms, which are 35 miles apart, included blood cultures and vaginal smears from cattle and swine. The latter were all negative for Vibrio fetus and no primary source of infection has been identified. (Reported by Dr. Monroe A. Holmes, Acting Director, Epidemiology Section, Oregon State Board of Health; the Professional Staff of the Pediatrics Department of the University of Oregon Medical School; Dr. Gerda Benda and Dr. William Austin, Attending Physicians of the two patients; and the Laboratory Branch of the CDC.) Editorial Note: Vibriofetus infections cause vibriosis in cattle and sheep which is a common cause of abortion and sterility in infected herds. The infection is uncommon in man and according to Hull (1963), only 22 human infections, all in adults, had been recorded up to that time; eight were in France and the remainder in the United States. Four of these cases occurred in women, placentitis and abortion with fever being the predominant symptoms. As far as is known the two laboratory confirmed cases above are the first to be described in children. The first documented human strain of V. fetus was isolated in 1947. Reference: Hull, Thomas G.: Diseases transmitted man. Thomas Press, Springfield, Illinois, 185. from animals to 1963, V:pp 170- SURVEILLANCE SUMMARY SHIGELLOSIS July 1 September 30, 1965 During the third quarter of the year, 2,248 shigella isolations from human sources have been reported from 52 centers. Compared to the total reported from 49 centers during the previous quarter, this represents an increase of 733 isolations (MMWR, Vol. 14, No. 42). The numbers of isolations reported indicate a seasonal pattern of in- creased activity in July going on to a peak of incidence in September. Since reporting was first instituted in January 1964, seventeen States have been reporting shigella isolations consistently. The data from these States indicate a decrease in the totals reported during the first 9 months of 1965 although the seasonal distribution is similar to the comparable period in 1964. The age and sex distribution of isolations during the third quarter is consistent with past experience as is the high concentration of isolations among children. Almost 70 percent of isolations were from children under 10 years of age, with children between the ages of 1 and 4 accounting for 40 percent of the total. Accumulating Morbidity and Mortality Weekly Report VIBRIO FETUS INFECTIONS IN HUMANS OREGON (Continued from front page) Morbidity and Mortality Weekly Report evidence -ugc,' -tr that there is no ,liiirriini in the frrequciIn' of occurrence of -Iiigrllh-i in the two sexes. Isolations from family grilii- with more than one member infected account for 26.8 percent of the total during the quarter. There were 13 different -,r0i.'I-O of human -higiellae determined and of these, 6 serotypes accounted for hi, percent of all isolations. Table I shows the order of frequency of the six most common serotypes ilIring the third quarter, in comparison to the second quarter. The major numbered -uligroup- of S. flexineri only have been indicated for these two quarters as all States do not undertake final -oro.lwping. The 24-month di-trillution in the last column is, however, based on :'in:il -'ro(tping. Table 1 Frequency of Shige'lla Srot\pe-; 427 Figure / 140- 120- 100- 80- 60- 40- - Human Sources Previous 24-\lonth Third Quarter Quarter* Period Rank Seroti p No. % % % 1 S. sonnei 728 32.4 34.1 37.9 2 S. flerneri 2 604 26.9 25.8 (2a)24.9 3 S. flexneri 3 270 12.0 11.0 (3a) 9.8 4 S. flexneri 4 176 7.9 6.3 (4a) 6.1 5 S. flexneri 6 86 3.8 3.6 6.0 6 S. flezneri 1 81 3.6 5.7 (2b) 5.5 *The 24-month period firurt give a percentage of the total of 12,474 isolations which is calculated according to the distribution of a sample finally serotyped. The regional differences in distribution of the S. flerneri and S. sonnei isolations remain much the same as in previous surveillance summaries. In the southern States, S. fleIrzne accounts for between 70 and 80 percent of all isolations while in the northern States the range is between 40 and 60 percent, reflecting an apparently greater seasonal incidence in the third quarter. S. sonnei isolations throughout the United States have been reported at a relatively constant rate. The 26 isolations of shigella from nonhuman sources during the third quarter of 1965 is in Table 2. (Reported by the Shigrlla Surveillance Unit, CDC.) 0 1 1 I * SEASONAL INCIDENCE OF REPORTED SHIGELLA ISOLATIONS FOR 17 STATES* WHICH HAVE REPORTED SINCE JANUARY 1964 1964 ---- 1965- 7' ( \ I / J F M A M J J A S 0OND *ALASKA, ARIZONA, HAWAII, ILLINOIS, KANSAS, MARYLAND, NEW JERSEY, NEW MEXICO, NORTH CAROLINA, NORTH DAKOTA, OHIO, OKLAHOMA, OREGON, SOUTH DAKOTA, TENNESSEE, TEXAS, VERMONT. Table 2 Frequency of Shigella Serotypes - Nonhuman Sources Serotype No. of Reporting Source e Isolations Center S. flexneri 5 Mich. Monkeys S. flexneri 2a 3 Texas Lab. stock cultures S. flexneri 2b 2 Texas Lab. stock cultures S. flexneri 3 13 Md. Monkeys 1 Pa. Monkey S. flexneri 4b 1 Ill. Monkey S. sonnei 1 Ill. Monkey TOTAL 26 BOTULISM FULLERTON, CALIFORNIA Two cases of botulism, following the ingestion of home-canned albacore in a salad, were reported in the MMWR, Vol. 14, No. 40. Laboratory investigations were conducted at the California Department of Public Health Laboratory, the Hooper Foundation and the CDC Lab- oratory. An extract of the salad examined at each of the laboratories proved to be toxic to mice. The toxin was (Continued on page 432) t1 c(' MI K 18. 1965 v r 428 Ilorbidity and Mortality Weekly Report CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED DECEMBER 18, 1965 AND DECEMBER 12, 1964 (50th 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... 38 35 30 9 2 57 114 2 41 89 3 154 NEW ENGLAND.......... 1 2 2 2 2 Maine.............. .- 1 1 - New Hampshire...... - Vermont.............. - Massachusetts..... I 2 Rhode Island....... 1 1 - Connecticut........ I 1 - MIDDLE ATLANTIC...... 3 6 4 1 5 15 4 13 6 New York City...... 2 1 1 1 2 2 3 New York, Up-State. 2 1 10 1 9 1 New Jersey......... 3 3 3 3 3 2 - Pennsylvania....... 1 1 2 EAST NORTH CENTRAL... 9 2 4 1 2 24 2 17 8 Ohio................ 1 3 2 2 Indiana ............ 6 2 9 6 3 Illinois........... 2 1 1 1 6 1 5 2 Michigan........... 1 1 1 1 3 1 2- Wisconsin.......... 3 2 1 WEST NORTH CENTRAL... 2 3 3 2 11 10 7 8 21 Minnesota........... .- 2 1 3 1 2 7 Iowa............... 5 1 2 1 1 Missouri........... 2 1 1 4 3 1 North Dakota ....... 1 - South Dakota....... 9 Nebraska........... 3 3 2 Kansas............. 3 2 1 1 1 1 1 SOUTH ATLANTIC....... 4 1 3 1 1 32 1 25 1 39 Delaware........... 2 - Maryland........... .- 1 1 1 1 1- - Dist. of Columbia.. 3 Virginia ........... 1 4 4 - West Virginia ...... 1 - North Carolina ..... 1 12 7 4 South Carolina..... 1 11 2 Georgia............ 1 3 3 1 21 Florida............ 2 10 8 9 EAST SOUTH CENTRAL... 1 2 1 4 6 2 5 1 31 Kentucky........... 1 1 - Tennessee.......... 1 2 3 1 2 2 Alabama............. 1 2 2 1 27 Mississippi........ 1 1 1 1 1 2 WEST SOUTH CENTRAL... 2 4 1 1 20 11 1 17 10 1 38 Arkansas ........... 1 1 1 1 1 2 Louisiana.......... I 1 2 1 1 11 Oklahoma............. 2 3 2 2 1 Texas.............. 1 3 1 15 8 13 8 24 MOUNTAIN............. 2 3 10 5 11 3 6- - Montana............ 1 - Idaho............... 1 -- 1 - Wyoming............ 2 2 - Colorado........... 3 9 2 2 - New Mexico......... 1 5 1 - Arizona............ 2 4 1 2 1 - Utah................ . Nevada.............. - PACIFIC.............. 15 13 3 3 1 9 3 1 5 3 9 Washington......... 1 3 1 3 3 Oregon............. 1 1 1 1 1 California.......... 15 10 3 3 5 2 1 2 5 Alaska.............. - Hawaii.............. 3 - Puerto Rico 16 129 Morbidity and Mortality weekly y Report CASESS OF SPF(:IFIII) NOTII-I\ II DISIASUS I'NITEI) SIATIS FOR WEEKS ENDED D1)( I Mb I R IN, 1965 AND 1ll ( I Mlt R 12, 1964 (50th \ I k) (ontinucd Brucel- losis Area Total incl. unk. Infectious Hepatitis including Seium Hepatitis Under 20 years Cumulative 20 years and over Totals 1965 1965 1965 b '-1w I200.' t= NEW ENGLAND........... Maine............... New Hampshire...... Vermont........... Massachusetts...... Rhode Island....... Connecticut........ MIDDLE ATLANTIC...... New York City...... New York, Up-State. New Jersey......... Pennsylvania....... EAST NORTH CENTRAL... Ohio................ Indiana............ Illinois........... Michigan........... Wisconsin.......... WEST NORTH CENTRAL... Minnesota.......... Iowa................ Missouri............ North Dakota....... South Dakota....... Nebraska............ Kansas.............. SOUTH ATLANTIC....... Delaware.......... Maryland............ Dist. of Columbia.. Virginia........... West Virginia...... North Carolina..... South Carolina..... Georgia............. Florida............. EAST SOUTH CENTRAL... Kentucky........... Tennessee.......... Alabama........... Mississippi........ WEST SOUTH CENTRAL... Arkansas.......... Louisiana ......... Oklahoma............ Texas.............. MOUNTAIN............. Montana............ Idaho............... Wyoming............ Colorado............ New Mexico.......... Arizona............ Utah................ Nevada............ PACIFIC............... Washington.......... Oregon.............. California.......... Alaska.............. Hawaii............. 141 11 16 111 2 1 UNITED 1 1Tf . 6,587 509 572 5,185 235 86 6,440 647 644 4,736 290 123 ritrrn lInti s Tt iuns ta Inus Cumu l t iv v C ui. 965 1964 1965 I " 7I I .' .7hb J 't ' 91 7 2 4 38 11 29 Puerto Rico 14 12 2 1,358 975 11 36 57 1965 32,-3-i 1,819 321 167 91 722 203 315 5,789 1,200 2,174 1,047 1,368 6,336 1,709 531 1,189 2,509 398 1,802 218 581 397 34 22 99 451 3,340 87 598 50 767 453 365 141 118 761 2,294 828 779 400 287 2,692 342 455 55 1,840 1,771 156 196 54 374 383 372 220 16 1l 1964 lh.* 1; 3,226 996 256 375 741 217 641 7,933 1,261 3,440 1,295 1,937 5,852 1,532 485 1,118 2,316 401 2,020 226 383 496 64 135 74 642 3,374 76 620 69 543 482 543 152 112 777 2,473 872 873 479 249 2,859 288 675 132 1,764 2,238 190 316 93 588 324 487 189 51 430 Morbidity and Mortality Weekly Report CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED DECEMBER 18, 1965 AND DECEMBER 12, 1964 (50th 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... 2,866 259,309 481,767 7,917 3 236 4 435 67 4,115 NEW ENGLAND.......... 140 37,371 21,261 973 2 7 48 Maine.............. 14 2,933 3,654 148 4 New Hampshire...... 383 809 9 5 Vermont............ 13 1,420 2,417 5 32 Massachusetts..... 94 19,468 6,777 154 2 3 2 Rhode Island....... 13 3,970 2,419 43 1 1 Connecticut........ 6 9,197 5,185 614 -- 3 4 MIDDLE ATLANTIC...... 358 17,714 53,296 167 1 68 11 256 New York City...... 182 3,443 15,504 7 30 - New York, Up-State. 24 4,431 13,096 121 1 16 11 240 New Jersey.......... 152 3,577 12,342 39 7- - Pennsylvania....... 6,263 12,354 15 16 EAST NORTH CENTRAL... 1,283 62,349 105,693 593 2 16 50 11 632 Ohio............... 32 9,162 20,046 35 10 5 338 Indiana............ 38 2,351 23,161 118 1 6 16 1 74 Illinois........... 411 4,042 16,772 98 1 7 11 1 91 Michigan........... 73 27,686 29,954 228 2 7 3 63 Wisconsin.......... 729 19,108 15,760 114 1 6 1 66 WEST NORTH CENTRAL... 96 17,399 31,312 369 30 17 7 811 Minnesota........... 39 847 345 17 1 1 3 178 Iowa............... 25 9,286 23,615 116 2 225 Missouri........... 17 2,678 1,094 103 20 11 2 124 North Dakota....... 12 4,007 5,350 111 48 South Dakota....... 116 67 15 3 1 59 Nebraska........... 3 465 841 5 2 3 36 Kansas............. NN NN NN 2 4 1 141 SOUTH ATLANTIC....... 254 26,768 40,133 864 35 1 80 11 536 Delaware............ 516 419 42 1 5 - Maryland............ 20 1,260 3,442 114 21 27 Dist. of Columbia.. 1 128 357 9 - Virginia........... 86 4,280 12,957 243 9 9 6 326 West Virginia...... 84 14,743 9,746 137 3 2 27 North Carolina..... 3 415 1,263 26 8 16 3 South Carolina..... 23 1,190 4,301 100 3 9 3 Georgia............ 628 214 6 15 12 2 72 Florida............. 37 3,608 7,434 187 5 1 78 EAST SOUTH CENTRAL... 373 15,894 69,148 1,147 1 25 1 47 15 826 Kentucky............ 186 3,659 18,835 75 3 10 2 95 Tennessee.......... 185 8,732 25,051 798 1 21 1 19 12 673 Alabama............ 1 2,354 18,502 104 1 10 16 Mississippi........ 1 1,149 6,760 170 8 1 42 WEST SOUTH CENTRAL... 102 32,035 73,657 825 97 60 12 671 Arkansas........... 6 1,194 1,154 1 66 15 97 Louisiana.......... 8 129 121 9 8 11 3 86 Oklahoma............ 1 234 1,058 12 11 10 1 137 Texas.............. 87 30,478 71,324 803 12 24 8 351 MOUNTAIN............ 115 20,822 21,287 1,566 16 1 33 95 Montana............. 7 3,901 4,059 23 4 1 5 Idaho............... 10 2,995 2,181 84 - Wyoming............ 2 873 285 23 4 1 - Colorado........... 32 5,989 3,393 760 1 9 New Mexico.......... 3 691 1,116 429 1 13 21 Arizona............ 56 1,507 6,760 109 14 57 Utah............... 5 4,641 2,480 138 8 1 2 Nevada............. 225 1,013 2 I PACIFIC.............. 145 28,957 65,980 1,413 14 1 73 240 Washington.......... 41 7,535 20,954 421 7 8 Oregon............. 22 3,469 8,944 29 5 8 9 California......... 80 13,694 34,070 851 9 1 57 221 Alaska.............. 2 207 1,152 26 2 Hawaii............. 4,052 860 86 1 - Puerto Rico 46 2,872 7,273 3 1 16 14 Morbidity and Mortality WeeklN Report Week No. Table 4. DEATHS IN 122 UNIT STATES CITIESS FOR WFII-K IND ) )1D IIt MHIIR 1, 1965 50 (By place of occurrence and week of filing certificate. Excludes fetal deaths) All tC.,""'- Pmunu .nl.n Under All tauc. r%.. i ,,nt, I'. r Area All 65 years and 1 year Area All 65 years and year and over Influenza All Ages and over Influenza All All Ages Causes nd All Ages Causes 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.---- Haterbury, 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.------- Trcnton, 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, 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.-------- 807 276 39 35 28 46 39 18 37 64 78 18 50 31 48 3,429 51 39 171 47 44 40 64 93 1,768 42 526 190 48 91 26 34 54 46 21 34 2,577 69 39 796 107 211 121 69 368 52 49 43 22 57 166 21 108 43 24 41 116 55 799 61 16 39 149 26 104 73 237 60 34 524 178 25 26 16 26 26 12 28 36 49 11 33 22 36 2,008 29 22 99 28 25 22 40 49 1,047 27 283 114 30 56 13 20 39 26 14 25 1,443 35 22 433 69 124 68 39 197 38 25 22 8 33 88 15 70 19 10 25 69 34 468 39 10 18 90 13 62 46 142 35 13 *Estimate based on average percent of divisional total. 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.---------- 1,103 139 243 46 62 66 58 68 37 76 71 195 42 676 124 60 49 130 127 48 30 108 1,193 32 38 35 168 46 74 228 65 176 82 132 59 58 416 46 18 126 18 81 20 59 48 1,608 24 48 32 43 66 621 8 36 116 81 91 174 39 120 64 45 Total 12,608 7,173 587 7 Cumulative Totals including reported corrections for previous weeks All Causes, All Ages ------------------------- 615,545 All Causes, Age 65 and over------------------- 347,646 Pneumonia and Influenza, All Ages------------- 24,907 All Causes, Under 1 Year of Age--------------- 36,232 " " Morbidity and Mortality Weekly Report BOTULISM FULLERTON, CALIFORNIA (Continued from page 427) neutralized by type A antitoxin and cultures of Clos- tridium botulinum type A were obtained from specimens of the salad. The quantity of toxin in the portions of salad examined varied from 2,500 to 25,000 MLD's per gram. Specimens of serum obtained from the two patients were examined at the Hooper Foundation and the CDC Laboratory and were not toxic when injected intra- peritoneally into mice. Eight out of the 18 jars of canned fish examined at the latter two laboratories were found to contain toxin neutralized by type A antitoxin and these eight also yielded cultures of Clostridium botulinum. The contents of seven of the contaminated jars had a putrid odor and were of mushy consistency; the contents of the eighth contaminated jar were of normal odor and appearance. The remaining 10 jars were of normal appearance and yielded neither toxin nor a culture of organisms. In one of the eight contaminated jars examined for toxin at CDC there were 250,000 MLD's of toxin per gram. Frozen fillets of the albacore were examined for toxin only at the CDC Laboratory, with negative results. (Reported by the California State Health Department Laboratory, the Hooper Foundation and the Laboratory Branch of CDC.) MEASLES IN RHODE ISLAND FROM 1961 1965 Morbidity and mortality from measles from 1961 to 1965 are line listed below: 1961 1962 1963 Reported Cases 7,118 3,184 1,378 Encephalitis 9 4 7 Deaths 2 2 1 in Rhode Island 1964 1965* 2,610 3,952 2 5 0 0 *1965 figures include January through November 27, 1965. It has been estimated that 15 percent of all children with measles experience one or more complications; these include encephalitis, pneumonia, bronchitis, otitis media, corneal ulcers, and myocarditis. From January 1964 to June 1965, at least 181 Rhode Island children were hospitalized because of measles and its complications, with an average hospital stay of 9.5 da.s and at a total cost of over fifty thousand dollars. (Reported by the Division of Epidemiology, Department of Health, Rhode Island.) T-IE MORBIDIT / AND MORTALITY WEEKLY REPORT. WITH A CIRCULA- TION OF 14.000. IS PUBLISHED AT THE COMMUNICABLE DISEASE CENTER ATLNTA. GEORGIA. C-iEF COMMuNICABLE DISEASE CENTER JAME5 L. GODDARD. M.D. C-IEF. EPIDEMIOLOGY BRANCH A.D. LANGMUIR. M.D. ACTINCC CHIEF. STA TISTICS SEC TION IDA L. SHERMAN. M.S. C-IE F. SURVEIL LANCE SECTION D.A. HENDERSON. M.D. EDITOR MWR D.J.M. MACKENZIE. M.B., F.R.C.P.E. IN ADDITION TO T.- E ESTABLISIED PROCEDURES FOR REPORTING MOR6IDITV AND MORTALITY THE COMMUNICABLE DISEASE CENTER WELCOME ACCOUNTS OF I1tTERESTING OUTBREAKS OR CASE IN. VESTIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH OFFICIALS AND WHICH ARE DIRECTLY, RELATED TO THE CONTROL OF COMMINICAEBLE DISEASEC SUCI COMMUNICATIONS SHOULD BE AD- DOESEED TO THE EDITOR MORBIDITY AND MORTALITY WEEKLY REPORT COMMUNICABLE DISEASE CENTER ATLANTA. GEORGIA 30333 NOTE. TE DATA IN THIS REPORT ARE PROVISIONAL AND ARE BASED ON .,EEK.L TELEGRAM TO THE CDC BY THE INDIVIDUAL STATE HEALT.- DEPARTMENTS. T.-E REPORTING WEEK CONCLUDES ON SAT- U DAV. COMPILED DATA ON A NATIONAL BASIS ARE RELEASED ON THE SUCCEEDING FRIDAY. ' DJNIV OF FL LI- - SOCUMENTS DEPT. _U.S DEPOSITORY 432 DECEMBER 18, 1965 o-- o - 3 p n 0 a an o a a . <-* r i" m > $o -4 M Z ZZ a r- m' mn aI- o |
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