Morbidity and mortality

"D ew. /2,y; f/ai7


Morbidity and Mortality



PUBLIC HEALTH SERVICE
U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE


Prepored by lhl


MElrose 4-5131


For release December 1, 1961 Atlanta 22. Georgia v.l. 10, No. 47

Provisional Information on Selected Notifiable Diseases in the United States and on

Deaths in Selected Cities for Week Ended November 26, 1961
Acute Respiratory Disease To dace there have In the last 3 wee a number of respiratory disease
been no confirmed outbreaks of influenza in the United outbreaks have bee la tified along the West Coast of
States. However, an outbreak clinically and epidemi- the United States. n id-November, absentee rates as
logically suggestive of influenza is being investigated in high as 15 and 2 per ent occurred in a number of the
Arizona. Outbreaks of less severe respiratory illnesses schools in the Los les X=e. The disease here was
are causing high school absentee rates on the West Coast. said to be a mild re ,ry illness associated with some
In a number of Indian populations in Northeastern gastrointestinal sym o cases had fever above
Arizona, outbreaks of severe respiratory disease charac- 1010. In the past week, n qj s as high as 50 per-
terized by fever, muscle aches, malaise, cough, and sore cent have been reported in f Oregon schools.
throat have been occurring since the beginning of Novem- Mild upper respiratory illnesses and gastrointestinal dis-
ber. Several communities have been affected and absentee turbances are accounting for the absenteeism. Both ill-
rates at the schools have been in the neighborhood of nesses are mild in nature, with temperatures under 1010.
10 to 15 percent. Laboratory studies are in progress in The students are usually not absent for more than two
this outbreak. days. It is not clear whether the California and Oregon

Table I. Cases of Specified Notifiable Diseases. United States
(Cumulative totals include revised and delayed reports through previous week)

Diease 47th Week Cumulative
(snmath revision of aItermat loal. AppraU -
Lists, 1065) First 47 wyeks Since seascal low veek mlte
Ended Ended se anal
Nov. Nov. edlsa Iedian lao
Weekly incidence low or sporadic 25, 26, itC-- V.-I.-t- point
--- Dta not available t.1 .o. 1o1. ;F- -o
Quantity zero :
tahru----------- ---02 7 ] 7
B em---------- -------...... 5 ]0 *
B eUoga la (dulrant fever)-----66 15 8 9 535 6 74. ?1 3
fDphtria.---------...-.......-05 8 28 42 515 720 7b ob06 J7 *.21 July 1
uO lualitli, Ltre@tlo aL --- -06 19 22 22 1,511 1,727 1,930 1,511 1.727 1,v30 Jan. 1
IpaUtis, latectious, ad
sum--------------O0SM..5 pt. 1,129 889 359 bb,265 35,676 17,48Y 13,56. 9,966 b,.85 Sept. 1
miUrt--------.----- -110117 -L 2 56 66 6 a a
M1---lM---.-...---...... --01 2,183 2,371 2,357 401,998 415.682 4i61,54 16.370 15,59 16c.Vli S=pl. 1
Nmi tl, aup9tlcp------ O pt. 33 49 --- 2,442 2,800 --- 2.,4.' ,*IU80 --- JIn. 1
KenItagI coal La ectila------ 6T7 43 30 48 1,935 1,982 12,19 ..ju -4.. ). Sept. 1
a.Fl l e.lti -------------- 0 19 40 105 1,247 3.065 5.71' 1,144 i,854 36,. Apr. 1
krlytie--...----------0.0,0O0.1 9 3i 77 806 1,137 J.us 7..t 1,7; ; ,6AI. Apr. I
iOfparf Lati------a---- 00. 6 2 17 197 tlb 2.758 .'72 u l1,bV Apr. 1
tuisall-d-----------00. 4 2 II 144 312; 98 126 Jq.' till Apr. 1
P itagaleel----.------)g..I 3 I 61 i *
lwes in m---.------- 3 *
ftlepoooel sore throat,
Lahin iau sarlet fher----4 0,051 ts55 5,573 --- 2.<.,~57 ..'2,b6L --- b,.4b ... --- A g.
jpbe d ter----------.....------ 0 10 12 Zu 7I. 155 V77 b.61 6.2 :9? Apr. 1
pPbiu fewr, aite .-.-------101. I A Jl b 1 *
ulesa alml s. .......-.-- 6 JO) 65 I, 11 1, 10. I 6 b 311 tO L .


^m
cckkHH








Morbidity and Mortality Weekly Report


illnesses are related. Field and laboratory studies are
in progress in several areas.

Poliomyelitis There were 19 cases of poliomye-
litis, 9 paralytic, reported for the week ending November
25. For the preceding week, there were 30 cases, 23
paralytic. The 19 cases reported this week represent
the lowest since the 11 cases for the week ending
July 22.

Hepatitis The 1,129 cases of hepatitis reported
for the 47th week are 86 cases less than reported for
the 46th week. This represents 240 more cases than were
reported for the 47th week of 1960. There has been a
slight increase in the number of cases of hepatitis re-
ported in the Middle Atlantic and South Atlantic States.

EPIDEMIOLOGICAL REPORTS
Infectious Hepatitis Alaska Progress Report
From June through September 1961, 103 cases of
infectious hepatitis occurred in the closely associated
Alaskan Indian villages of Hoonah and Excursion Inlet.
The mode of transmission of the disease was thought to
be primarily person to person.
Hoonah is a fishing village with a winter population
of 798 Tlingit Indians. It is situated on an island 40
miles west of Juneau. Excursion Inlet is located 20 miles
away from Hoonah and has a summer population of ap-
proximately 300. About 150 of the inhabitants of Hoonah
work in the salmon factory at Excursion Inlet during the
summers. An initial report on the infectious hepatitis
outbreak occurring there appeared in MMWR, Vol. 10,
No. 34. This report gives further information on the out-
break and describes the results of the gamma globulin
trials.
The time distribution of the cases of hepatitis, 84%
of which were icteric, is shown in the graph below:

HOONAH EXCURSION INLET HEPATITIS EPIDEMIC 1961
IC....., -... o an.. I" l


of

Ceseir


C Cao. whrh c..l...d no imun.
globulnh bacous ol ObhIlnc o1
SC .. i n mni Iha.n 6
a d.y.....n .h..i..drhnu
delr oiler globuhn admlnitrellen
( "gloIbvln foluwre"I


3 17 I IS 29 7 6 9 3
Jv.- Jal T III S s*
(I l i. GI. h.lln Adml ....... -l l


At the height of the epidemic, between August 9 and
August 12, 89% of the susceptible populations of Hoonah
and Excursion Inlet were given immune globulin. Two
hundred and seventeen received 0.06 cc. per pound, 221
received 0.01 cc. per pound, and 204 received 0. 05 cc.
per pound. A total of 80 individuals was absent at the
time of administration of gamma globulin and did nor
receive any globulin. The age distribution of the three
groups who received the different dosages of immune
globulin was approximately the same; however, the in-
dividuals who did not receive gamma globulin fell into
the older age groups. After the administration of immune
globulin, 27 cases of infectious hepatitis occurred.

No. With No. With
Group Number Hepatitis Hepatitis
Within 6 days After 6 days
No. immune globulin 80 5
0.06 cc/lb. globulin 217 5 2
0.01 cc/lb. globulin 221 4 3
0.005 cc/lb. globulin 204 6 2
Hepatitis prior to trial 76 -
Total 798 15 12

Fifteen of these cases occurred within 6 days after
the administration of gamma globulin. The 12 other cases
were distributed as follows: 2 cases, one icteric the
other anicteric, occurred in the group that had received
0.06 cc. per pound of globulin; 3 cases, 2 icteric and one
anicteric, occurred in the group that had received 0.01 cc.
per pound immune globulin; 2 cases, both icteric, occurred
in the group that had received 0.005 cc. per pound immune
globulin; and 5 icteric cases occurred in the 80 individ-
uals who had not received immune globulin. There was
very little difference in the protection afforded by the
different dosages of gamma globulin. Of the 642 individ-
uals who had received gamma globulin, 7 or 1.1% devel-
oped hepatitis. On the other hand, of the 80 individuals
who had received no immune globulin, 5 or 6.2% developed
hepatitis. No cases of hepatitis have appeared in Hoonah
or Excursion Inlet since the 23rd of September.
(Reported by the Alaska Division of Public Health,
Dr. E. O. Wicks, Director, and a team from the Arctic
Health Research Center and the Communicable Disease
Center).


E. coli Diarrhea Washington
Between October 2 and October 26, 1961 isolates of
enteropathic E. coli serotype 0111:B4 were obtained from
12 patients on one pediatric ward in a hospital in the
State of Washington. Three of the patients had severe
diarrhea; in the remainder the severity ranged from mod-
erate diarrhea to none at all. All patients on the ward
were under one year of age; several were premature in-
fants. The ward census ranged from 28 to 36 with a me-
dian census of 32 patients.
(Continued on page 8)









Morbidity and Mortality Weekly Report 3

Table 2. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES, EACH DIVISION AND STATE. AND
PUERTO RICO, FOR WEEKS ENDED NOVEMBER 26. 1960 AND NOVEMBER 25. 1961

(By place of occurrence. Numbers under diseases are category numbers of the Seventh Revislon of the International Lists, 1955)

Poliomyelitis 08C Brucel-
Menlir- losls
7. 1Paralyt c L.;. p,-Oa. l gills, (undu-
fincl.ua_ .:_.._ not "r Eifa -y -caparalyti: aseptic Lant

SCmulatlve, .umula tve, fever)
47th Week first 47 weeks 47th Week first 47 weeks 8 C.2 540 pt. 044


1961 196&: 196 19EC I l Ie :i .- .. i. :

UTD STAS---------- 19 40 1,247 3,065 9 36 806 2,137 6 2 33 15

EW E GLAD------------------ 1 1 36 221 1 25 179 1
Mane---------------------- 1 4 48 -
New Hampshire-------------- 2 -
Ver~lnt--.----------------- 9 11 8 6 -
Massachusetts------------- 1 -I 15 31 9 20 -
Rhode Island--------------- 1 102 1 78 I
Connecticut--------------- 5 35 3 28 -- -
DDIE ATLANTIC-------------- 2 8 330 459 7 219 327 1 1 3
New York------------------- 2 3 243 248 2 155 161 1 1 1
New Jersey---------------- 35 82 28 60 -
Pennsylvania-------------- 5 52 129 5 36 106 2
EAST NORH CENTRAL----------- 8 7 172 523 3 6 106 323 3 8
Chio----------------------- 1 2 47 121 1 21 63 I -
Indiana-------------------- 3 2 21 131 2 2 12 99 1 2 1
Illinois------------------- 1 2 35 143 1 2 18 96 3 1
iehllgan------------------- 3 37 93 1 30 54 2 -
tiieconin------------------ 32 35 25 11 -- 2
WEST NORTH CENTRAL----------- 1 1 73 174 1 33 101 3 9
Minnesota----------------- 6 54 6 44 3 -
ow--------------------- 1 19 22 1 10 4 5
ssourl--.----------------- 24 44 7 2 -
North Dakota--------------- 4 14 1 5 -
South Dakota-----.--------- 3 5 -
Nebraska------------------- 8 16 9 *
Kansas--------------------- 9 19 4 6 --
SOUTH ATIA C---------------. 2 6 213 572 2 6 156 3 1 1
Delaware------------------. 2 -
Myland----------------- 41 150 31 135 -
District of Columbia------- 3 5 1
Virgnia------------------- 1 3 12 47 1 3 12 43 1
Weat Vrginia-------------- 1 32 59 1 22 48 -
North Carolina------------- I 21 91 1 11 68 -
South Carolina------------- 34 129 '26 87
Georgia-----..------------ I 30 24 1 3 2
Florida-------------------- 1 38 67 1 27 45
EAST SOUTH CENTRAL--------- 5 83 247 5 8 1015 -
Kentucky--------------- 7 130 5 5
Tennessee------------------ 4 20 52 4 9 35 !
Alabama--.---..--.------- 11 23 11 .23 -1
Mississippi -------------- 1 25 42 1 23 1
WIST SO CETRAL--.--------- 1 2 151 279 1 2 84 177 -
Arkansas------------------ 1 21 31 31 .'3 -.
Loulians.---------------.. 54 49 .3 Jo -
Oklahoma -------------------- -- 4 17 I
Texa------------..... --------- 2 72 182 2 31 11
MOUIUTAI--------------------- 45 92 6 :7 *
Mantana-------.----.-- ------ 4 ;' 2 1. -
Idaho----------------...-- -- 14 I 1
Wyoaing-------------------- 20 1
Colorado---- ---....-..-.-...-- 8 19 I b
New Mexico----------------- 3 7 I
Arizona----...-.......--...-- 6 -
Utah---------------------- 8 7 :
Nevada---..-- --..----....-... -
PACIFIC----..----.. -----.---- 4 10 144 44: 9 U.'4 I .. /
Washington----------------- 4 2 Jb 2 Iv tb
Oregon-----..----.---------- 17 l : 1 | -
California---------------- 10 93 -1 I 'II hiS 1 1
Alaska-------------------- -
Hawii -.-------------------- -- 5

Puerto Flico------------------ 6 7 41 4 6 I I -









4 Morbidity and Mortality Weekly Report

Table 2. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES, EACH DIVISION AND STATE, AND
PUERTO RICO, FOR WEEKS ENDED NOVEMBER 26, 1960 AND NOVEMBER 25, 1961 Continued

(By place of occurrence. Numbers under diseases are category numbers of the Seventh Revision of the International Lists, 1955)


Diphtheria 055 Hepatitis, infectious, and
Encephalitis, serum 092,N998.5 pt. Heales
infectious
Area Cumulative, Cumulative,
47ch Week first 47 weeks 082 47th Week first 47 weeks 065


1961 1960 1961 1960 1961 1960 1961 1960 1961 1960 1961 1960


UNTIED STATES------ -- 8 28 515 720 19 22 1,129 889 66,265 35,676 2,183 2,371

NEW ENGLAND------------------ 8 12 1 51 40 2,169 1,038 372 194
Maine----------------- 2 7 2 158 70 89 9
New Hampshire-------------- 4 197 30 61
Vermont---------------- 1 9 188 25 4 3
Massachusetts-------------- 7 9 27 11 928 501 198 134
Rhode Island--------------- 4 6 237 196 3 32
Connecticut---------------- 1 8 12 461 216 17 16
MIDDLE ATIAIIC-------------- 20 16 2 6 138 108 8,940 4,408 261 536
New York------------------ 7 4 2 4 65 46 3,858 2,375 144 202
New Jersey----------------- 2 2 42 11 2,122 320 75 90
Pennsylvania-------------- 13 10 31 51 2,960 1,713 42 244
EAST NORTH CENTRAL------ 16 41 3 4 251 180 13,258 6,438 331 697
Ohlo----------------------- 1 16 96 78 4,411 2,226 28 244
Indiana------------------ 2 7 1 28 19 1,941 736 21 35
Illinois-------------------- 10 6 2 1 29 25 2,413 1,387 151 19
Michigan------------------ 3 10 1 2 87 57 4,154 1,868 68 93
Wisconsin------------------ 2 11 1 339 221 63 306
WEST NORTH CENTRAL--------- 1 6 46 56 2 116 69 6,372 2,487 132 87
Minnesota------------------ 1 6 31 32 57 23 1,519 426 19 9
Iowa----------------------- 2 8 23 10 1,838 396 34 2
Missouri------------------- 1 2 18 20 1,375 843 1 15
North Dakota--------------- 4 2 1 4 133 171 48 61
South Dakota--------------- 6 9 3 4 194 145 30
Nebraska------------------ 2 1 6 8 619 254 -
Kansas--------------------- 2 2 8 694 252 UN NN
SOUTH ATIANTIC--------------- 125 209 2 1 195 98 8,475 4,115 159 295
Delaware----------------- 4 11 181 256 3 96
Maryland------------------- 1 1 1 15 12 733 418 26 6
District of Columbia------- 3 5 4 129 58 3 1
Virginia------------------- 15 39 24 8 1,397 724 39 70
West Virginia-------------- 1 4 24 25 1,477 785 42 38
North Carolina------------- 1 11 14 1 73 14 1,988 381 25 50
South Carolina------------ 13 50 29 3 475 149 21
Georgia-------------------- 39 34 1 3 722 257 3 -
Florida----------------- 42 67 1 20 18 1,373 1,087 18 13
EAST SOUTH CENTAL-------- 2 13 41 115 2 3 129 148 9,884 5,064 183 61
Kentucky------------------- 11 9 40 34 51 2,880 1,772 35
Tennessee------------------ 1 3 9 2 60 49 3,885 1,703 134 55
Alabama-------------------- 2 22 33 23 32 1,689 1,100 12 6
Mississippl---------------- 1 7 33 2 1 12 16 1,430 489 2
WEST SOUTH CENTRAL---------- 4 9 239 234 1 4 40 45 4,758 2,730 151 77
Arkansas------------------- 4 16 1 10 10 934 201 14 4
Louisiana------------------- 1 2 29 63 3 9 525 166 1 -
Oklahoma------------------- 9 25 2 322 318 12 1
Texas--- ------------ 3 7 197 130 4 25 26 2,977 2,045 124 72
MOUNTAIN-------------------- 12 36 1 63 66 3,754 2,759 116 170
Montana-------------------- 2 3 4 10 329 156 25
Idaho---------------------- 11 18 13 297 308 5 13
Wyoming------------------- 5 2 3 156 34 35 1
Colorado------------------- 4 3 22 18 1,303 1,001 21 50
New Mexico-------------- 5 4 3 6 308* 302 NN -
Arizona-------------------- 3 4 10 622 602 26 63
Utah---------------- ------ 7 1 4 3 603 257 29 17
Nevada-------------------- 1 6 3 136 99 1
PACIFIC---------------------- 8 1 5 4 146 135 8,655 6,637 478 254
Washington----------------- 2 16 24 991 875 213 63
Oregon- ------------------- 23 10 1,366 1,041 65 94
California----------------- 2 5 4 99 95 5,825 4,416 147 90
Alaska-------------------. 4 1 7 4 405 225 49 6
Hawaii-------------------- 1 2 68 80 4 1

Puerto Rco--------------- 1 1 58 130 7 17 904 701 30 18


*Transmission error Deduct 113 cases for week ending
February 25, 1961.


NM-Noc NOliflable









Morbidity and Mortality Weekly Report 5


Table 2. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES, EACH DIVISION AND STATE. AND
PUERTO RICO, FOR WEEKS ENDED NOVEMBER 26. 1960 AND NOVEMBER 25. 1961 (onrinuJt

(Bt place of occurrence. Ilhbers under diseases are category numbers of the Seventh Revision of the International Lists, 1955)

Strepto-
engoccocal coccal Typhold fever 060 Typhus
Ne.laria Menlngoccocal Psitt.a-
IMnfections costs sore fever, tables in
troat, ndec la ls
Area etc. Cumulative,
110-117 057 096.2 060,051 47th Week first 47 veeke 101

11961 61 1960 1961 1961 19e6 i96.C 1961 :9& 1961 1961 196l

UNIrD aDS--------- 43 30 3 4,855 10 12 755 758 69 30

MIB M B D------------------ 4 244 20 11
ale---------------------- 2 3 1
lew Bampshire------------- 2 2
Vermont-------------------- -
Massachusetts ------------- 1 63 14 5 -
Rhode Island------------- i 41 2 -
Connecticut--------------- 134 3 4 -
MZDIZE ATIAWIC------------ 8 7 1 173 1 92 54 3 9
lew York------------------- 2 1 1 107 51 33 3 9
New Jersey--------------- 2 3 37 1 17 7 -
Pennsylvania--------------- 4 3 29 24 14 -
EAST IORli CETRA.L--------- 12 6 1 498 2 3 100 98 8 1
Ohio---------------------- 3 1 76 2 2 41 29 2 1
Indiana-------------------- 1 I 98 21 24 3 -
Illinols------------------- 2 1 59 29 21 -
Michiwan----------------- 5 3 148 6 16 2 -
isconsin------------------ 1 1 117 I 3 8 -
WMST aW CBNTRAL.-------- 4 1 201 1 35 46 15 6
Minnesota------------------ 2 22 5 1 6 1
---------------------- 36 2 11 2 3
Mi urt-------------------- 1 21 24 3 1
North R ot----------- 1 52 1- -
South Dakota-------------- 2 3 4 2 1
Nebraka------------------ 1 3 2
Kansas--------------------- -- 90 3 2 -
80TH ATUAATIC--------------- 6 3 230 1 2 127 115 5 3
Delaware ------------------ 2 1 1 -
Maryland----------------- 8 1 6
District of Colubia------- 13 9 -
Virginia----------------- 75 20 24 3
West Virginia--------------- 2 I 56 2 10 14
North Carolina------------- 3 2 22 16 9
South Carolna------------- 17 8 12 -
Georgia---------------- --- 36 27 -
Florida------------------- 1 46 19 13 -
EABT SOUTH CETAL--------- 3 817 3 80 117 6 I
Kentucky---------------- 56 2 18 31 3
Tennessee---------------- 724 50 55 3
Alabaa--------------- 3 10 23 1
Mississipp---------------- 27 1 2 -
MBT SOUTH (IETRAL----------- 3 560 2 I 157 202 4. 4
Arkiansas----------------.. 7 31 52 12
Louisiana---------------- 2 3 2 27 5 1
lahm------------------- 7 12 12 -
Texas---------------------- 1 543 1 87 79 II 9
MOU ..r--------...---------- 1 1,081 2 b4 .5
Montam ------------------- 61 2 20 1 -
Idaho----....------------- 83 1 j
Wyoming-------------.--.--- 5. -
Colorado------------------ 261 7 1
w Nexico----------------- 273 17 I: -
Arizona-----------------. 2U1 I1 10 -
Utah----..--------.--------- 6 -
Nevada--------....------ --- I 2 -
PACIEIC-----.--------------. 5 10 1 1,051 I 2 so B o 6 1
Washington-----------...--- 1 Jil .

California--------..--. ---- -- 3 I 596 ? iv l l 6 1
Alaka--*--------------- 1 14 I
avart --i--- ------ -

Puerto Rco----------------- -- ------ 6 22 il







Morbidity and Mrtality Weekly Report


The chart shows the number of deaths reported for
117 major cities of the United States by week for the cur-
rent year, a 5-week moving average of these figures
plotted at the central week, and an adjusted average for
comparison. For each region the adjusted average was
computed as follows: From the total deaths reported each
week for the years 1956-1960, 3 central figures were
selected by eliminating the highest and lowest figure
reported for that week. A 5-week moving average of the
arithmetic mean of the 3 central figures was then com-
puted with adjustment to allow for population growth in
each region. The average value of the regional increases
was 2 percent which was incorporated in the adjusted
average shown in the chart.
Table 4 shows the number of death certificates re-


ceived during the week indicated for deaths that occurred
in selected cities. Figures compiled in this way, by week
of receipt, usually approximate closely the number of
deaths occurring during the week. However, differences
are to be expected because of variations in the interval
between death and receipt of the certificate and because
of incomplete reporting due to holidays or vacations. If a
report is not received from a city in time to be included
in the total for the current week, an estimate is used.
The number of deaths in cities of the same size may
also differ because of variations in the age, race, and sex
composition of the populations and because some cities
are hospital centers serving the surrounding areas. Changes
from year to year in the number of deaths may be due in
part to population increases or decreases.


Table 3. DEATHS IN SELECTED CITIES BY GEOGRAPHIC DIVISION


(By placeof occurrence and weekof filing certificate. Excludes fetal deaths. Data exclude figures shown nparentheses in table 4)

47th 46th Percent47
week week Adjusted aan Ct At 47 eeks
endad nded n averde, adjusted
Nov. Nov. 47th average
25, 18, eek to 1961 1960 e t
1961 1961 1956-60 current ch1619
week

TOTAL, 117 PMO N D CITIES---------------------- 10,539 11,856 11,721 -10.1 535,933 538,193 -0.4

New Enland------------------(------l----( cities) 606 741 689 -12.0 32,981 33,849 -2.6
Middle Atlantic----------------------------(20 cities) 2,954* 3,379 3,158 -6.5 152,187 149,714 +1.7
East North Central------------------------ (21 cities) 2,332* 2,621 2,495 -6.5 114,729 116,604 -1.6
West North Central---------------..----------(9 cities) 736 769 848 -13.2 36,581 37,345 -2.0
South Atlantic-------------------.... ------(11 cities) 846 987 996 -15.1 46,250 46,126 40.3
aet South Central---------------------------(8 cities) 528* 560 542 -2.6 24,272 24,303 -0.1
Vest South Central-------------------------(13 cities) 832* 987 1,087 -23.5 45,704 46,741 -2.2
Mountain---------------------....----------- (8 cities) 325 368 371 -12.4 17,110 16,885 +1.3
Pacific---------------------------------. (13 cities) 1,380 1,444 1,535 -10.1 66,119 66,626 -0.8

*Includes estimate for missing reports.


NUMBER OF DEATHS IN


JAN FEB MAR APR MAY JUN JUL AUG


SEP OCT NOV DEC








Morbidity and Mortality Weekly Report 7


Table 4. DEATHS IN SELECTED CITIES

(Py place of occurrence and veek of filing certilfcate. Excludes fetal deaths I


Area


HEW ENGLAND:
Boston, Mass.--------
Bridgeport, Conn.--------
Cambridge, Mass.-------
Fll River, Mass.-------
Hartford, Conn.---------
Lowell, Mass.-----------
ynn, aasa.--------------
Nev Bedford, Msas.-------
New Haven, Conn.-------
Providence, R.I.--------
Somerville, Mas .-----
Springfield, Has -..-----
Waterbury, Conn.--------
Worcester, MasS.---------

MIlM ATLANTIC:
Albany, .Y.---------
Allentown, Pa.------_
Buffalo, N.Y.---------
Cade, n.J.-----------
Elizabeth, N.J.-------
Erie, Pa.------------
Jersey City, l.J.----
leMark, N.J.-----
New York City, N.Y.------
Paterson, l.J.-----
Philadelphia, Pa.------
Pittsburgh, Pa.------
Reading, Pa.---------
Rochester, N.Y.---------
Schectady, N.Y.-------
Scranton, Pa.-----
Syracuse, .Y.---------
Trento, n.J.-----
Utica, .Y-.------------
Yankers, .Y.-----------

EAST MOI CENTRAL :
Akron, C io--------------
Canton, ilo-------------
Chicago, Ill.-----------
Cincinnati, Ohio---------
Cleveland, alo--------
Columabu, Ohio-----------
Dayton, Ohlo-------------
Detroit, MNch.----------
Evansville, Lnd.--------
Flint, ich.------------
mrt Wayne, Lad.---------
Gary, Ind.---------------
Grand Rapids, Mich.------
Indianapolis, Ind.-------
Madison, Wis.--------
Milwaukee, Wla.---------
Peoria, III.-------------
Rockford, Ill.----------
South Bend, Ind.--------
Toledo, Ohlo-------------
Toungstoan, Ohio--------

WEST NMORM C(l1TRAL:
Des Moines, lven---------
Duluth, iLnn.-------------
KaAns City, KaI.-------
Kausa City, to.---------
Lincoln, Nebr.----------
Miineapolia, Klin .-------
Cua, Nbbr.------------


47th
week
ended
Nov.
25,
1961



194
38
27
22
53
10
29
19
27
68
13
39
22
45


43
32
123
47
18
34
61
89*
1,548
37
461
151
19
97
25
32
60
29
23
25


47
35
698
148
152
117
68*
332
39
43
33
30*
45
149
27
122
30
27
27
102
61


56
16
36
158
(26)
105
48


46th
week
ended
Nov.
18,
1961



256
55
24
35
46
38
25
27
33
64
13
48
20
57


54
30
149
37
37
34
95
101
1,674
43
512
233
21
107
23
36
86
43
32
32


57
38
817
189
225
144
75
350
38
40
36
27
50
126
43
103
40
35
34
96
58


55
21
33
112
(28)
116
73


Cumulative,
first 47 weeks


1961


11,310
1,831
1,365
1,295
2,288
1,160
1,030
1,209
2,094
2,923
613
2,069
1,231
2,563


2,173
1,599
6,789
1,978
1,389
1,817
3,236
4,737
77,727
1,824
23,637
8,902
1,090
4,756
1,135
1,650
2,891
2,085
1,332
1,440


2,675
1,484
34,743
71,334
9,470
5,371
3,723
15,569
1,696
1,993
1,777
1,436
2,123
6,689
1,554
5,748
1,3J7
1,334
1,337
4,618
2,718


2.524
1,199
1,74 b
6.013
(1305j
(I3230
3.130


19.C


11,777.
1,926
1,432
1,320
2,304
1,115
1,139
1,164
2,087
3,002
625
2,118
1,300
2,543


2,035
1,638
6,738
1,991
1,375
1,810
3,325
4,530
76,512
1,795
22,729
8,958
1,107
4,728
1,091
1,784
2,933
1,909
1,271
1,455


2,653
1,628
35,968
7,349
9,895
5,554
3.555
15,763
1.745
1,884
1,719
1,428
1,928
6,771
1.529
5,837
1,411
1,347
1,372
4,680
2,588


2,573
1.183
1.651
5.a34
(1.215)
5,1.5
3,436


Area


47th
veek
ended
Nov.
25
1" I


46th Cunrula.ve,
reek
eded first 47 weeks
ended
Nov.

. 1
i9C. At..


-I. 4 I


WEST NORT CENTRAL-Con..
St. Louis, Mo.--------
St. Paul, Minn.---------
Vichita, Kans.---------

SOUTH ATLANTIC:
Atlanta, Ga.------------
Baltimore, d .----------
Charlotte, N.C.--- ---
Jacksonvllle, Fla.------
Miami, Fla.-------------
Norfolk, Va.-------------
Richmond, Va.------------
Savannah, Ga.------------
St. Petersburg, FIa.-----
Tampa, a.-------------
Washington, D.C.--------
Wilmington, Del.---------

EAST SOUT5 CENTRAL:
Jirmlnnghf, Ala.---------
Chattanooga, Tenn.-------
Knoxville, Tenn.---------
Lulsville, 1y.--------
Memphis, Tenn.-----
Mobile, Ala.------------
Montgomery, Ala.--------
Hashville, Tenn.--------

WEST SOUTH CENTRAL:
Austin, Tex.------------
Batan Rouge, La.---------
Corpus Christl, Tex.-----
Dallas, Tex.------------
El Paso, Tex.------------
Fort Worth. Tex.---------
Houston, Tex .----------
Little Rock, Ar .--------
New Orleans, La.---------
Oklahoma City, Okla.----
San Antonio, Tex.--------
Shreveport, La.----------
Tulas, Okla.-------------

MOWUTAIN:
Albuquerque, N. Nex.-----
Colorado Springs, Culo.--
Denver, Colo.-----------
Ogden, Utah----------
Phoenli, Arlz.----------.
Pueblo, Colo.-----------
Salt Lake City, Utah-----
Tu"son, Ariz.------------

PACIFIC.
Berkeley, Cali.--------
Presno, Calif.----------
Glendale, Calif.--------
Honululu, tHkwli--------
Lma b ha, Cali .------
Las Angeles, Calif.------
Oasland, Calir.---------
Pasadena, LCar.---------
Portland, Ore.---------
Secrualto, Calif.----- ,
San Diegu, Calir .------
S Sa FranclcC', CalIf.---
San JLs., Calf .---------
Seattlie, Uah.-----------
SpokuE "ah.----------

tcB. t. h.--------------.
ai. -- !.. 1. I-.--..-.-. .....--


198
60
59


85
218
26
49
56
38
83
23
(67)
57
188
23


94
27
29*
96
155
37
18
72


16
23*
17
117
34
51
108
51
149
57
104
60
45


20
17
106
22
6H
14 ,
43
35



(42)
(2.21

(.0



16
II I



44

1)
l14

1J5 I

(44


120
225
20
66
94
4.
89
26
(51)
55
206
42


89
40
40
121
119
38
39
74


33
23
27
125
37
72
168
39
198
89
95
49
32


47
4
I00
80
17
51



I:
J71


6'.
b4
1.i
b I
]?
11%,
61
103
It- "


61

(2)


1l) 786
3 *1 o7
(.*,.231 (;,0,7)

I, ., 1,921


1,uIt, 4..5




.l070 l .;:1
Ll.7)?) (1,a ')
6.113 6.388
:, L tl :,2.3
1, 'Il 1,43
1, rs) 1, 9"
li


11,02.
3,088
2,200


5,311
11,465
1,68-.
2,706
3,529
2,317
3,643
1,516
(3,136)
3,035
9, 196
1,848


4,012
2,171
1,310
5,295
5,318
1,881
1,505
2,780


1,568
1,313
1,031
5,828
1.637
3,021
7,676
2,627
7,875
3,454
4,746
2,361
2,5-7


1,485
768
%.184
7YB
3,8.26
7S8
2.255
1.IY


11.413
3.2W0
3,240
2,170


5,506
11,744
1,801
2,760
3,348
1,863
3,661
1,577
(3.283)
3,058
9,031
1,777


3.952
2,211
1,310
5,304
5,204
1,942
1,601
2.779


1,568
1,340
1,085
5,822
1,7ab
3,097
2,666
2,666
8,348

4,658
2,528
2,550


1,4V2
783
5,581
7?3
1,554
:06
:, 266
1.665


*Eatiute based an average perceaage of divisamal total.

() Figures shown is par nmaLis are from cities which be
been reporting less thana lee yars and haam ar nsot La-
cluded in Table 3.





3 '12Z I


Morbidity and Mortality Weekly Report


In the following table, data on the 12 infected pa-
tients are given for age, sex, date of admission to hospi-
tal, date of onset of diarrhea (or date of positive stool
specimen if no diarrhea occurred), and admitting diagnosis:

Diarrhea
Date or
Age Sex Admitted Culture Admission Diagnosis
1. 6 wks. M 10/4/61 10/2/61 Dehydration and diarrhea
2. 4 mo. M 10/20/61 10/14/61 Vamiting and diarrhea
3. 2 mo. M 10/12/61 10/17/61 Galactosemia
4. 3 mo. M 10/11/61 10/18/61 Croup
5. 6 wks. M 9/21/61 10/22/61 Neurologic problems
6. 3 wks. M 10/9/61 10/22/61 Trachea-esophageal fistula
7. 5 mo. F 10/20/61 10/23/61 Fibrocystic disease
8. 3 mo. M 9/5/61 10/24/61 Meningocele
9. 2 mo. F 9/13/61 10/24/61 Encephalocoele
10. 3 mo. M 10/21/61 10/24/61 Vomiting
11. 3YH mo. M 10/21/61 10/26/61 Atelectasis
12. 2 mo. M 9/25/61 10/26/61 Premature


An additional infant with coarctation of the aorta and
and recurring cardiac failure was discharged from this
ward on October 2, 1961 and admitted to another hospital
the following day. Diarrhea began on October 6 and entero-
pathic E. colt, serotype 0111:B4 were isolated from the
stool. This child died.
On October 23 the ward was closed to new admis-
sions, and all patients were started on Neomycin 0.1 gm.
per kilogram of body weight every 24 hours. Treatment
was given for 7 to 10 days. By November 7th 10 patients
remained on the ward and Neomycin was discontinued.
Reculturing of the patients on November 10 revealed two
positive isolations for 0111:B4. These two cases were
restarted on Neomycin and on November 13 transferred to
a ward of older children. The ward rooms were cleaned
and repainted prior to the reopening of the ward to new
patients.

During the calendar year of 1960, 30 enteropathic
E. coli isolations were made in the Seattle-King County
Department of Public Health. Through October 31, 1961
there were 26 isolations implicating 7 different serotypes.


Serotype Number of violations
0125:815 1
026:56 5
0119:B14 3
055:B5 2
0127:B8 1
0111:B4 12 (9 hospital outbreak)
0126:B16 2
26 (25 Patients)


One of the patients from whom serotype 0126:B16 was
isolated yielded 0111:B4 on follow-up examination. All
of these patients were less than 2 years of age except
one, a physician whose diarrhea began while traveling in
Mexico and from whom the serotype, 0127:B8, was ob-
tained. These isolations were made throughout the year.


Twelve of the 25 patients were reported from physicians'
offices rather than hospitals.
(Reported by Dr. Donald R. Peterson, Director, Division
of Epidemiology and Communicable Disease Control of
Seattle-King County Health Department; and Dr. Ernest A.
Ager, Head Communicable Disease Control, State of
Washington Department of Health.)



FOR SOURCE AND NATURE OF MORBIDITY DATA
SEE LAST WEEK'S
MORBIDITY AND MORTALITY WEEKLY REPORT


UNIV OF FL LIB
DOCUMENTS DEPT.





U.S DEPOSITORS


JiS-
ii C

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0
IN i -n

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