NATIONAL COMMUNICABLE DISEASE CENTER — Vol. 19, No. 10 1 WEEKLY W w m § b i I \ g For K m Weeli Endin9 ^ faar$7W, 197 ft c m U-s- DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE / PUBLIC HEALTH SERVICE ^HEALTH sáfÍÁáeVftljD DATE OF RELEASE: MARCH 20, 1970 - ATLANTA, GEORGIA 30333 30333 ADMINISTRATION EPIDEMIOLOGIC NOTES AND REPORTS AN OUTBREAK OF HEPATITIS - Chicago, Illinois Between Aug. 20, 1969, and Jan. 30, 1970, a total of 39 cases of infectious hepatitis occurred among 250 residents al an interdenominational, missionary cooperative community "ho live and work in a west Chicago, primarily Negro, area. Most of the cases (32 of 39) occurred between mid-October an(i mid-January (Figure 1). 'n the first half of 1968, an outbreak of 24 cases of 'nfectious hepatitis had occurred among this same mission- ar' c°mmunity. Except for the number of cases, the charac- terist>cs of the current outbreak were practically identical ♦ L _ l° th rates e ones in 1968: generally uniform age-specific attack among missionary community personnel, ages 1-35 years (Table 1); attack rates twice as high among those who sPent greater than 5 hours per day working or attending Scho°l in the surrounding disadvantaged area as opposed to CONTENTS Epidemiologic Notes and Reports An Outbreak of Hepatitis — Chicago, Illin o is ..................... ..... 101 Transfusion Malaria — Pennsylvania ...................................... ..... 102 Arbovirus Isolations — New York 1969 ................................ ..... 103 Summary of Reported Cases of Infectious Syphilis ............... ..... 103 International Notes Animal Rabies — England ........................................................... ..... 104 Dysentery — El Salvador ........................................................... ..... 104 Influenza — Worldwide 1969-70 ............................................... ..... 105 Influenza — Guatemala 1969 ..................................................... ..... 107 Quarantine Measures .................................................................... ..... 107 those who had no direct contact with it and who worked primarily within the mission; a pattern of spread in which a few index patients were identified who then transmitted the disease to family members or close friends (all the index patients had close daily contact with the disadvantaged (Continued on page 102) TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES (Cumulative totals include revised and delayed reports through previous weeks) DISEASE Patiti« Patiiis’ v!alar¡a MX®. (ru|H;oía) Post-infectious serum............. infectious total CivUtan°CCal infl'cti°ns. total MumPs ' • • • & eliUs‘. i^heiia Ip ................................................... I etanus ('rman measles) ............................. Tvihremia.................................................... ■Silt's i„‘i:k:borne (Rky. Mt. spotted fever) -jtniniaU 10th WEEK ENDED March 14, 1970 28 2- 5 11 5 133 1,046 58 1,377 59 59 2,889 1.902 3 2 56 March ! 1969 25 1 23 3 101 993 25 557 77 72 5 2,442 1,542 2 1 2 MEDIAN 1965 - 1969 25 4 2 22 12 901 25 2.788 91 77 10 CUMULATIVE, FIRST 10 WEEKS 1970 285 24 83 190 65 1,219 10,864 661 10,362 664 636 28 25,502 1 1 13,047 15 12 44 1969 293 17 22 200 41 982 8,809 442 4,297 800 749 51 22,282 1 1 7,638 18 22 38 1 ___ MEDIAN 1965 - 1969 274 36 28 217 106 8,187 387 21,673 808 748 60 2 2 20 23 52 6 ___ 111. TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY elayed rePorts: Typhus, Cum. 1 1 19 9 Psittacosis: Calif.-l ................................................. Rabies in Man: .............................................................. Rubella congenital syndrome: Alaska-1, Calif.-l Trichinosis: Ind.-l ................................................... Typhus, murine: * ............................................................ Cum. 15 12 1 murine: La. delete 1 (1969)
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N A TIO N A L COM M UNICABLE DISEASE CENTER— Vol. 19, No. 10
1 WEEKLYW w m § b i
I \ g For
K m W e e li E n d in 9 ^ f a a r $ 7 W , 197
f t c m
U-s- DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE / PUBLIC HEALTH SERVICE ^HEALTH sáfÍÁáeVftljD
D A T E O F R E L E A S E : M A R C H 20, 1970 - A T L A N T A , G E O R G I A 303 3 3 30333
ADMINISTRATION
E P I D E M I O L O G I C N O T E S A N D R E P O R T S
AN OUTBREAK OF HEPATITIS - Chicago, I llin o is
Between Aug. 20, 1969, and Jan. 30, 1970, a total of 39
cases of infectious hepatitis occurred among 250 residents
al an interdenominational, missionary cooperative community
"ho live and work in a west Chicago, primarily Negro, area.
Most of the cases (32 of 39) occurred between mid-October
an(i mid-January (Figure 1).
'n the first half of 1968, an outbreak of 24 cases of
'nfectious hepatitis had occurred among this same mission-
ar' c°mmunity. Except for the number of cases, the charac-
terist>cs of the current outbreak were practically identical♦ L _l° th
ratese ones in 1968: generally uniform age-specific attack
among missionary community personnel, ages 1-35
years (Table 1); attack rates twice as high among those who
sPent greater than 5 hours per day working or attending
Scho°l in the surrounding disadvantaged area as opposed to
CONTENTS
Epidemiologic Notes and Reports
An Outbreak of Hepatitis — Chicago, I l l i n o is ..........................101
those who had no direct contact with it and who worked
primarily within the mission; a pattern of spread in which a
few index patients were identified who then transmitted the
disease to family members or close friends (all the index
patients had close daily contact with the disadvantaged
(Continued on page 102)
T A B L E I. CASES OF S P E C IF IE D N O T I F IA B L E DISEASES: U N I T E D S T A TE S(Cumulative totals include revised and delayed reports through previous weeks)
DISEASE
Patiti«Patiiis’
v!alar¡a
M X ® . (ru|H;oía)
Post-infectiousserum.............infectious
total
CivUtan°CCal infl'cti°ns. total
MumPs ' • • •
& eliU s‘.
i^heiia Ip ...................................................I etanus ('rman measles) .............................
T A B L E II . N O T I F IA B L E DISEASES O F LOW F R E Q U E N C Y
elayedrePorts: Typhus,
Cum.
1
1
199
Psittacosis: Calif.- l .................................................Rabies in Man: ..............................................................Rubella congenital syndrome: Alaska-1, Calif.- l
N° r th D ako ta ............................ 0 1 1 1 1 2South D ako ta ............................ 0 5 2N ebraska .. . 2 - 5 3 U. S. TOTAL................................ 1,699 1,555 3,314 3,093
M aryland__ 45 39 95 85P a t r i o t o f C o lum b ia .......... 34 34 72 78V ir g in ia ..................... 14 17 39 42" « t V ir g in ia ............... 2 1 5 1" ° r th C a ro l in a ....................... 51 44 100 85 Note: Cum u lative T o ta ls in c lu d e re v ised and de layed re p o rtsSouth C a ro l in a ....................... 27 52 61 114 through p rev ious months.
F lo r id a138 93 214 169
94 151 211 267
104 Morbidity and Mortality Weekly Report MARCH 14, 1970
I N T E R N A T I O N A L N O T E S
ANIMAL RABIES - England
On March 1, 1970, rabies was diagnosed in a 3-year-
old mongrel bitch that had died in New Market, England, on
February 27. She first became ill on February 20 and when
rabies was suspected on February 25, was placed in iso
lation. The dog had been imported on May 30, 1969, from
Pakistan, where she had received antirabies vaccine. On
Nov. 30, 1969, she had been released from an approved
kennel in Essex after completing the 6-month quarantine
period, then in effect. No case of rabies had occurred at
the quarantine station while the dog was there, and she
had no known contact with any of the three imported dogs
that developed rabies (1) during or after quarantine in the
United Kingdom during 1969 (MMVYR, Vol. 18, No. 44).
Another dog, imported and quarantined with the in
fected dog and owned by the same person, has been placed
under detention. Investigation is underway to detect any
other possible contacts.
After the recent case was confirmed, the British Minis
try of Agriculture’s Division of Animal Health took the
following actions: (1) An independent committee of inquiry
was appointed to review' the policy and precautions against
rabies in Great Britain and to make recommendations; (2)
The period of quarantine for dogs and cats already in
Great Britain w’as extended from 8 to 12 months, effective
March 12; and (3) an announcement was made that, as soon
as possible, an order to prohibit the importation into Great
Britain of all canine and feline animals (including exotic
canine and feline animals for exhibition) except from North
ern Ireland, the Irish Republic, the Channel Islands, and
the Isle of Man would be forthcoming. The second and third
measures will be reviewed by the Division when the com
mittee of inquiry has made its report.
(Reported by the Animal Health Division, Ministry of Agri
culture, Fisheries and Food, United Kingdom; and the
Medical Officer, Foreign Quarantine Program, London.)
E ditoria l Comment:Dogs from certain designated rabies-free areas are
exempt from rabies vaccination as a condition of entry ¡nt-°
the United States. This case of rabies in an imported dog
does not change the status of the United Kingdom as a
rabies-free area, and no additional entry requirements will
be placed on dogs imported from this area.
Reference: ,(1) World Health Organization Weekly Epidemiological Recor >
U ( 47):637, Nov. 21, 1969.
DYSENTERY
During July and August 1969, a marked increase in re
ported cases of severe dysentery was noted in El Salvador.
The initial areas affected were the Department of Chala-
tenango, which borders Honduras to the north and where
during this time the effects of a border dispute had created
a large refugee population, and the Department of Ahuacha-
pan, which is contiguous with Guatemala to the northwest
and where a known epidemic of dysentery due to Shigella
dysenteri'ae type 1 was occurring (MMVVR, Vol. 19, No. 7)
(Figure 2). Subsequently cases of severe dysentery devel
oped among residents of all 14 departments of El Salvador,
with the general pattern of spread being from north to south
along main routes of commerce. An initial peak in cases in
El Salvador was observed in October, 3 months after the
July peak in Guatemala; however, a greater upsurge in 3
cases occurred in El Salvador in January 1970 (Figure 3).
Available age-specific attack rates indicated infants
to be at greatest risk to disease. The attack rate among
children w'as similar to that for adults. As in Guatemala,
initial confusion as to the etiology of the epidemic led to
high mortality rates when only anti amebic therapy was used.
The case-fatality rate, however, diminished when adequate
antibiotic and fluid therapy was used.
Strains of S. dysenteriae type 1 from El Salvador have
shown identical antibiotic sensitivity patterns with the
strains from the Guatemalan epidemic. The organisms w'ere
resistant to the commonly used sulfa drugs, tetracycline,
- El Salvador
F ig u re 3R E P O R T E D C L I N I C A L C A S E S O F D Y S E N T E R Y
m a r c h 1 4 , 1 9 7 0 Morbidity and Mortality Weekly Report 105
F ig u re 2 E L S A L V A D O R
I . AHUACHAPAN
2 . SANTA ANA3 . S0NS0NATE4 CHALATENANGO
5 LA LIBERTAD6 SAN SALVADOR
7 . CUSCATLAN8 . LA PAZ
9 . CABANAS10. SAN VICENTE
11 • USULUTAN
12. SAN MIGUEL
■3. MORAZAN >4 . LA UNION
^°ramphenicol, streptomycin, and novobiocin. They were
•'c'n, colistin, cephalosporin, and naladixic acid and
°derately sensitive to penicillin.
To date, the mode of transmission in El Salvador has
been identified; in Guatemala, contaminated water
a prominent role in some community outbreaks and
m ther areas, person-to-person spread was the predominant
6 °f spread. An extensive system of continued sur-
ance is underway in El Salvador. Daily and weekly
reports of morbidity and mortality due to dysentery are
forwarded to the Ministry of Health from governmental
health units which cover approximately 85 percent of the
population. In addition, fecal specimens are sent to the
Central Laboratory for bacteriologic identification.
(Reported by Dr. Eduardo Navarro, Chief of Epidemiology,
and Dr. Roberto Masferrer, Chief, Central Laboratory,
Ministry of Public Health and Social Assistance, San
Salvador, E l Salvador; Dr. Max Block, Chief, Central Lab
oratory Rosales Hospital; and an EIS Officer.)
INFLUENZA - Worldwide 1969-70
T Lvir current epidemic of A2/Hong Kong-like influenza
tho " aS ^'rst; recognized in July 1968 in Hong Kong and
spread rapidly throughout Southeast Asia and caused
Wjn(aj0r epidemic in the United States during the fall and
c r 1968-69. Although localized outbreaks were re-
th<> *n most areas of Europe during the winter of 1968-69,
d aCtiYity t*lere no approach that in theof i° ®ta es- Subsequently, during the winter and spring
a > a number of outbreaks were reported from South m®rica A c .
ai Arrica, Australia, and Southeast Asia.
So, n a" an(l winter of 1969-70, the current influenza Son th
and •’ v>rus reappeared in Europe and Northern Asia
Cont S tltne causes epidemics of major proportions. In
^ ^he United States noted only modest increases
\vas cxP°cted levels. During this period, influenza activity
Sq.i,,a*S° documented in the Middle East, Northern Africa, uihern a
••Asia and the Pacific, and other North American
countries. In all, between June 1969 and March 1970, 41
countries reported outbreaks to the World Health Organi
zation (Table 2).
The vast majority of these countries reported outbreaks
in December 1969 and January 1970, with earlier reports
coming primarily from the southern hemisphere. Of the 41
countries, 32 had experience with A2/Hong Ko:ig/68-like
virus; five others had primarily A2/Hong Kong activity with
some influenza B involvement. In Argentina, there appeared
to be two distinct waves of influenza, the first caused by
A2/Hong Kong/68-like influenza virus and the second by
B/Massachusetts/66 influenza virus. Israel reported an
initial outbreak due to influenza B followed by a more
widespread outbreak of A2/Hong Kong-like virus. Two
countries, Romania and Bulgaria, reported the primary agent
to be influenza B, and both of them reported isolated
(Continued on page 106)
106 Morbidity and Mortality Weekly Report MARCH 14, 197°
INFLUENZA - (Continued from page 105)
cases and outbreaks of A2/Hong Kong-like influenza virus
later in the year, which were less extensive than the initial
countrywide outbreaks of influenza B. In most countries,
the outbreaks were described as clinically mild, though
Tab le 2 In f luenza, June 1969
respiratory mortality was generally elevated. All aSe
groups seemed affected in most of the countries reporting-
(Compiled from the World Health Organization Weekly EP1
demiological Record, 44(^6-52), 1969, and 45(1-10), 1S70-)
■ March 1970
Region CountryDate of
Appearance
Date of
Peak ActivityEpidemiologic Data Virus Isolated
Uruguay June 69 Widespread with school absenteeism of up to 50% and industrial absenteeism
of up to 20%.
A2/Hong Kong/6«
South
America
Chile June 69 Primarily involved Santiago and Central Provinces; epidemic proportions in
these areas.
A2/Hong Kong/68
Argentina June 69 July 69 Widespread activity; epidemic lasted about 18 weeks with two waves: the first
caused by A2/Hong Kong virus; the second by B virus.
A2/Hong Kong/68
B/Mass/66 __—
Austral-
Asia
New Zealand June 69 A2/Hong Kong/68,
Aug 69 Primarily reported from Melbourne and Sydney.
New Guinea Sept 69 Sept-Oct 69 Papua Highlands. Severe complications frequent, particularly pneumonia. Over
2,000 deaths reported.
A2/Hong Kong/68,
Kong/68A2/Hong
Spain Nov 69 Involved provinces o f Madrid, Lugo, Navarra, Barcelona, and Valencia. Attack
rates of 15-30%. All age groups affected.
A2/Hong Kong/68
Portugal Nov 69 Widespread throughout the country. A2/Hong K.ong/6*l
Italy Dec 69 Widespread activity. Attack rates estimated 30-40%.
France Nov 69 Dec 69 Widespread activity. All age groups affected.
Yugoslavia Sept 69 Dec 69 Primarily affecting Zagreb, Croatia, Slovenia, and Belgrade.
A2/Hong Kong/68,
Kong/68.
Kong/68,
A2/Hong
A2/Hong
Romania Nov 69 Dec 69 Bucharest first-later other areas. B virus thought to be primarily responsible.
A2/Hong Kong isolated in Jan 70.
B/Mass/66 A2/Hong Kong
UnitedKingdom
Nov 69 Dec 69/Jan 70 Widespread throughout, particularly London and Southeast, Midlands, and Scotland. Marked increase in respiratory mortality.
A2/Hong Kong/68
B/Mass/66
Austria Dec 69 Dec 69 Widespread, particularly affecting Kamten, Vienna, Vorarlberg, Upper and Lower Austria, Burgenland, Styria.______________________________________________
A 2/Hong Kong/68
W. Germany Dec 69 Dec 69
Furope
and
Northern
Asia
Widespread activity, mild or moderately severe with a number o f deaths. 31% attack rate in Hanover based on seroconversion.
A2/Hong Kong/68
Belgium Dec 69 Dec 69 Brussels primarily affected, with a 15% attack rate affecting all age groups. A2/Hong Kong/68,
Bulgaria Oct 69 Dec 69 Sofia affected. All age groups involved. B virus primarily responsible, but later a few isolates o f A2/Hong Kong.________________________________________________
B/Mass/66 R
A2/Hong K o n ^
Greece Dec 69 Dec 69 Clinically mild. 20% attack rate in Athens with all age groups affected.
Denmark Dec 69 Dec 69/Jan 70 Widespread activity. Clinically mild, but occasionally complicated by
pneumonia. Excessive mortality among elderly persons.
A2/Hong Kong/gjt
Kong/68A2/Hong
Finland Dec 69 Dec 69/Jan 70 All areas affected.
Norway
A2/Hong Kong /^t
A2/Hong Kong/68,
Sweden Dec 69 Jan 70 Widespread activity. Clinically mild.
Switzerland Dec 69 Jan 70 Widespread activity.
A2/Hong Kong /^ t
A2/Hong_Kong/6*,
Netherlands Jan 70 Widespread activity.
USSR Dec 69 Central, Northwest, and Eastern Regions involved. Primarily due to A2/Hong
Kong with some B/Rome/66.
Albania Dec 69 Jan 70 Clinically mild. Adults affected primarily.
A2/HongKong/£il
A2/Hong Kong/68
B /Rom e/66____
A2/Hong Kong/£5-
Czechoslovakia Dec 69 Jan 70 Widespread activity. Clinically mild but with some increased mortality. Overall
attack rate approx. 4.7%. Primarily A2/Hong Kong.
Hungary Dec 69 l eb 70 Central, southern, and southwestern areas. Absenteeism in Budapast. Mild to
10T A B L E IV . D E A T H S IN 122 U N IT E D ST A T ES C IT IE S F O R W E E K E N D E D M A R C H 1 4 , 1970
(By p la c e o f o ccu rre nce and week o f f i l i n g c e r t i f i c a t e . E xc ludes f e t a l d e a th s )
All Causes
Area
" ÏH ENGLAND;
®°ston, M ass .-----
r i d g e p o r t , Conn.-
Cambridge, M a s s .~
„ 11 R iv e r , Mass.-
Har t f o r d , C on n .—Lo« e l l , Mass.............
7 nn , M ass.--..........
e« Bed ford , Mass.
ew Haven, Conn.--
r °v id e nce , R. ! . .
^ m e r v i l le , Mass.-
“P r in g f ie ld , Mass.
te rb u ry , C onn .—
Worc e s te r , M a s s .-
ATLANTIC:
A n any> N. Y .-----A U enfovn, P a .—
u f f a lo , N. Y .----
p f"detl. N. j . -----
l * abe th , N. J . —
,r l e, P a ........... .
' rsey C i ty , Nn . .......
p.6“ Y«>< C i ty , N. Y
P M f s°n, N. j.----¡ ^ > ade lPh ia , Pa . . .
R j Sbur8h, P a .----
P a ..............-,
Srh r > N- Y ----Sp ta dy N. y . -
Sv » P a .------y^acuse, n . Y .----
r to n > n - j -..........y a , N. Y .-------
°nkers , N.
J.----
ast noRTh cen tral
¿ t 0 n . O h io ..................
CMt0 n ’ O h io ...............« j ago, i n . .............
C l e v e u T ’ ° h io —ColumK * °h io - — “mbus, Ohlo........
Det- ’ 0 h l° -------E ^ 0 i t > M ic h ............
l i d i a nR a p Id s ' M ich-Madi. p o l i s , I n d . -Mi , tlSon , W is .------
P. aukee, Wis a ° r l a , I ,R°ckf^ j
^Ktord, ti i s°uth D. . u *s . . , “
:« ie d „ e5 ; I n d —
^ ^ M o i n CENTRAL:
Kansas c i í V’ Kans‘Ur,Co, C i t y . M o .~ Hinn„ "■ N e b r .----
° ^ t'aaPN1KS’ M lnn ‘ St Neb r . ------
St! p °u ‘ s . Mo.— .
A l l
Ages
720244
47
2125
43
21 19
31
59
55
21 47
23
64
3,23046
37
135
40
35
40
57
881,609
27
416
218
50
11135
45
107
62
26
46
2 ,746
56
43
778
202
221125
82
348
6658
51
57
51
157
41
137
41
35
37
105
55
867
72
25
37
143
19
11280
246
77
56
25
65 years
and over
Pneumonia
and
In f lu e n z a
A l l Ages
Under
1 year
A l l
Causes
Area
457141
34
13
18
26
1014
26
35
33
1236
14
45
1 ,883 27
27
76
25
20
26
31
39
950
17
223
118
29
74
20
29
69
35
20
28
1 ,548
38
29
408
111 115
70
44
191
49
29
24
30
36
85
2293
28
21 20
65
40
535
48
2216
94
13
77
47
138
46
34
4818
63
1
213
1565
5
3
123
5
4
68
11021
3
7
26 3
3
2 2
97
16
23
107
3
1063
21
3
3
6
2
1
4
2
3
1
38
2
5
1
1
2
4
3
6
6
3613
21
123
3
1
2 1
2
125214
2
24
863
213
10
4
21
4
1 1
1
122
2
1
41
5
6 7
3
16
4
3
2 2
14
5
5
2 1
2
34
3
1
4
7
4
103
2
SOUTH ATLANTIC:
A t la n t a , G a .---------
B a lt im o re , Md. -------
C h a r lo t te , N. C .-----
J a c k s o n v i l le , F l a .--
M iam i, F l a .----------
N o r fo lk , V a .---------
R ichm ond, V a .--------
Savannah , G a .--------
S t . P e te r s b u rg , F la .-
Tampa, F l a . ------------
W ash ing ton , D. C .---
W ilm in g to n , D e l .-----
EAST SOUTH CENTRAL:
B irm ingham , A l a . -----
C h a ttan o o g a , T en n .--
K n o x v i l le , T en n .-----
L o u is v i l l e , K y .------
M emphis, T e n n .-------
M o b ile , A l a .---------
M ontgomery, A l a . -----
N a s h v i l le , T en n .-----
WEST SOUTH CENTRAL:
A u s t in , T ex .------ ---
Baton Rouge, L a .-----
Corpus C h r i s t i , Tex.-
D a l la s , T ex .---------
E l P aso , T e x .--------
F o r t W orth , T ex .-----
Houston , T ex .--------
L i t t l e Rock , A r k .---
New O r le a n s , L a .-----
Oklahoma C i t y , O k la .-
San A n to n io , T ex .---
S h re v e p o r t, L a .------
T u ls a , O k la .---------
MOUNTAIN:
A lb u q ue rq ue , N. Mex.-
C o lo rad o S p r in g s , C o lo .
D enver, C o lo .--------
Ogden, U tah----------
P h o e n ix , A r i z . -------
P u e b lo , C o lo .--------
S a l t Lake C i t y , U tah---
Tucson, A r i z . --------
PACIFIC:
B e rk e le y , C a l i f . -----
F re sn o , C a l i f . -------
G le n d a le , C a l i f . -----
H o n o lu lu , H a w a ii-----
Long Beach , C a l i f . —
Los A n g e le s , C a l i f . ----
O a k land , C a l i f . ------
P asadena , C a l i f . -----
P o r t la n d , O re g .------
S acram en to , C a l i f . ---
San D ie g o , C a l i f . ----
San F ra n c is c o , C a l i f .
San J o s e , C a l i f . -----
S e a t t le , W ash .-------
Spokane , W ash .-------
Tacoma, W ash .--------
T o ta l
Expected Number
C um u la tiv e T o ta l (includes reported corrections
for previous weeks)____________
All Causes
A l l
Ages
1 ,312163
227
77
10196
50
8644
115
85
197
71
723
114
63
58
125 160
59
23
121
1 ,252
43
54
27
217
60
74
20160
145
86 140
46
99
518
39
30
140
19
122
19
71
78
1 ,698
31
56
23
53
97
546
78
55
142
59
109
155
40
155
56
38
13,066
13,178
144,062
65 years
and over
6767b
11134
48
55
27
39
26
85
42
96
37
379
61
40
30
73 78
27
11 59
665
20
33
13
113
33
34
100
30
6648
78
29
68
315
2216
881272
1045
50
1,018
20 24
2030
56
336
50
42
80
37
57
86
21 93
38
28
7,476
7,758
83,614
Pneumonia and
Influenza All Ages
7016
7
2
3
3
7
2
5
4
7
9
5
53
4
9
2
1215
2
3
6
1Ü5
3
6
1
2
1
6
223
3
9
2
5
43
2
1
2
6
102
14
3
4
3
4
581
510
7,287
Under 1 year
All Causes
521U1084
111
12
19
4
45
5
2 3
5 8
7
3
12
60
3
3
9
6
3
11
4
4
5
5
2
5
27
3
3
102
6
1
6 2
5
3
15
2
1
1
113
104
563
506
6 ,237
15
♦Mortality data are being collected from Las Vegas, Nev., for possible inc lus ion in th is
table, however, for s ta tis tica l reasons, these data w ill be listed only and not included in
the total, expected number, or cumulative total, until 5 years of data are collected.
"latebased on average percent of divisional total
112 Morbidity and Mortality Weekly Report MARCH 14, 197°
ERRATA:
Vol. 19, No. 6, p. 62In the article “ Measles - United States, Epidemio
logic Year 1969-70,” Houston, Texas, was erroneously
included as having a major outbreak of measles. It should
be deleted. In addition, the outbreak in New Jersey oc
curred in Burlington County, not Bergen County as stated.
Vol. 19, No. 9, p. 92In the article “ Salmonellosis — Los Angeles, Cali
fornia,” the outbreak occurred on Dec. 13-14, 1969, not
1970 as stated.
Vol. 19, No. 9, p. 95In the article “ Tularemia — United States 1960-1968,”
part of the fourth sentence in the fourth paragraph was
omitted. The correct sentence is as follows: “ The majority
of states east of the Mississippi River, excluding New
England and the Middle Atlantic states, showed a marked
predominance of tularemia in the winter months, particularly
in December.”
T H E M O R B I D I T Y A N D M O R T A L I T Y W E E K L Y R E P O R T , W I T H A C I R C U L A* T I O N O F 2 1 , 0 0 0 I S P U B L I S H E D A T T H E N A T I O N A L C O M M U N I C A B L E D I S E A S E C E N T E R , A T L A N T A , G E O R G I A .
D I R E C T O R , N A T I O N A L C O M M U N I C A B L E D I S E A S E C E N T E RD A V I D J . S E N C E R .
D I R E C T O R , E P I D E M I O L O G Y P R O G R A M A . D . L A N G M U I R . Nl , D'
E D I T O RM A N A G I N G E D I T O R
M I C H A E L B . G R E G G , M- D* P R I S C I L L A B . H O L M A N
I N A D D I T I O N T O T H E E S T A B L I S H E D P R O C E D U R E S F O R R E P O R T ! ! ^ M O R B I D I T Y A N D M O R T A L I T Y , T H E N A T I O N A L C O M M U N I C A B L E D I S E A S t C E N T E R W E L C O M E S A C C O U N T S O F I N T E R E S T I N G O U T B R E A K S O R cI N V E S T I G A T I O N S W H I C H A R E O F C U R R E N T I N T E R E S T T O h E A L . I l O F F I C I A L S A N D W H I C H A R E D I R E C T L Y R E L A T E D T O T H E c O N T „ p O F C O M M U N I C A B L E D I S E A S E S . S U C H C O M M U N I C A T I O N S S H O U L D A D D R E S S E D T O :
N A T I O N A L C O M M U N I C A B L E D I S E A S E C E N T E R A T T N : T H E E D I T O R _
M O R B I D I T Y A N D M O R T A L I T Y W E E K L Y R E P ° r A T L A N T A , G E O R G I A 3 0 3 3 3
N O T E : T H E D A T A I N T H I S R E P O R T A R E P R O V I S I O N A L A N D A * ^ B A S E D O N W E E K L Y T E L E G R A M S T O T H E N C D C B Y T H E I N D I V l D U A S T A T E H E A L T H D E P A R T M E N T S . T H E R E P O R T I N G W E E K C O N C L U D E A T C L O S E O F B U S I N E S S O N F R I D A Y ; C O M P I L E D D A T A O N A N A T I O N * B A S I S A R E O F F I C I A L L Y R E L E A S E D T O T H E P U B L I C O N T H E S U C C E E D I N G F R I D A Y .