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

Transfusion Malaria — Pennsylvania...................................... .....102

Arbovirus Isolations — New York 1969 ................................ .....103

Summary of Reported Cases of Infectious S y ph ilis ....................103

International Notes

Animal Rabies — England........................................................... .....104

Dysentery — El S a lv a d o r ........................................................... .....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)

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) .............................

Tvihremia....................................................

■Silt's i„‘i:k:borne (Rky. Mt. spotted fever)-jtniniaU

10th WEEK ENDED

March 14, 1970

282 -

5

115

1331,046

58 1,377

59 59

2,889

1.9023

2

56

March ! 1969

251

233

101993

2555777725

2,442

1,54221

2

MEDIAN

1965 - 1969

2542

2212

901

252.788

917710

CUMULATIVE, FIRST 10 WEEKS

1970

2852483

19065

1,21910,864

66110,362

664636

2825,502

1

1

13,047151244

1969

29317 22

200

41982

8,809

4424,297

800749

5122,282

1

1

7,63818 22 38

1

___

MEDIAN

1965 - 1969

2743628

217106

8,187

38721,673

808

74860

22

2023526

___ 111.

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

Trichinosis: Ind.-l ...................................................Typhus, murine: * ............................................................

Cum.

1512

1

murine: La. delete 1 (1969)

102 Morbidity and Mortality Weekly Report MARCH 14, 1970

HEPATITIS — (Continued from front page)

Figure 1CASES O F H E P A T IT IS AMONG A MISSIONARY COM M UNITY

CHICAGO, IL L IN O I S - AUG UST 1 969 -FE B R U A R Y 1970

area residents); and a high rate of endemic hepatitis in the

surrounding area.

Because of these characteristics, ail present members

of the missionary community who had not been ill were

treated with immune serum globulin (ISG). As the population

of the missionary group is a mobile one, arrangements were

made to give ISG to new residents who will have close con­

tact with the lower socioeconomic area — either through

work or attending schools. Surveillance for hepatitis in the

group will continue.

T a b le 1H e p a t i t is C a s e s * by A ge, Sex, and A ge — S pec if ic

A tta c k R a te s , a M is s io n a r y C om m u nity C h ic a g o — A u g u st 1 9 6 9 - February 1970

Age

Group(Years)

Population 111 Age — Specif'c

Attack RateS(Percent)Male

Fe­

maleTotal Male

Fe­

maleTotal

<1 2 2 4 0 0 0 0

1-5 18 14 32 5 0 5 15.6

6-10 18 21 39 3 6 9 23.1

11-15 3 3 6 0 1 1 16.7

16-20 4 4 8 0 0 0 0

21-25 26 23 49 6 1 7 14.3

26-30 23 26 49 3 6 9 18.4

31-35 14 19 33 3 4 7 21.2

36-40 8 7 15 0 1 1 6.7

41-45 2 2 4 0 0 0 0

46 + 1 1 2 0 0 0 0___ _

Total 119 122 241 20 19 39 16.2___ .

*Includes both icteric and anicteric cases.

(Reported by Joyce Mathison, M.D., Staff Physician, F'if^

City Community Corporation; Olga Brolnitsky, M.D., Ch

Epidemiologist, Murray C. Brown, Commissioner, Chica9°

Board of Health, and Kenrad Nelson, M .D., Research Epl

demiologist of the Chicago Board of Health at the Munich

Contagious Disease Hospital; Norman Rose, M.D., Chief’

Bureau of Epidemiology, Illinois Department of P ^ lC

Health; and an EIS Officer.)

TRANSFUSION MALARIA - Pennsylvanie

On Nov. 7, 1969, a 28-year-old man experienced a

severe hemorrhage from agastric ulcer. He was hospitalized

and during the next 5 days received 11 units of whole

blood. On November 12 he underwent subtotal gastrectomy

for resection of his ulcer, and during the operation was

given 2 more units of whole blood. On November 29, he had

sudden onset of fever and chills, and Plasmodium falciparum

parasites were seen on peripheral blood smears. The pa­

tient was treated with chloroquine and quinine and made a

complete clinical recovery but relapsed on January 15. He

was then treated with quinine and triple sulfa drugs and

has subsequently remained well. He had been in the U.S.

Army and had served in Germany and France. He denied

ever having had unexplained fever episodes or having used

commonly shared syringes.

All 13 units of blood had been supplied by a blood

bank in Buffalo, New York. The donors were interviewed,

and a serum sample for malarial indirect fluorescent anti­

body titers was obtained from each individual. A 24-year-

old man who had denied overseas military service and

symptoms of malaria at the time he donated blood had, in

f16fact, returned from duty in Vietnam 6 months earlier. p

was the only donor with positive serologies; these titerS

were: P. falciparum 1:256; P. vivax 1:16; and P. mal°r‘ae

1:16. Further attempts to demonstrate parasitemia will be

made by the Erie County Health Department, New Y°r '

(Reported by J. R. Hall, M.D., Meadville City Hosptt^’

Pennsylvania; I. Fred Gratch, M.D., Epidemiologist,

sion of Communicable Diseases, Pennsylvania Departffle

of Health; Michel A. Ibrahim, M.D., Epidemiologist, &r‘e

County Health Department, New York; and James 0. Cul'ver’

M.D., Director, Bureau of Epidemiology, New York

Department of Health.)

Editoria l Comment:This is the second case of transfusion malaria re

ported to the Pennsylvania Department of Health; the firSt

occurred in 1946. (1)

Reference: ^

(1) Public Health Reports, “ Malaria Infection Acquired Thr°u^

Blood Transfusion. Report of a Case.” 61:1,630, Nov> 1946.

Ma r c h 14, 1970 Morbidity and Mortality Weekly Report 1 0 3

ARBOVIRUS ISOLATIONS - New York 1969

In 1969, two infections with California group (CE) virus occurred in New York; both were confirmed by a four­

fold titer rise. Cases occurred in a 6-year-old girl from

Albany County whose symptoms of encephalitis began on

■August 6 and in a 33-year-old farmer from Columbia County

whose only complaint, a severe headache, began on August

14. These were the only two cases of illness serologically

confirmed as due to an arbovirus in New York state in

1969.

On August 28, mosquito collections were made in a

swamp at Tappan Landing, Rockland County. This location

■s one-half mile from the area where the one previous

laboratory confirmed case of CE virus infection in New

^ork had been observed in 1966 (1). These collections

resulted in isolation of a strain of CE virus from a pool of

24 Aedes canadensis mosquitoes. No isolations were made

from 13 other pools containing 183 mosquitoes of genera

Aedes and Culex.

In early fall, an outbreak of encephalitis-like illness

occurred in a pheasant flock at a farm near Walden, Orange

County. A strain of Eastern equine encephalomyelitis

(EEE) virus was isolated from the brain of each of two sick

birds collected on October 17, 9 days after pheasant deaths

were first reported. The farm is within 12 miles of the

location where a strain of EEE virus was isolated from a

pheasant in 1952 (2).

(Reported by Rudolph Deibel, M.D., Director, Virus Lab­

oratories, and Elinor Whitney, Arbovirus Laboratory, Di­

vision of Laboratories and Research, and James 0 . Culver,

M.D., Director, and Thomas Bast, Ph.D., Associate Medi­

cal Entomologist, Bureau of Epidemiology, New York State

Department of Health; and an EIS Officer.)

References:

(1) National Communicable Disease Center, Encephalitis Sur­

veillance Report, 1966 Annual Summary.(2) Beaudette, F .R . et al.: United States Livestock Sanitary

Association, Omaha, Nebraska, 1954. Pp. 309-321.

SUMMARY OF REPORTED CASES OF IN F E C T I0U S SYPHILIS

CASES OF PRIMARY AND SECONDARY SYPHILIS: By R epo rting Areas February 1969 and February 1970 - P ro v is io n a l da ta

R epo rtin g Area February

Cum ulative

J anuary-Feb ruary R epo rtin g Area FebruaryCum u lative

J anuary-Feb ruary

1970 1969 1970 1969 1970 1969 1970 1969

NEW ENGLAND................................ .......... 41 ' 27-

45 80 89 186

Maine.............. _ _ 1 1 4 12 16 39_ _ _ - 17 39 31 70

Vermont.............................. _ _ _ - 14 7 23 3531 14 57 32 10 22 19 42

Rhode I s la n d ........................... 4 3 10 6

C onne c ticu t.............................. 6 10 14 14 324 298 510 536

22 9 37 19

MIDDLE ATLANTIC....................... 411 283 844 595 61 50 97 100

Upstate New York.................. 32 24 65 58 9 2 15 12

New York C i t y ......................... 309 180 630 399 232 237 361 405

Pa* (E x c l. P h i l a . ) .............. 10 20 21 30

18 24 35 30 54 56 96 103

New Je rse y ................................ 42 35 93 78 _ _ 1 -- 1 1 1

East north CENTRAL............... 206 207 445 414 _ 1 — 2

O h io .. . 30 30 67 65 4 8 7 11

In d ia n a ............ 35 29 74 59 14 25 26 43

°ownstate I l l i n o i s ............. 7 25 21 54 27 17 41 40

Chicago......... 63 71 147 137 1

^ c h ig a n ..................... 68 51 125 98 9 4 19 6

W iscons in .................................. 3 1 11 1

155 146 347 310

^ S T NORTH CENTRAL................ 52 25 95 52 4 5 8 7M innesota .................................. 10 1 17 5 3 2 5 10Iowa. . 0 7 1 9 147 139 332 293M issouri. 32 15 50 29

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

16TERRITORIES................................ 113 100 201 167

411 433 806 844111 97 198 156

2 3 3 11

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

°nsitive t0 ampicillin, gentamiein, nitrofurantoin, kana-

•'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

moderate severity. Primarily A2/Hong Kong.

A2/Hong Kong/68

Influenza B

A2/Hong Kong/68

Influenza

A2/Hong Ko ng/6^-

Africa

Senegal Apr 69 Aug/Sept 69 Clinically mild illness.

Algeria Jan 70 , Kong/6®,

Kenya Jan 70 Nairobi primarily affected.

A2/Hong I1____

A2/Hong Kong

A2/Hong Kong

Influenza B____

A 2/Hong

MiddleEast

Southern

Asia

andPacific

Israel Nov 69 Dec 69 Widespread activity. 20-40% school absentee rates. Early outbreak due to

influenza B, but most due to A2/Hong Kong.___________________________________

Dec 69 Beirut only affected area.

Thailand Sept 69 A2/Hong Kong/68.

Japan Nov 69 Areas affected: Tokyo, Kanagawa, Yamanashi, Saitama, Chiba, andTochigi.

Philippines Dec 69 Jan 70

A2/HongKQ|^>

A2/Hong Kong/Ü?-

Fiji Dec 69 Dec 69 Localized outbreak only. .Kong/68.

India Jan 70 Regional outbreaks in several states. Clinically mild.

A 2 /H o n g J_ _

A2/Hong K o n g /^

A2/Hong Ko g g ^

A 2/Hong Kong/68North

America

Mexico Jan 70 Primarily affected Mexico City with high attack rates.

USA Nov 69 Feb 70 45 of 50 states reported activity, but heaviest activity along East Coast,

Southeast, and Pacific Northwest. Modest excess mortality.

Canada Jan 70 Localized outbreaks in New Brunswick, Newfoundland, Nova Scotia,

Saskatchewan, Manitoba.

A2/Hong r

*'ARCH 14, 1970 Morbidity and Mortality Weekly Report 107

INFLUENZA - Guatemala 1969

During the early weeks of 1969, there was an increase

ln the number of reported cases of influenza-like illness in

Guatemala. Reports of cases reached a peak in the 12th

"eok 0f th0 year (week ending March 22, 1969) and then

A lined (Figure 4). Because of the lack of laboratory

ac'ilities, the causative agent could not be identified, but

illnesses were felt to represent A2/Hong Kong/68 in-

uenza virus infection, which was occurring epidemically

ln other countries at the time.

In late July, another rise in the number of reported

Cases of influenza was noted which, after a brief decrease,

c°ntinued to increase until the 40th week (ending October 4),

" hen 2,300 cases were reported. The number of reported

Cases decreased steadily after the 40th week and approached

n°rnial levels (400 to 500 cases) by the 48th week.

In October, serum specimens were sent for identifica­

tion to the World Health Organization International Influenza

^enter for the Americas (NCDC, Atlanta). Of 19 paired sera,

showed diagnostic (fourfold) rises in antibody titer to‘ 2 Hr» f r .

- nong kong/68 influenza virus; in addition, several un­

paired sera also were positive at high levels for antibodies

■° lhis virus.(7?

ePorted by Dr. Cesar A. Mendizabal Morris, Chief, Divi-

" °f Epidemiology, Guatemala Directorate General of

fo *° ^ 6 0 anc ^ e ^ International Influema Center °T the Americas, NCDC, Atlanta.)

Figure 4CASES O F I N F L U E N Z A - R E P U B L IC O F G U A T E M A L A

1968-1969

Editoria l Comment:It is possible that some of the cases reported as in­

fluenza in late July-early August 1969 actually reflected

human illness due to Venezuelan Equine Encephalomyelitis

(VEE) virus, which was epidemic and epizootic at that time

(MMWR, Vol. 18, No. 34). Much of the human illness con­

firmed serologically as due to VEE was clinically similar

to influenza. The later peak of reported cases in October

was almost certainly not due to VEE infection, since other

evidence indicated that VEE activity had subsided by then.

QUARANTINE MEASURES

Changes in the " Supplement — United States D

Yellow F ever Vaccination Centers,” MMWR, Voi

Thee Allowing changes should be made in the list of

States Designated Yellow Fever Vaccination Centers:

NEW

Alb,York

any

TeXas

Aus t in

State Dept of Health

Change area code to 518

Austin-Travis County Health Dept.

Change clinic hours to Wed., 3-4 p.m.

Tho following centers should be included in the list of

n,tetl St •k ates Designated Yellow Fever Vaccination Centers:

l ; u ' » a n a'lew 0r| eons Ochsner Clinic

1514 Jefferson Highway 70121

504, 834-7070

Clinic hours: Thurs., 8-10 a.m.

Fee: Yes

Board of Health

44 Winn St. 01801

617, 933-0700

Worcester

MISSOURIK i rksvi 11 e

TENNESSEEFranklin

esignated

18, No. S3

Clinic hours: By appointment

Fee: Yes

Immunization Clinic

Dept, of Public Health

Worcester City Hospital 01608

617, 798-8151

Clinic hours: Thurs., 12:30-2 p.m.

Fee: No

Kirksville Osteopathic Hospital

800 West Jefferson St. 63501

816, 665-4611

Clinic hours: By appointment

Fee: Yes

Williamson County Dept, of Public

Health

Carters Creek Pike 37064

615, 794-1542

Clinic hours: Mon.-Fri., 8:30 a.m.

—4 p.m.

Fee: Yes

108 Morbidity and Mortality Weekly Report

TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

M A R C H 14, 1970 A N D M A R C H 8 , 1969 (10th W E E K )

AREA

ASEPTIC

MENIN­

GIT IS

BRUCEL­

LOSIS

DIPH­

THERIA

ENCEPHALITIS HEPATITISMALARIA

P rim a ry in c lu d in g

un sp . cases

P ost I n ­

fe c t io u sSerum In f e c t io u s

1970 1970 1970 1970 1969 1970 1970 1970 1969 1970C1

UNITED STATES............ 28 2 5 11 23 5 133 1,046 993 58 6

NEW ENGLAND........................... 1 - - 2 4 _ 5 88 66 1

- - - - - - - 8 6 -

- - - - - - - 1 8 -- - - - - - - 6 - -

- - - 1 1 - 1 45 18 1

1 - - -- 3 - - 18 19 -

- - 1 - - 4 10 15

MIDDLE ATLANTIC................. 3 - 1 1 2 2 40 197 161 3

New York C i t y ................. - - - - - - 22 61 53 1

New Y o rk , U p - S ta te . . . 1 - 1 - 2 1 5 42 20 2

New J e r s e y .* ................... 1 - - 1 - - 9 53 26 -1 — “ — “ 1 4 41 62 -

EAST NORTH CENTRAL.......... 4 - 3 2 5 _ 23 183 167 7

O h io . . .* ............................... 2 - - 1 3 - L, 47 65 2

1 - - - - - - ■ 12 12 -

I l l i n o i s ............................. - - 3 1 - - 5 33 26 11 - - - 2 - 14 82 52 4

— ~ - “ - 9 12 -

WEST NORTH CENTRAL.......... 3 - - _ 1 _ 1 70 41 132 - - - - - - 11 12 -

- - - - 1 - - 6 5 -

- - - - - - 1 28 7 2

N orth D ako ta ................... 1 - - - - - - o 1 -

- - - - - - - 1 1 -

- - - - - - - 5 1 1

- - - - - - 17 14 10

SOUTH ATLANTIC................... 4 1 - 4 2 - 9 104 107 16

- -- - - - - - 6 - -

M ary land ............................ 1 - - - 1 - 1 14 22 0

D is t . o f C o lu m b ia . . . . - - - - - - - 1 1 -

V i r g i n i a ............................. - 1 - 2 - - 1 16 3 3

West V i r g i n i a ................. - - - - - - - Q 4 1

N orth C a r o l in a ............... 1 - - - 1 - 4 31 11 10

- - - 1 - - - 7 11 -

- - - - - - - 5 18 -

F lo r id a ............................... 2 — 1 ~ “ 3 15 37 ”

EAST SOUTH CENTRAL.......... - - - - - - 1 50 73 2

- - - - - - - 25 39 1

~ - - - - - - 15 20

A la b a m a .............................. - - - - - - 1 5 7

— “ — ~ ” 5 7 1

WEST SOUTH CENTRAL.......... 1 - - - 1 3 5 77 71

- - - - - - - 1 4 1

- - - - 1 ? 1 8 11 1

- - - - - - - 3 8

1 ~ - - - 1 4 65 48

MOUNTAIN.................................. 1 1 - - 2 - 3 53 57 1

- - - - - - - 2 5 1

- - - - 1 - - 2 7 -

“ “ - - - - - - -

~ - - - - — 1 16 19 -1 1 - - - - 1 8 7 -

- - - - - - 13 8 -

U ta h ...................................... - ~ - - - - 1 10 10 -

— — — ~ 1 ~ “ 2 1 -

PAC IF IC .................................... 11 - 1 2 6 - 46 224 250 131 - - - - - 27 35 -

- - - - 1 - 9 14 26 110 - 1 2 5 - 34 181 189 12

“ - - - - 3 - - -— _ - - - - 2 - -

_ _ _ _ _ _ _ 24 19V ir g in I s la n d s ................... - - _ _ _ _ _ _

Delayed re n o r ts : K n c e p h a l i t i s , p r im a ry : O h io d e le te 1

H e p a t i t i s , in f e c t io u s : N .J . d e le te 1 , A la sk a 5 , P .R .

M a la r ia : O k la . 1 (1969)25

Morbidity and Mortality Weekly Report 109

TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

M A R C H 14, 1970 A N D M A R C H 8, 1969 (10 th W E E K ) - C O N T I N U E D

MEASLES (R ubeo la )MENINGOCOCCAL INFECTIONS,

TOTALMUMPS POLIOMYELITIS

C um u la tiv e C um u la t iv e Cum.

1970

T o ta l P a r a ly t i c

1970 1970Cum.19701970 1970 1969 1970 1970 1969 1970

1,377 10,362 4 ,297 59 664 800 2,889 25,502 - - 1

36 205 208 1 30 24 395 3,439 _ _ _1 1 2 - - 1 74 507 _ _ _

4 13 58 - 3 - 10 187 - - -

- 1 - - 3 - 29 178 _ - _

28 149 28 1 11 11 139 1,043 _ _ _

2 14 7 - 3 3 41 351 - - _

1 27 113 - 10 9 102 1,173 - - -

299 1,702 1 ,334 5 104 121 335 2 ,628 _ _ _

45 243 813 - 26 19 126 793 _ - -

9 60 116 2 22 17 _ 4 _ - -

84 731 258 2 30 52 77 759 _ _

161 668 147 1 26 33 132 1,072 - - -

262 2,429 440 6 89 90 764 6 ,403 _ _ _4Q 725 45 1 43 28 118 870 - _

12 107 104 2 10 14 50 565 _ _ _

137 1 ,212 81 - 16 12 56 595 - _ _

42 211 56 2 17 30 212 1,532 _ _ _

22 174 154 1 3 6 328 2,841 - - -

30 1,103 135 2 14 41 175 1 ,688 _ _ _- 4 1 - 4 7 1 173 _ _ _

6 30 68 - 3 5 136 1 ,076 _ _ _

6 125 11 1 6 17 3 36 _ _ _

2 47 2 - - _ 5 151 _ _ _

5 41 - - - _ 1 2 _ _ _

11 812 53 1 1 2 1b 221 _ _ _

- 44 - - - 10 13 29 - - -

n o 1,440 7^1 22 161 150 267 2 ,45916 112 8 - 2 3 5 54 _ _ _22 220 8 1 12 16 21 178 _ _ _15 253 - - 1 o 9 68 _ _ _34 266 279 5 13 22 41 474 _ - _12 68 72 1 2 6 70 816 - _ _16 167 47 2 32 19 NN NN _ _ _24 83 46 1 7 21 19 209 _ _ _- 2 1 - 24 26 _ _ _ _ _

71 269 330 1 2 68 35 102 660 - - -

17 135 36 1 39 36 142 1,723 _ _ _17 85 13 - 12 8 47 680 - - -

- 25 8 1 19 19 90 948 _ - -

- 12 - - 5 7 5 86 - _ -

- 13 15 - 3 2 - 9 - - -

385 2,376 1,053 15 117 110 218 2,376 _ _ 15 16 2 3 12 11 2 29 _ _ _7 15 8 3 27 31 _ 3 _ _ _7 68 102 - 8 14 77 781 _ _ _

366 2,277 941 9 70 54 139 1,563 - - 1

72 439 78 1 7 25 134 1,129 _ _ _1 10 3 - - 2 25 175 - _ _- 5 - - - 3 2 49 - - -- - - 1 1 — - 10 - - _

- 9 7 - 3 6 41 406 _ _ _

2 64 34 - - 5 45 245 _ _ _69 343 32 - 1 6 20 184 _ _ _- 4 1 - 2 1 1 60 - - _

~ 4 1 - - 2 - - - - -

66 533 222 6 103 203 459 3,657 _

- 35 20 1 15 12 180 1,490 _ _ _13 83 34 - 8 6 26 287 _ _ _49 389 163 5 79 179 186 1 ,458 _ _ _- 1 4 - - - 31 177 _ _ _4 25 1 - 1 6 36 245 - - -

17 487

3

116

1

2

1

3 12 243 - - -

AREA

UNITED STATES.

POLAND.Halne....

Hampshir^«tinont... assachi“se tts.

c°niIs land . .*.

Inectlcut.

Mll>DLEATLANTIC,

Y°rk C ity ,

New ^orlt> uP - S t a te . . .

New

York ' Jersip -^ e y ..

'""sylvania

A0hio°RTH CENTRAL-

Mì ln° is__»1,

'ÏST

Sc°n s in .

northc en t ra l .

/""esota.l°wa, '«1,

Ss° u r i .«orth Dakot;

an<

^ATLANTIC, «¿avare.

^ g in u .? ! lumbia

C thvcir8i"iä::::V parolina...^ 4 a ? r011- -lo>-ida..;...........

CENTRAL.

m2*—Hi a#a . . .

iasipp i::::::

^ SourHansas CENTRAL.

O^iana.

Texas!“*-

v

Id,»nt.

Alt).ana.

Vvh°-

V ¿ad°. Ari ”exi=

vadl*

>AciHc

,= 4 ^1 ,'

;•

Mumps: A la sk a 34, P .R . 1550

110 Morbidity and Mortality Weekly Report

TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

M A R C H 14, 1970 A N D M A R C H 8, 1969 (10 th W E E K ) — C O N T I N U E D

AREA

RUBELLA TETANUS TULAREMIA TYPHOID

FEVER

TYPHUS

TICK-

(Rky . M t.

FEVER

BORNE

S p o tte d )

r a b ie s

ANIMA

1970

Cum.

1970 1970Cum.1970 1970

Cum.1970 1970

Cum.1970 1970

Cum.1970 1970

UNITED STATES.......... 1 ,902 13,047 3 15 - 12 2 44 - - 56

NEW ENGLAND........................ 126 571 - 1 - - - 2 _ - 1

M a in e ................................. 8 53 - - - - - - - - 1

New H am psh ire ............... 11 60 - - - - - - - - -

V erm ont............................. “ - - - - - -80 239 - 1 - - - 1 - -

Rhode I s l a n d ................. 6 14 - - - - - - - - ~20 181 - “ - - - 1 - - ~

MIDDLE ATLANTIC............... 143 1,041 - 2 - - 1 11 - - 3

New York C i t y ............... 61 167 - - - - 1 4 - - -

New Y o rk , U p - S ta te .. 16 102 - - - - - 4 - - 3

New Je r s e y ...................... 29 365 - 1 - - - 1 - - -37 407 — 1 ~ “ - 2 - - ~

EAST NORTH CENTRAL.... 482 3,155 1 3 _ 5 _ 2 _ _ 2

O h io .................................... 133 455 - - - 2 - 1 - - 1

42 575 - 1 - 3 - - - - -

I l l i n o i s .......................... 37 340 1 1 - - - — — - 1

179 904 - 1 - - - 1 - - -91 881 “ ” ~ ~ - - —

WEST NORTH CENTRAL. . . . 114 1 ,218 - - - 2 - - - - 6

5 57 - - - - - - — - 1

82 759 - - - - - - - - 2

11 95 - - - 2 - - - - 1

2 64 - - ~ - - - - - -

- 1 - - - - - - - - -11 227 - - - - - - - - -3 15 - - - - - - - - 2

SOUTH ATLANTIC................. 142 1 ,448 - 5 - 1 1 11 - - 19

1 12 - - - - - - - - -

M ary land .......................... 15 85 - - - - - 3 - - -

D is t . o f C o lu m b ia . . . 2 7 - 1 - - - - - - -

V ir g i n i a .............. .. 32 275 - - - - - 1 - - 11

34 406 - - - - - - - - 2

N orth C a r o l in a ............ - 3 - - - - - 1 - - -

South C a r o l in a ............ 24 79 - - - - - - - - -

- - - 1 - - - 4 - - 5

34 581 - 3 - 1 1 2 - - 1

EAST SOUTH CENTRAL.... 57 708 - - - 2 - 1 - - 6

245 - - - 1 - - - - 4

27 378 - - - 1 - - - - 1

A labam a............................. 20 69 - - - - - 1 - - 1

1 16 — “ ~ ” - - - ~ *"

WEST SOUTH CENTRAL.... 324 1,947 1 2 - 2 - 1 - - 9

4 4 1 1 1 - 1 - - 1

- 3 - 1 - - - — - - 3

Oklahom a.......................... 23 459 - - - 1 - - - - 2

297 1,481 - - - - - - - - 3

MOUNTAIN............................... 77 535 - - - - - 4 - - -32 126 - - - - - 1 - - -5 18 - - - - - - - - -2 32 - - - - - - - - -

10 110 - - - - - 1 - - -8 32 - - - - 1 - - -

20 147 - - - - - 1 - - -- 70 - - - - — - — - -

“ - - - - - - - - - -

PACIF IC .................................. 437 2 ,424 1 2 - - - 12 - - 10

254 1,122 - - - - - 1 - - -

O regon ............................... 17 243 - 1 - - - — — - —155 918 1 1 - - - 10 - - 10

1 56 - - - - - 1 - - -10 85 - - - - - - - -

_ 9 1 3 _ _ _ 1 _ _

V ir g in I s la n d s ................... - - - - - - - - _ _ _

CUB-1970

583

281

42

288271

10

75161717

215

16*

1

8532

30

16

39

1613

1031529

1049

^Delayed reports: Rubella: Mich. 15, Alaska 9 Typhoid fever: Alaska 1 RMSF: La. 1 (1969)

Rabies in animals: P.R. 2

Morbidity and Mortality Weekly Report 111

Week No.

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 .

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