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Table 3. CASES OF SPECIFIED DISEASES: SELECTED CITIES FOR WEEK ENDED
JANUARY 17, 1953-Continued
(Numbers after diseases are category numbers of the Sixth Revision of the International Lists, 1948)
The chart shows the number of deaths reported for 106 major cities of the United States by week for the current year, and, for comparison, the median of the number of deaths reported for the corresponding weeks of the three previous calendar years. (The median is the central one of the three values arranged in order of magnitude.) If a report is not received from a city in time to be included in the total for the current week, an estimate is made to maintain comparability for graphic presentation.
The figures reported represent the number of death certificates received in the vital statistics offices during the week indicated, for deaths occurring in that city. 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.
While week-to-week changes in the total number of deaths reported for all major cities generally represent a change in mortality conditions, this may not be true for variations in weekly figures for each city. For example, in a city where 50 deaths are the weekly average, the number of deaths occurring in a week may be expected to vary by chance alone from 36 to 64 (d ± 2Vd, where d represents the average number of deaths per week).
The number of deaths in cities of the same size may also differ because of variations in the age, race, and sex composition of their 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.
Provisional Information on Selected Notifiable Diseases in the United States for
The following reports have been received by the Influenza Information Center, NIH, and by the National Office of Vital Statistics.
Dr. R. F. Feemster, Massachusetts Department of Public Health, reports significant rises in antibody titer for influenza A-prime in 4 of 5 paired sera from Navy personnel in Boston. The onsets were about January 3, and approximately 15 percent of this group became ill with an influenza-like disease during a 10-day period. Dr. Maxwell Findland, Boston City Hospital, reports the collection of paired sera from 10 patients in an armed service hospital in the Boston area. Eight sera showed 8- to 32-fold rises in antihemagglutinin for FM-1, and somewhat smaller rises with PR-8. One showed a 32-fold rise for PR-8 and 8-fold for FM-1, and 1 showed no change. Onsets of illness were on January 8 to 10. Clinically, the patients had symptoms consistent with influenza and had fever of 3 days duration or less, with no complications. Laboratory tests on throat washings have not been completed.
Dr. H. J. Shaughnessy, Illinois Department of Public Health, reports that 5 paired serum specimens from western Illinois have shown significant rises in complement fixing against influenza A-prime (FM-1). Another set of paired specimens showed a suggestive rise against type B.
Dr. Morris Schaeffer, CDC Virus Laboratory, Montgomery, Alabama, reports the isolation of influenza virus type A-prime (preliminary typing) from cases in Jacksonville, and Gainsville, Florida, and in the State of Nebraska. Clinical influenza has been prevalent in all of these areas for 2 weeks.
The Preventive Medicine Division, SGO, Army, reports continued moderate increases in respiratory disease rates in military installations in nearly all parts of the United States, but some have shown a decline in the last week. Influenza A-prime has been identified by serologic tests in Virginia, and by isolation of virus in Kentucky and Texas.
The Division of Preventive Medicine, United States Air Force, reports a continued high incidence of clinical influenza both in the United States (particularly in the Midwest) and overseas. Laboratory confirmation of influenza A-prime at a base in New Mexico is reported, and also a slight increase in clinical influenza at a base in California.
The National Institutes of Health has isolated influenza A prime virus (preliminary typing) from 2 cases in the Washington, D. C., metropolitan area.
Dr. W. H. Y. Smith, Alabama Department of Public Health, reports a marked increase in upper respiratory infection in the State, most of which is reported to be influenza.
Dr. E. H. Lennette, California Department of Public Health, reports 23 cases of influenza diagnosed by serologic tests during the week of January 18 to 24. Fifteen of these were A-prime, and 8 could be classified only as being in the A group. For the week ended January 24, the largest number of clinical cases reported was from Santa Barbara County. Fourteen other areas in the State also reported cases.
Anchorage area of Alaska. Absenteeism in the schools has been as high as 35 percent. A small village south of Anchorage is similarly affected. The disease has been characterized by symptoms of fever and malaise with a duration of 2 to 3 days. Material for laboratory tests is being collected.
An increase of 15 percent occurred in the number of deaths from influenza and pneumonia reported by 58 cities for the week ended January 17. A total of 404 deaths was reported as compared with 350 (corrected figure) for the previous week. The numbers reported for these cities by geographic division, with figures for the previous week in parentheses, were: New England, 18(27); Middle Atlantic, 147 (117); East North Central, 64(58); West North Central, 46(44); South Atlantic, 31(29); East South Central, 19(6); West South Central, 40(26); Mountain, 20(17); and Pacific, 19(26). When the figures for the week ended January 17 are compared with the average for the previous 3 weeks, it is found that influenza and pneumonia deaths increased in all groups of cities except the New England group. The largest percentage increase occurred in the East and West South Central groups. Incomplete data for the week ended January 24 suggest that the increase will not be as large as for the previous week. Total deaths from 106 cities for the weeks ended January 10, 17, and 24 have been approximately 10 percent above the 3-year median figures. These two groups of figures, namely, the number of deaths from influenza and pneumonia in 58 cities and total deaths in 106 cities, suggest that the currect influenza epidemic is having some effect on mortality in the United States.
While the incidence of influenza and other respiratory infections has been reported to be high in certain countries of Europe, Africa and the Far East, laboratory evidence of infection has been received from only a few areas. A-prime virus has been isolated from cases in Tokyo. Serologic tests have indicated A-prime infections in United States military personnel in England, Germany, and France. A small outbreak of type B influenza has been reported in troops in Denmark but no spread to civilians. The WHO Regional Office for the Western Hemisphere (PASB) reports an increased incidence of influenza-like illnesses and respiratory disease in Mexico City during recent weeks. The disease appears to be benign, and there has been no increase in mortality rates. Local outbreaks of respiratory disease are now occurring in Quebec and Newfoundland. The disease is mild, and some of the patients have gastro-intestinal symptoms. Material is being collected for laboratory tests. The WHO Regional Office has also received information from WHO in Geneva that the number of cases of respiratory disease is increasing in southwest London. A-prime infection has been identified. In France the dissease is more widespread, but milder than in 1950 and 1951. In Berlin, Germany, school children are principally affected; in Essen, an A-prime influenza is reported; and in the Saar, 20 percent of the population are reported to be ill. The disease is mild. Psittacosis
Dr. M. M. Sigel, Children's Hospital, Philadelphia, reports additional information on the diagnosis of psittacosis among contacts of previously reported cases. The manager and clerk of a store in Newport, Pennsylvania, which was the source of an infection in a customer, became ill and were treated intensively with antibiotics. Convalescent sera from both individuals showed THE LIBRARY OF THE
Dr. F. P. Pauls, Alaska Department of Health, reports an outbreak of respiratory disease with influenza-like symptoms in the
a positive complement fixation reaction in dilution of 1/4 compared with a negative reaction in the acute phase sample. Sera from the members of the family of the fatal case occurring in Pittsburgh in November have been tested. Serum taken December 30 from the wife who had no demonstrable illness, was positive for psittacosis. Serum from the daughter, who was ill, was also positive. Serum from the son, who had an illness in November, was likewise positive. The CDC Laboratory at Montgomery has previously tested early samples of the sera from these 3 individuals and found them negative. Serum from a 20-year-old contact with this family who had no demonstrable illness, also gave a positive reaction. Paired serum samples from another patient in Pittsburgh, who became ill December 26, also showed a significant rise in complement fixing antibodies for psittacosis.
Dr. Dean Fisher, Maine Department of Health and Welfare, reports 3 cases of salmonellosis in a private family. Since the food responsible for the infection was not identified, the incubation period could not be determined. Stool specimens from the father and a small child showed S. typhimurium. No other pertinent
information could be obtained.
A summary of the reports on salmonellosis in infants, following the ingestion of dried egg yolk, shows that cases were found in 17 States and the District of Columbia. There was a total of 45 cases of S. montevideo infection in which laboratory confirmation of the diagnosis was obtained. There were 38 cases clinically diagnosed without laboratory confirmation. Four infants fed on the dried egg were reported to have other types of salmonella infection. S, barielly was found in 1, S. tennessee in 1, and S. oranienburg in 2. S. montevideo infections were also reported in which there was no history of contact with the egg product. Since the dried egg was not placed on the market until July 1952, and the first reports of illness were not made until November, it is quite probable that many more cases occurred, but were not recognized as salmonella infections. In addition to the above, other outbreaks of S. montevideo infections were reported in 1952. One was in a group of infants, discovered early in 1952, in a hospital in Massachusetts; another involved a family group in California in which ice cream was the vehicle of infection, and a third followed a church supper in Michigan in which a carrier presumably contaminated an article of food.
Table 1. COMPARATIVE DATA FOR CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
NOTE.-The 46 cases of diphtheria reported from Massachusetts last week was an error made in the process of transmission of reThere were no cases reported in the State for that week.
SOURCE AND NATURE OF DATA
These provisional data are based on reports from State and territorial health departments to the Public Health Service. They give the total number of cases of certain communicable diseases reported during the week usually ended the preceding
Saturday. When the diseases which rarely occur (cholera, dengue, plague, typhus fever-epidemic, and yellow fever) are reported, they will be noted under the table above.
Symbols.-1 dash [-]: no cases reported; asterisk [*]: disease stated not notifiable; parentheses, [) : data not included in total; 3 dashes [---] data not available.