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Provisional Information on Selected Notifiable Diseases in the United States for
The following reports have been received by the Influenza Information Center, N. I. H., and by the National Office of Vital Statistics.
Strains of influenza A-prime virus have been recovered from three localized outbreaks of influenza in New York State by the laboratories of the New York State Health Department, and Dr. S. S. Kalter of Syracuse. Dr. Kalter also reports a number of cases of an influenza-like disease among the students at Syracuse University. Dr. R. M. Albrecht, New York State Health Department, reports that an outbreak of a disease clinically resembling mild influenza has been present among students in a college in the eastern part of the State since early January.
Dr. M. M. Sigel, Children's Hospital, Philadelphia, reports the isolation of influenza A-prime virus from patients at the University of Pennsylvania, although the incidence of disease was considered low. He has also obtained serologic evidence of influenza A from 2 other patients in the Philadelphia area, and from 4 Navy personnel from aboard ship with onsets on January 9. Dr. H. M. Powell, the Lilly Research Laboratories, Indianapolis, has isolated 2 strains of influenza A-prime obtained on January 13 from students at DePauw University, and 3 strains taken January 15 from students at Earlham College, Indiana. A high incidence of influenza was previously reported in both places. Dr. C. C. Croft, Ohio Department of Health, has isolated influenza A-prime virus from Columbus and from Delaware, Ohio. Two paired serum specimens from Delaware showed diagnostic rises in titer to both FM-1 and A-prime Cuppett antigens. Dr. John H. Dingle, Western Reserve University, Cleveland, has isolated one strain of influenza A-prime, but reported that there was no epidemic prevalence at that time. Dr. Charles Hunter, Kansas State Department of Health, has isolated influenza A-prime from 2 localities in Kansas. Dr. Henry Bauer, Minnesota State Department of Health, has isolated several strains of influenza A-prime and found significant rises in 7 paired serum samples for influenza A-prime since January 9. Dr. A. P. McKee, at the Influenza Regional Laboratory, Iowa City, has received reports from collaborating laboratories in Minnesota, South Dakota, Kansas, and Nebraska, indicating the prevalence of an influenzalike disease and the collection of material for specific identification. In Kansas, incidence was still high for the week ended January 24, but there was no increase in the number of cases as compared with the previous week.
On January 28, Dr. G. E. McDaniel, South Carolina Board of Health, reported a continued high incidence of influenza and upper respiratory disease in the State, but the peak apparently had been reached. High fever and intractable cough have characterized these illnesses. Dr. W. J. Murphy, Georgia Department of Public Health, at the same time reported that outbreaks of respiratory disease, presumably influenza, were occurring in numerous communities in the southwest, south central, and northeast parts of the State. Material for laboratory tests is being collected. In Kentucky, approximately 20,000 cases of respiratory infection have been reported in 18 counties. Dr. W. H. Y. Smith, Alabama Health Department, states that reports began to be received in the middle of January that schools were
being closed because of upper respiratory infections. Subsequent to this, a mild type of influenza appeared to be occurring throughout the State, and for the week ended January 31, more than 18,000 cases were reported. Laboratory specimens are being obtained in areas of high incidence. In Arkansas, the peak in incidence of influenza apparently had been reached by January 17, since cases reported for the week ended January 24 were fewer in number. Most cases have been mild but exceptions have been noted. On January 29, Dr. S. J. Phillips, Louisiana State Health Officer, reported that the influenza appeared to be subsiding in 16 parishes of the State, and on the increase in 3. School absenteeism has run as high as 50 percent. Pneumonia is estimated to have occurred in less than 5 percent of the cases, except in i parish where the estimate was 19 percent. Five deaths from influenza have been reported, 1 in each of 5 parishes.
Dr. Gordon Meiklejohn, University of Colorado, Denver, reports that the peak of incidence of influenza has been passed in the Denver area, although cases still are occurring. In other parts of the State, notably Grand Junction, incidence is now reported at a peak level. He has demonstrated an increase in influenza A antibody in 35 paired sera. In 9 of these, a significant rise for influenza A-prime is shown by hemagglutination inhibition tests.
In Montana, high incidence of respiratory disease has been confined to a few counties, and there was no apparent increase in the number of cases for the week ended January 24, as compared with the previous week. There appears to be an increased incidence in respiratory disease, clinically influenza, in Wyoming. Laboratory tests on specimens collected are not yet complete. Reports from Utah indicate some increase in respiratory disease. In Idaho, incidence is high in only a few areas.
Dr. A. S. Lazarus, University of Washington, Seattle, reports 15 paired sera showing a significant rise in titer for influenza Aprime. For the week ended January 31, a total of 5,503 cases of respiratory infectious, including influenza, were reported in the State. In California small numbers of cases of influenza were reported from 15 counties. Forty additional laboratory confirmations of an A type influenza were obtained.
The Divisions of Preventive Medicine of the Army, the Air Force, and the Navy, all report that the incidence of respiratory disease and influenza appears to be declining in nearly all military establishments where it has been high during recent weeks. The Army reports positive serological tests for influenza A-prime in military establishments in California and Utah. The Air Force also reports positive serological tests from bases in Florida, South Carolina, Texas, Colorado, South Dakota, California, and Alaska.
The Army Medical Service Graduate School reports the identification of influenza A-prime virus from Japan in late December; and from Texas and Kentucky in January. They have also obtained significant rise in titer with paired serum samples from Illinois, Washington, D. C., and from Japan and Newfoundland.
An increase of 15 percent occurred in the numbers of deaths from influenza and pneumonia reported by 58 cities for the week ended January 24. A total of 463 deaths was reported as compared with 404 for the previous week. The numbers reported for these cities by geographic division, with figures for the previous week
in parentheses, were: New England, 35 (18); Middle Atlantic, 127 (147); East North Central, 83 (64); West North Central, 61 (46); South Atlantic, 45 (31); East South Central, 28 (19); West South Central, 33 (40); Mountain, 22 (20); and Pacific, 29 (19). The total number (463) for the week ended January 24 is approximately 50. percent higher than for the same week last year. However, in 1952 the influenza epidemic, predominately type B, did not appear until February. The same is true of the timing of the A-prime epidemic of 1951.
The health officers of 9 large cities have supplied information on the age distribution of influenza and pneumonia deaths for the month of January 1953. Of the approximately 835 deaths reported, 26 percent were under 15 years of age, nearly 2 percent were between the ages of 15 and 24, 30 percent between 25 and 64, and 42 percent were 65 and over. These proportions are similar to the distribution of deaths for influenza and pneumonia for the United States in 1949, a year when there was no widespread outbreak of influenza. However, the few deaths, in which influenza was reported as the cause of death, were predominately (70 per
cent) in persons 65 years of age and over.
The WHO regional office for the western hemisphere (PanAmerican Sanitary Bureau) reports that the incidence of an influenza-like disease in Mexico continues to increase, but the cases are mild and are not affecting the general death rate. Reports from Brazil and the Dominican Republic indicate there is no unusual prevalence of influenza. However, they do report a mild form of influenza present in Nicaragua, Costa Rica, and Guatemala, but there has been no increase in mortality.
Dr. C. H. Andrewes, World Influenza Center, London, reports on a preliminary examination made on recently isolated influenza type A virus. Eight strains from Southern England and 3 U. S. strains (Matern, Gandsey, and Conley) are all inhibited to the highest titer by sera prepared against A/Sweden/3/50 and A/ England/1/53. There are big P-Q differences within the group, but a general similarity with evident closer affinity to the 1951 Scandinavian strains than to any other. Strain A/Paris/1/53, is, however, more like the Liverpool subtype.
Table 1. COMPARATIVE DATA FOR CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES (Numbers after diseases are category numbers of the Sixth Revision of the International Lists, 1948)
Symbols.-1 dash [-]: no cases reported; asterisk [*]: disease stated not notifiable; parentheses, [) in total; 3 dashes [---]: data not available.
: data not included
Table 2. CASES OF SPECIFIED DISEASES WITH COMPARATIVE DATA: UNITED STATES,
(Numbers under diseases are category numbers of the Sixth Revision of the International Lists, 1948)