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Table 3. CASES OF SPECIFIED DISEASES: SELECTED CITIES FOR WEEK ENDED

MARCH 28, 1953 --Continued
(Numbers after diseases are category numbers of the Sixth Revision of the International Lists, 1948)

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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 5C 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.

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219 1,325

257 1,306

218 1,329

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Provisional Information on Selected Notifiable Diseases in the United States for

Week Ended April 4, 1953

This is the third consecutive week that a decrease has occurred in the number of reported cases of meningococcal infections. For the current week a total of 117 cases was reported as compared with a high of 166 for the week ended March 14. Last year the incidence of the disease began decreasing after the third week of March, California and Georgia reported 18 and 14 cases, respectively, for the current week.

Communicable Disease Center. The complement fixation test was negative for one case, but positive for the others in titers ranging from 1:8192 to 1:128. Encysted Trichinella spiralis was demonstrated in a specimen of sausage received in the State Department of Health Laboratory on March 16.

EPIDEMIOLOGICAL REPORTS

Shigellosis

Dr. L. M. Schuman, Illinois Department of Public Health, reports that 7 cases of shigellosis occurred in an institution between February 9 and March 16. The disease was confined to children in 2 nurseries with a total population of 240 inmates. Shigella flexneri II (type W) was isolated from all patients. In routine rectal swabbing of the entire nursery group and 40 young female inmate ward helpers, 13 carriers of the organism were found. An inspection of the milk and water supplies and their handling showed them to be satisfactory. Antibiotic therapy of the cases, carriers, and inmates, as well as improved supervision of the inmate helpers in food handling, seem to have checked the outbreak,

Plague infection

Mr. S. F. Quan, San Francisco Field Station, Public Health Service, reports that the following specimens obtained in Kittitas County, Washington State, have been proved positive for plague:

Specimen No. WB-2 consisting of one vial, which contained 93 fleas (Monopsyllus eumolpi, Micropsylla sectilis, Catallagia decipiens) taken from 40 chipmunks (Euta mia minimum), trapped 18 miles east of Ellensburg on U. S. Highway 10 in Kittitas County on March 12, 1953.

Specimen No. WB-2, from the same area, consisting of 2 vials out of 3 containing a total of 303 fleas (Monopsyllus wagneri, Catallagia decipiens, Micropsylla sectilis, Meringis shannoni, Monopsyllus eumolpi, Malaraeus telchinum, Atyphloceras sp.) taken from 54 deer mice (Peromyscus maniculatus), trapped on March 12.

Mr. Bertram Gross, Hawaii Department of Health, reports the finding of one plague infected rat within the endemic area of the Hamakua District, on March 16, 1953. The rat (R. alexandrinus), which was found dead in District 3A, Kapule na area, proved positive for P, pestis on laboratory examination. This is the second infected animal found this year. The first was found in this area and was reported last week.

Gastro-enteritis following the eating of turkey

Dr. G. R. Jones, Kentucky Department of Health, has reported another outbreak of gastro-enteritis following the ingestion of tur key. These were from government surplus stock obtained from another source than that reported for 3 outbreaks last week. The turkeys were cooked, allowed to stand overnight, boned, and then permitted to stand at room temperature for 90 minutes before serving. Sixty-five of 158 persons eating in the school cafeteria became ill. The length of the incubation period is not known.

Dr. R. L. Cleere, Executive Director, Colorado Department of Public Health, reports 2 minor outbreaks of mild gastro-enteritis occurred following the ingestion of government surplus tur keys, but neither was proven to be due to the turkey meat. The source of the turkeys was not as reported in last week's Communicable Disease Summary.

Dr. W. R. Giedt, Washington State Department of Health, reports 2 cases of gastro-enteritis at a school. Both patients became ill about 1 hour after they had sampled turkey meat. A third person, who sampled the meat, had few ill effects. The turkey was boned and refrigerated at the school the previous day. Samples of the turkey submitted for laboratory examination yielded hemolytic coagulase positive staphylococci, Paracolonlike organisms were also isolated and identified. The source of the turkeys was not given.

Psittacosis

Dr. D. S. Fleming, Minnesota Department of Health, reports a case of psittacosis in an adult female. The patient became ill on March 1 with chills, fever, malaise, and a dry cough. A physician diagnosed the case as influenza with complicating pneumonia and treated her sucessfully with penicillin. Since the patient raised parakeets and canaries, psittacosis was suspected and blood specimens were taken and sent to the Division of Medical Laboratories which received them on March 10 and 18 for psittacosis complement fixation tests. The first specimen was positive in a titer of 1:64, and the second in 1:128. The patient's birds were quarantined. Five parakeets were obtained for virus studies and forwarded to the Communicable Disease Center, Montgomery, Alabama. None of the birds were ill. However, in September of last year, a bird died 3 or 4 weeks after being purchased.

Trichiniasis

Dr. D. S. Fleming, Minnesota Department of Health, reports 10 cases of clinical trichiniasis which had onsets between February 15 and March 9, 1953. The disease occurred in persons who ate raw home-made smoked pork sausage. The original clinical diagnosis in some of the cases was influenza. Symptoms were fever, headache, cough, aching of muscles, and edema. Eosinophilia were present. Blood specimens were collected from 8 of the patients on March 20 and the serum forwarded to the

Gastro-enteritis

Dr. A. C. Hollister, Jr., California Department of Public Health, reports an outbreak of gastro-enteritis among 42 persons attending a private dinner party in a restaurant. Of these, 32 became ill from 9 to 19 hours after the meal. Creamed turkey was suspected. No food was available for laboratory examination. The turkey was cooked in the morning, not refrigerated, and added to cream sauce late in the afternoon.

Dr. L, L, Parks, Florida State Board of Health, reports 2 cases of gastro-enteritis following the ingestion of coconut cream pie. The suspected vehicle of infection was eaten in a private home at 7:00 p.m., and illness occurred between 3 and 6 hours later. The pie was purchased at a local store. It was found that the pie had been delivered to the store in an unrefrigerated truck and left out on an open shelf overnight. Cultures taken of the pie sbowed Aerobacter aerogenes type I and a Gamma type of streptococcus (non-hemolytic).

Influenza

The following reports were received by the Influenza Information Center, N. I. H., and the National Office of Vital Statistics.

New York State Department of Health reports that 25 paired sera from patients in an outbreak of respiratory illness, which occurred during the early part of the year at the University of Syracuse, Syracuse, New York, were examined in a complementfixation test. Ten showed 3-fold or greater rise in titer with an influenza virus A antigen; 1 showed 5-fold rise in titer with an

influenza virus B antigen; 3 showed 3-fold or greater rise in titer with both antigens; 11 showed less than 3-fold rise in titer with both antigens.

Dr. C. E. Weigele, New Jersey Department of Health, reports the occurrence of influenza in a state institution in Cape May County in February. Investigation revealed that the respiratory illnesses resembled the common cold. Hemagglutination tests done on 15 typical cases showed a rise in titer for influenza A during convalescence. Of the 411 cases reported, the 15 can be said to have been confirmed by laboratory examination.

Dr, E, H, Lennette, California State Department of Health Laboratory, reports the serologic diagnoses for influenza A and A-prime in 6 cases from various parts of California, having onsets February 14 and March 9, 1953.

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)

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Anthrax

--062

1

2 Botulism

-049.1

21 Brucellosis (undulant fever)

-----044

33

35 Diphtheria--

-------055

49

52 110 Encephalitis, acute infectious---082 28

22

16 Hepatitis, infectious, and serum -

--092,N998.5 pt. 679 419 Malaria

--110-117 11

13 Measles----

---085 18,534 32,79323, 853 Meningococcal infections---------057 117 166

98 Poliomyelitis, acute-

-080
67
71

45 Rabies in man-----

--034

1 Rocky Mountain spotted fever----104A

1 Scarlet fever and streptococcal sore throet

--050,051 4,018 3,648 2,328 Smallpox--

--084 Trichiniabis-

--128

3

5 Tularemia

--059

8
12

15 Typhoid fever ---

-040 21

25

40 Typhus fever, endemic

-101

2

3 Whooping cough-

-056 519 925 1,318

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Symbols. - 1 dash [-]: no cases reported; asterisk [] : disease stated not notifiable; parentheses, [ ] in total; 3 dashes [---] : data not available.

: data not included

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