Table 3. CASES OF SPECIFIED DISEASES: SELECTED CITIES FOR WEEK ENDED MAY 2, 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 100 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 certifi cates 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 ± 2d, 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 incidence of infectious hepatitis continues to increase. From 777 cases reported last week, the number rose to 912 for the current week. For the corresponding week of 1952 there were only 178 cases reported. For the current week, Texas reported 11 cases of typhoid fever and Ohio reported 8. Texas also reported 4 cases of dengue. Although the number of poliomyelitis cases reported for the current week (110) is essentially the same as for the week ended May 2, when 111 were reported, the number is about 20 percent above the number (92) for the same week last year. Cumulative totals since the beginning of the "disease year," which began with the week ended April 11, are higher in 7 of the 9 geographic regions as compared with the same period last year. The cumulative total in the New England States is the same as last year, and in the West South Central States, it is 50 percent lower. For the current week no State reported any unusual number of cases when compared with the previous 4 weeks. Alaska reported 4 cases with 1 death. Botulism EPIDEMIOLOGICAL REPORTS Dr. F. T. Foard, North Carolina State Board of Health, gives information on the case of botulism reported for the week ended April 4. Frozen lobster tails, purchased from a local store, were prepared by dropping them in boiling water for an indeterminate time. The patient had no lunch, but for dinner she ate only lobster tails. Approximately 12 hours after the meal, she became ill with gastro-enteritis and diarrhea. About 18 hours later, visual difficulties began to develop; rather marked diplopia and nystagmus were accompanied by generalized muscular incoordination and difficulty in swallowing. The symptoms persisted with slow but gradual clearing during the next 15 days. On the basis of these symptoms, a diagnosis of botulism was made by an internist and ophthalmologist. No specimens were collected for laboratory examination. The patient has now apparently recovered completely. Whooping cough MAY 1 & 1953 cases were associated with the outbreak of Aust a Gastro-enteritis Dr. W. L. Halverson reports 2 outbreaks of gastro-enteritis in private families. The first outbreak was among 8 persons who ate a turkey dinner. Of these, 6 became ill from 4 to 24 hours after eating the meal. Baked turkey was suspected but no pathogenic organisms were isolated from samples of the meat. Stool specimens of the patients were negative. The second outbreak was also among 8 persons. Five of these became ill with symptoms of nausea, vomiting and diarrhea; most of the patients had cramps, prostration, muscle weakness, etc. Ham which was baked for several hours was suspected to be the vehicle of infection. Samples of the meat were taken, and also a specimen from a patient, but no laboratory report was given. Dr. Halverson also reports an outbreak of gastro-enteritis in an institution in California. Sixty-nine persons became ill from 12 to 16 hours after eating their noon meal. The symptoms were sudden onsets with cramps and diarrhea. One of the patients had peptic ulcers at the time of the investigation which was made 2 days after onset of illness. The meal consisted of roast pork with brown gravy, boiled potatoes, boiled chard, and coffee. The pork was roasted on April 6, cooled, and refrigerated. The next day it was placed in a steam table for service at 11:00 a. m. The steam table and refrigerator were in good working order. The meal was served to 3 groups of persons but only the persons who ate pork at this meal became ill. No food was available for laboratory examination. Stool specimens taken from 7 food handlers and 2 patients were negative. Dr. Morris Greenberg, New York City Department of Health, reports an outbreak of gastro-enteritis following a society luncheon at a hotel where 245 persons were served. From a preliminary epidemiological investigation, which com prised 57 individuals, it was estimated that 208 persons became ill from 3 to 18 hours later. Of the investigated group, all who ate turkey became ill, while those who did not eat it remained unaffected. Cooking of foods had been completed 3 hours prior to meal time, with considerable handling by personnel in the intervening period. During this time the foods were kept at room temperature or in a warming oven. No source of contamination was found among the food handlers. Stool specimens of the patients were negative Dr. J. R. Enright, Hawaii Department of Health, reports an outbreak of whooping cough which occurred on the Island of Niihau. Forty-three cases were reported as compared with 42 for the entire Territory of Hawaii during 1952. The patients ranged in ages from 3 months to 7 years. The disease has evidently affected about all in this age group on the island which has a total population of 207. The island is privately owned and visits to it are made.and food samples yielded no significant organisms. only by permission of the owners. The disease may have been introduced following a funeral which was held on the island. Permission had been granted by the owners for certain Kauai residents to visit the island temporarily to attend this funeral. One of the visitors is said to have been suffering from an upper respiratory infection which may have been the source of the outbreak. Malaria Dr. W. L. Halverson, Director, California Department of Public Health, reports 2 military cases of vivax malaria and 4 civilian cases for the current week. Of the civilian cases' 2, type not stated, were in Korean veterans, and 2 new tertian Dr. Morris Greenberg reports an outbreak of gastroenteritis among 105 persons who attended a buffet luncheon in New York City. Of 76 participants investigated, 47 became ill about 10 hours after eating a large variety of foods. The food was prepared by a caterer at his commissary 1 to 2 days before the meal, and transported to the scene of the party the day before. Preliminary investigation indicates that foods were handled and transported with inadequate refrigeration during the 24-hour period prior to the time of serving. A number of perishable foods, chicken a la king, chopped liver, and assorted hors d'oeuvres, were eaten by a greater than average proportion of those who became ill. However, each of these foods was also eaten by a significant number of unaffected persons. It is likely that several or all of these foods were contaminated. None of these foods was available for bacteriological examination. Stool cultures were negative. Communicable diseases in other areas Dr. A. S. Osborne, Science Attache, American Embassy, London, reports that 2 more cases of smallpox have been reported in the Yorkshire and Lancashire areas of England. One of these had no direct contact with previous cases but did attend a coroner's autopsy on a patient who had died of a hemorrhagic disease thought to be leukemia. The second case likewise had no known contact with previous cases. The total number of cases reported in the present outbreak is now 28 with 7 deaths. Two of the fatal cases were not diagnosed until after death. No rash was seen in either. Other cases in persons who were desperately ill in the early stages had very sparse rashes. Table 1. COMPARATIVE DATA FOR CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES Symbols.-1 dash [-]: no cases reported; asterisk [*]: disease stated not notifiable; parentheses, [ ] : data not included in total; 3 dashes [---] data not available. |