211953

The total number of cases of poliomyelitis reported for the week ended July 11 was 949 as compared with 1,044 for the same week last year. The cumulative total since the seasonal low point of incidence is 4,112, which is only 2 percent above the total (4,025) for last year. During the past 4 weeks the total was 2,513 cases as compared with 2,663 for the same period last year.

States which showed a substantial increase in the current week as compared with the previous 2 weeks were: Connecticut, New Jersey, Pennsylvania, Ohio, Illinois, Kansas, Virginia, North Carolina, and Tennessee.

In North Carolina poliomyelitis cases have been most numerous in the western third of the State, centering in Caldwell and Catawba Counties where 26 and 21 cases, respectively, were officially reported for the current week. For the current week 5 cases were reported in Macon County, Illinois, where mass immunization with gamma globulin is being carried out. No official reports are available for the other areas where gamma globulin has been given on a mass immunization basis, namely, in New York and Alabama.

Deaths from poliomyelitis for the current week were reported as follows: Colorado, 1; Oklahoma, 1; Minnesota, 4 (of which 3 were in Ramsey County); and Virginia, 1.

A high proportion of nonparalytic cases continues to be reported from many of the States.

Plague infection

EPIDEMIOLOGICAL REPORTS

Mr. Bertram Gross, Hawaii Department of Health, reports the finding of 2 plague infections within the endemic area of the Hamakua District on June 17, 1953. They were proved positive for P. pestis by mass flea inoculations. One sample was of 2 fleas, X. hawaiiensis, obtained from 1 male rat, R. hawaiiensis, and the other was of 2 fleas, X. hawaiiensis, obtained from one female rat, R. hawaiiensis. Both rats were trapped in District 3A, Kapulena area. Since January 1, 1953, 5 other plague infections have been found in this area.

Amebiasis

Dr. A. L. Marshall, Indiana State Board of Health, has reported preliminary information on a group of cases of amebiasis, the majority of which occurred among workers in a single manufacturing plant in the northern part of the State. Thirty-one cases were reported, 1 to 3 each week, over several months. Investigation of food handlers in the plant cafeteria and in nearby eating places revealed that a number of such employees were affected. The water supply and connections in the plant are being studied intensively, and water from the city supply is being used temporar

ily. About one-half of the employees in a sample group were found to be carrying Endameba histolytica, while in another large manufacturing plant nearby, only 4 percent were found to be carrying the organism. All carriers of the organism are being treated systematically under medical supervision.

Shigellosis

Dr. H. Kleinman, Red Lake Indian Hospital, Minnesota, has reporfed 8 additional cases of sonnei type dysentery in the Red Lake Indian Reservation. A previous report of cases in this area appeared in the Communicable Disease Summary for the week ended May 23, 1953.

Dr. W. L. Halverson, Director, California Department of Public Health, gives preliminary information on an outbreak of shigellosis following a wedding reception attended by 132 persons. Of these, at least 62 became ill. Cases also occurred in families of persons who attended the reception. Shigella sonnei was isolated from stool specimens of 50 patients. Frozen turkeys which were left at room temperature both before and after they were cooked were suspected as the vehicle of infection. The investigation is not yet complete.

Trichiniasis

Dr. F. H. Wentworth, Ohio Department of Health, reports an outbreak of trichiniasis in a family in the northeastern part of the State. Preliminary investigation indicates that the vehicle of infection was prepared bologna which had been ground in a butcher shop in the same grinder in which raw pork had been ground. The diagnosis was based on the clinical picture and an eosingphilia which ranged from 18 to 75 percent in the various patients. Information is not yet available whether the pork involved was 'I from grain or garbage fed hogs.

Gastro-enteritis

Dr. W. L. Halverson, Director, California Department of Public Health, reports 2 outbreaks of gastro-enteritis among persons eating in private homes. The first outbreak involved 5 persons among 13 who ate an evening meal. Only those who had eaten custard filled cake were affected. The symptoms were nausea, vomiting, and cramps, which began about 4 1/2 hours after the suspected food was eaten. A sample of the cake was collected for laboratory examination but the results have not yet been received. The other outbreak occurred among 45 persons, involving 11. The incubation period was 1 1/2 to 5 hours. Specimens were taken from the food and a laboratory examination on these revealed the presence of coagulase positive hemolytic staphylococcus in potato salad, cole slaw, and borsch. There was no history of any previous illness in the food handler

but a cut was observed on one finger.

Dr. Halverson also reports an outbreak of gastro-enteritis among persons who ate in a cafe in California. Of 15 persons eating the suspected food, 11 became ill about 6 1/2 hours later. The symptoms were nausea, abdominal cramps, vomiting, and diarrhea. A culture of vomitus from one patient was positive for staphylococci and streptococci. The suspected vehicles of infection were potato salad, and banana and coconut cream pies. The pies were made in the cafe one afternoon, cooled, and placed in a pie case where they remained until noon the next day. The case is equipped with a refrigeration unit and contains a thermometer, but the operator failed to check the temperature. On the day following the outbreak, when an investigation was made, it was discovered that the refrigeration unit was out of order. None of the cream pies were available for bacteriological studies. However, numerous Staphylococcus Albus colonies were present in the potato salad.

Communicable diseases in other areas

Information has been received on the widespread outbreak of Salmonella typhimurium infection in Sweden. The cases have been scattered throughout the country, and the infection appeared to spread with explosive force. The primary source of infection is believed to be a large meat packing house which distributes its products throughout the country. Rats are reported to be numerous in this establishment. A paratyphoid epidemic was traced to this same source in 1941. A total of 4,351 cases with 52 deaths have been reported, and 27 carriers have been found in the meat packing house. The mortality rate is about 1 percent, and deaths are chiefly among infants and the aged. Travelers to Sweden are urgently advised to obtain typhoid-paratyphoid inoculations prior to entering the country.

A report from Godthaab, Greenland, states there have been 12 deaths from poliomyelitis and 30 hospitalized cases at Egedesminde.

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