Table 3. CASES OF SPECIFIED DISEASES: SELECTED CITIES FOR WEEK ENDED (Numbers after diseases are category numbers of the Sixth Revision of the International Lists, 1948) Table 3. CASES OF SPECIFIED DISEASES: SELECTED CITIES FOR WEEK ENDED (Numbers after diseases are category numbers of the Sixth Revision of the International Lists, 1948) This is the fifth successive week that the number of deaths reported in 106 major cities exceeded the 3-year median for the corresponding week, 1950-52. For the 5-week period ended January 31, a total of 57,155 deaths was reported, 12 percent more than the total of 51,163 deaths for the 5 corresponding weekly 3-year medians. The excess for the current week ended January 31, was 14 percent. This increase is believed to be associated with the recent widespread outbreak of upper respiratory infections. 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. Influenza Washington 25, D. C. Vol. 2, No. 5 Week Ended EPIDEMIOLOGICAL REPORTS The following reports have been received by the Influenza Information Center, N.I. H, and the National Office of Vital Statistics. The New York State Health Department reports that serological evidence of influenza type A has been obtained in a sporadic case on Long Island, in which there was a clinical diagnosis of atypical pneumonia. Dr. James R. Strain, Maryland Department of Health, reports that during the first 3 weeks of January there was an increased number of deaths from influenza and pneumonia combined, but the number has declined to expected levels. The National Institutes of Health reports the recovery of 15 strains of influenza A-prime from cases occurring in the Washington, D. C., metropolitan area during the middle of January. Physicians in 70 counties and 8 cities in Virginia reported more than 14,000 cases of an influenza-like infection for the week ended January 31. Although this is a substantial increase over the number reported for last week, in some instances it represents an accumulation of cases for the whole period of high incidence rather than the cases actually occurring during the week, according to a statement made by the State Department of Health. One health officer states that 69 percent of his physicians reported, and that in their opinion, the wave of infection is definitely on the decline in that community. Dr. Julius Goldberg, Medical College of South Carolina, Charleston, reports a significant rise in antibody titers against influenza A (FM-1 and PR-8) in sera obtained from 4 cases. Approximately 1,000 cases of an influenza-like disease were reported in Charleston County during the past 3 weeks. Dr. Thomas Francis, Jr., University of Michigan, reports the isolation of three strains of influenza virus crossing with Aprime antisera. Material was collected in the middle of January, but to date there has been no extensive epidemic in the Ann Arbor, Michigan, area. Dr. F. H. Wentworth, Ohio Department of Health, reports that an outbreak of respiratory illness in a group of college students was characterized by sudden onset, malaise, myalgia, headache, fever, cough, and coryza, Nausea was observed in several cases. There was no change in the leucocyte count. A virus isolated from throat washings has been identified provisionally as A-prime. Throat washings from attendants in a Columbus hospital yielded a similar type of virus. Dr. A. P. McKee, University of Iowa, reports the isolation of two strains of influenza A-prime virus from material submitted by the Nebraska State Health Department. Large numbers of cases of influenza continue to be reported in Tennessee, Georgia, and Alabama. In Arkansas the disease is on the decline, after reaching a peak in the week ended January 17. Dr. Andrew Hedmeg, Louisiana Department of Health, reports that except in a few parishes, the epidemic of influenza is on the downward trend, Eight deaths from influenza have been reported since the beginning of the outbreak. Dr. John H. Dingle reports the isolation of two strains of influenza from cases in Wyoming during the early part of January, one of which has been identified as A-prime. In Montana, disease reports indicate a widespread prevalence of influenza. Dr. W. R. Geidt, Washington State Department of Health, reported on February 5 that prevalence was decreasing. He also reports February 7, 1953 that a relatively large number of infants, ranging in ages from 1 to 3 months, had died suddenly during the past 3 months in Pierce County. Ten have been found dead in their cribs in the morning after having appeared well when put to bed. Autopsies have revealed a tracheobronchial exudate, and a serous exudate in scattered areas of the lungs. Dr. E. H. Lennette, California State Health Department, reports serologic evidence of influenza A and A-prime in 34 cases from the San Francisco area, having onsets from January 4 to 8. The State Department of Health reports that the wave of influenza-like illnesses in California reached a peak in the week ended January 24. School and industrial absenteeism has been generally the same or slightly above the level of the influenza B epidemic 1 year ago, and much lower than the 1948 outbreak of influenza A. Dr. Frank P. Pauls of the Alaska Department of Health has reported a significant rise in titer against influenza A-prime in four causes from the Anchorage, Alaska, area. Data from the Greater Anchorage School District shows that on January 16, absenteeism began to increase, reaching a maximum on January 26, of 31.4 percent. Since that time, it has decreased and the evidence indicates that the outbreak of influenza has passed its peak, and is now on the downgrade. The Army Medical Service Graduate School and army area laboratories have identified influenza A-prime virus from cases in military personnel in Kentucky, Texas, New Jersey, and Washington, D. C. An increase of 20 percent occurred in the number of deaths from influenza and pneumonia reported by 58 cities for the week ended January 31. A total of 554 deaths was reported as compared with 463 for the previous week. The numbers reported for these cities by geographic division, with figures for the previous week in parentheses, were: New England, 26 (35); Middle Atlantic, 177 (127); East North Central, 61 (83); West North Central, 95 (61); South Atlantic, 47 (45); East South Central, 46 (28); West South Central, 57 (33); Mountain, 29 (22); and Pacific, 16 (29). There has been no marked change in the proportion of deaths from influenza and pneumonia in the various age groups, as indicated by reports from 7 large cities. It is evident from reports received from various parts of the country that influenza is now showing a downward trend as shown in the accompanying maps which have been prepared on the basis of information received from certain States. The disease apparently has been most widespread in the central and southern parts of the country, and generally, it has been a mild infection due to the A-prime type of influenza virus, lasting a few days, and having a low complication rate. The WHO Regional Office (Pan-American Sanitary Bureau) reports influenza in Austria, Germany, locally in the Netherlands, and an increasing number of cases in Iceland, Sweden, and Switzerland. The numbers of cases appear to be decreasing in France, Finland, Belgium, Spain, and North Africa. There has been no unusual prevalence in Italy, Yugoslavia, or Turkey. There is evidence of a considerably increased spread of influenza in London and the surrounding towns, and of a rather lesser increase throughout the southern half of England. As yet, only localized outbreaks have been reported from the north of England and from Wales. The total number of deaths from influenza in the Great |