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

JANUARY 31, 1953

(Numbers after diseases are category numbers of the Sixth Revision of the International Lists, 1948)

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EAST NORTH CENTRAL Akron-----Canton---Chicago--CincinnatiCleveland ColumbusDayton-DetroitEvansvillePlint--Fort Wayne-Grand Rapids--IndianapolisMilwaukee-Peoria--South Bend Toledo---Youngstown-

WEST NORTH CENTRAL Des MoinesDuluthKansas City, Kans, Kansas City, Mo. Minneapolis--OmahaSt. Louis-St. Paul Wichita-

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

JANUARY 31, 1953-Continued
(Numbers after diseases are category numbers of the Sixth Revision of the International Lists, 1948)

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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 insections.

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 + 2Vā, 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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646 3,135 2,152

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+7.9 +10.1 +34.5 +21.8 +26.2 +22.2 +48.8 +4.7

2,906 13,290 9,638 3,797 3,594 2,081 3,688 1,266 5,716

2,800 12,658 8,617 3,233 3,136 1,799 3,115

754 739 451 756

207 1,268

946 5,715

+3.8 +5.0 +11.8 +17.4 +14.6 +15.7 +18.4 +33.8 +0.0

1,325

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Provisional Information on Selected Notifiable Diseases in the United States for

Week Ended February 7, 1953
EPIDEMIOLOGICAL REPORTS

that a relatively large number of infants, ranging in ages from

1 to 3 months, had died suddenly during the past 3 months in Influenza

Pierce County. Ten have been found dead in their cribs in the The following reports have been received by the Influenza In- morning after having appeared well when put to bed. Autopsies formation Center, N.I.H, and the National Office of Vital Statistics. have revealed a tracheobronchial exudate, and a serous exudate

The New York State Health Department reports that serologi- in scattered areas of the lungs. cal evidence of influenza type A has been obtained in a sporadic Dr. E. H. Lennette, California State Health Department, case on Long Island, in which there was a clinical diagnosis of reports serologic evidence of influenza A and A-prime in 34 atypical pneumonia. Dr. James R. Strain, Maryland Department cases from the San Francisco area, having onsets from January of Health, reports that during the first 3 weeks of January there 4 to 8. The State Department of Health reports that the wave of was an increased number of deaths from influenza and pneumonia influenza-like illnesses in California reached a peak in the combined, but the number has declined to expected levels. The week ended January 24, School and industrial absenteeism has National Institutes of Health reports the recovery of 15 strains been generally the same or slightly above the level of the inof influenza A-prime from cases occurring in the Washington, fluenza B epidemic 1 year ago, and much lower than the 1948 outD. C., metropolitan area during the middle of January.

break of influenza A. Physicians in 70 counties and 8 cities in Virginia reported Dr. Frank P. Pauls of the Alaska Department of Health has more than 14,000 cases of an influenza-like infection for the week-reported a significant rise in titer against influenza A-prime in ended January 31. Although this is a substantial increase over four causes from the Anchorage, Alaska, area. Data from the the number reported for last week, in some instances it repre- Greater Anchorage School District shows that on January 16, sents an accumulation of cases for the whole period of high in- absenteeism began to increase, reaching a maximum on January cidence rather than the cases actually occurring during the week, 26, of 31.4 percent. Since that time, it has decreased and the according to a statement made by the State Department of Health. evidence indicates that the outbreak of influenza has passed its One health officer states that 69 percent of his physicians re- peak, and is now on the downgrade. ported, and that in their opinion, the wave of infection is definitely The Army Medical Service Graduate School and army area on the decline in that community.

laboratories have identified influenza A-prime virus from cases Dr. Julius Goldberg, Medical College of South Carolina, in military personnel in Kentucky, Texas, New Jersey, and Charleston, reports a significant rise in antibody titers against Washington, D. C. influenza A (FM-1 and PR-8) in sera obtained from 4 cases. An increase of 20 percent occurred in the number of deaths Approximately 1,000 cases of an influenza-like disease were from influenza and pneumonia reported by 58 cities for the week reported in Charleston County during the past 3 weeks. ended January 31. A total of 554 deaths was reported as compared

Dr. Thomas Francis, Jr., University of Michigan, reports with 463 for the previous week. The numbers reported for these the isolation of three strains of influenza virus crossing with A- cities by geographic division, with figures for the previous week prime antisera. Material was collected in the middle of January, in parentheses, were: New England, 26 (35); Middle Atlantic, 177 but to date there has been no extensive epidemic in the Ann Arbor, (127); East North Central, 61 (83); West North Central, 95 (61); Michigan, area. Dr. F. H. Wentworth, Ohio Department of Health, South Atlantic, 47 (45); East South Central, 46 (28); West South reports that an outbreak of respiratory illness in a group of Central, 57 (33); Mountain, 29 (22); and Pacific, 16 (29). There college students was characterized by sudden onset, mala ise, has been no marked change in the proportion of deaths from inmyalgia, headache, fever, cough, and coryza. Nausea was observed fluenza and pneumonia in the various age groups, as indicated in several cases. There was no change in the leucocyte count. by reports from 7 large cities. A virus isolated from throat washings has been identified pro It is evident from reports received from various parts of visionally as A-prime. Throat washings from attendants in a the country that influenza is now showing a downward trend as Columbus hospital yielded a similar type of virus. Dr. A. P. shown in the accompanying maps which have been prepared on McKee, University of Iowa, reports the isolation of two strains the basis of information received from certain States. The disof influenza A-prime virus from material submitted by the ease apparently has been most widespread in the central and Nebraska State Health Department.

southern parts of the country, and generally, it has been a mild Large numbers of cases of influenza continue to be reported infection due to the A-prime type of influenza virus, lasting a few in Tennessee, Georgia, and Alabama. In Arkansas the disease days, and having a low complication rate. is on the decline, after reaching a peak in the week ended Jan- The WHO Regional Office (Pan-American Sanitary Bureau) uary 17. Dr. Andrew Hedmeg, Louisiana Department of Health, reports influenza in Austria, Germany, locally in the Netherlands, reports that except in a few parishes, the epidemic of influenza and an increasing number of cases in Iceland, Sweden, and Switzeris on the downward trend. Eight deaths from influenza have been land. The numbers of cases appear to be decreasing in France, reported since the beginning of the outbreak.

Finland, Belgium, Spain, and North Africa. There has been no Dr. John H. Dingle reports the isolation of two strains of unusual prevalence in Italy, Yugoslavia, or Turkey. There is influenza from cases in Wyoming during the early part of January, evidence of a considerably increased spread of influenza in London one of which has been identified as A-prime. In Montana, disease and the surrounding towns, and of a rather lesser increase reports indicate a widespread prevalence of influenza. Dr. W. throughout the southern half of England. As yet, only localized R. Geidt, Washington State Department of Health, reported on outbreaks have been reported from the north of England and from February 5 that prevalence was decreasing. He also reports Wales. The total number of deaths from influenza in the Great

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