November 16, 1953

Vol. 2, No. 44

While the number of diphtheria cases reported for the current week (101) was well above that for the same week last year (67) the total number reported since the first of September this year was about 23 percent less than for the same period of 1952. More than three-fourths of the cases for the current week were concentrated in the South Atlantic and South Central States. Georgia reported 33 or one-third of the total for the entire country. An average of 14 cases was reported weekly during the month of October in Georgia.

A total of 703 cases of poliomyelitis was reported for the current week which was about 16 percent below the total for the previous week. Fifteen deaths were reported from 8 States. The cumulative total of cases since the seasonal low point is 31,427 as compared with 51,523 in 1952; and the cumulative total for the calendar year is 32,941 as compared with 52,716 for the same time last year.

Information has been received of a suspect case of human plague in New Mexico. The patient, an adult woman, was seen by a physician on October 30. Bacteria were detected in a specimen of blood, and mice were inoculated with a blood sample. Gross pathology consistent with that caused by Pasteurella pestis was found on autopsy of the mice. Cases of plague in persons occurred in the same area of this State in 1949 and 1950, who presumably contracted their infection by handling cottontail rabbits.

EPIDEMIOLOGICAL REPORTS

Equine Encephalomyelitis

Dr. C. B. Tucker, Tennessee Department of Public Health, has reported that cases of western-type equine encephalomyelitis in horses have been confirmed by laboratory examination. The cases occurred in the northwestern part of the State. Other suspect cases, on which no laboratory studies have been carried out, have been found in 2 other counties in the same part of the State.

Encephalitis

Twenty-four cases of arthropod-borne encephalitis confirmed by laboratory examination have been reported in California since the first of the year. The cases are equally divided between St. Louis and western equine types of infection. There have been 10 cases in the Sacramento Valley, all but 1 being the western equine type. Seven of the 24 cases have occurred in the San Joaquin Valley, all but 1 being the St. Louis type. Seven cases, 2 of the western equine and 5 of the St. Louis type, have been reported in Riverside and Imperial Counties. In addition to the above, 105 cases of encephalitis of unknown etiology, 62 cases following mumps, 28 following measles, and 6 following chickenpox have been reported. A case accompanying infectious mononucleosis, and a fatal case of herpes encephalitis have also been reported

Psittacosis

Dr. D. S. Fleming, Minnesota Department of Health, has reported 2 cases of psittacosis. The first was a woman who had loss of appetite, pain in the arms and legs, swelling of the right knee, a temperature which reached 104 degrees, hoarseness, and cough. An X-ray examination showed pneumonitis at the base of the right lung. One complement-fixation test was positive 1 to 512 about 3 weeks after onset. There was no known exposure to psittacine birds, pigeons, or to domestic and wild fowls or birds. The patient had been employed in a restaurant but denied handling any fowl. She had a history of generalized arthralgia in July 1953, and rheumatic fever 5 years ago.

The second was a man with onset October 14. A pneumonic process in the right lung was found on X-ray examination which disappeared in about 2 weeks. Complement fixation was positive 1:512 on October 26. History of contact with birds of any kind was denied. Other members of the family, consisting of the wife and 5 children, have had ill-defined mild upper respiratory infections. Dr. R. F. Feemster, Massachusetts Department of Public Health, in a preliminary report states that illness resembling psittacosis occurred in a family 10 days following the purchase of 2 parakeets from a chain store. One of the birds died very shortly after it was bought, and the other is now ill. The live bird will be sacrificed and examined for presence of psittacosis virus. The birds were obtained from the same dealer in New York City, whose parakeets were presumed to be the source of infection of a case reported earlier in the year in Massachusetts.

Salmonellosis

It has been reported by the Oakland California Health Department, that 22 persons became ill after eating barbecued chicken at a party in a private home. Five additional cases in persons living elsewhere, but attending the party, are also known to have occurred. Twenty-five pounds of frozen eviscerated chickens were removed from a deep freeze, allowed to thaw at room temperature overnight, and partially cooked in an oven for 45 minutes. The chickens were left unrefrigerated 1 day, then barbecued. Symptoms occurred 10 to 48 hours after eating. Stool specimens from 18 ill persons, including 2 who assisted in preparing the chicken, contained Salmonella organisms, type S. Muenchen. Specimens of frozen fowl from the same lot were negative.

Poisoning from noxious plants

The Los Angeles Health Department reports that 2 persons became ill 20 to 30 minutes following the ingestion of brussel sprouts and tree tobacco obtained from a garden. The latter (Nicotiana glauca), was mistaken for swiss chard, and the two plants were boiled together and served as a vegetable.. The symptoms consisted of nausea and dizziness followed by great muscular weakness, dullness, and stupor. Diarrhea and vomiting followed. After 2 days a marked weakness of the eye muscles occurred resulting in double vision. Both patients recovered.

Q fever

Dr. D. S. Fleming, Minnesota Department of Health, has reported a case of Q fever in an adult male. Complement fixation was positive 1:1024. The patient had visited France, Egypt, Palestine, and Greece. Onset of symptoms and pneumonitis

occurred 2 weeks after he left Greece. During the trip, dairy products were avoided and there was no contact with animals, except when riding on camels. The patient recalled insect bites on his legs, but no known tick bites.

Gastro-enteritis

Dr. Morris Greenberg, New York City Department of Health, has reported 2 outbreaks of gastro-enteritis. In the first, epidemiological investigation indicated that roast chicken with dressing served to 100 persons at a wedding party was the probable vehicle of infection. Of 59 persons contacted, 35 reported that they became ill 4 to 5 hours after eating. No food was obtained for laboratory examination. The second outbreak occurred in employees of a hospital and smoked tongue was considered to be

the source of infection. Forty-four of the 208 employees were contacted, and 37 were reported to have developed diarrhea and abdominal pain 5 to 21 hours after a noonday meal. A Salmonella organism was said to have been cultured by the hospital laboratory from stools of 2 persons who were ill, but this was not confirmed in the health department laboratory. The smoked tongue was cooked the day before serving and allowed to stand at room temperature for several hours.

Dr. E. W. Seaforth, Lac du Flambeau Indian Reservation, has reported an outbreak of bacillary dysentery in the Reservation. A Shigella flexner organism was isolated from the blood-streaked stools of 6 patients. Acute gastro-enteritis was noted in 35 other persons. Bacteriologic examination of water from wells throughout the Reservation revealed that 4 of them were unsafe.