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The chart shows the number of deaths reported for 106 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 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.

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705 3,053 2,083

631 2,784 2,108

640 2,941 2,202

692 744 414 712

190 1,159

664 734 433 696

230 1,107

668 719 392 691

218 1,116

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Provisional Information on Selected Notifiable Diseases in the United States for

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With only 6 weeks left, it appears that there will be about 350 less cases of diphtheria in 1953 than in 1952, when 3,051 cases were reported for 52 weeks. The estimated decrease in incidence for 1953 will be approximately half the annual decreases of 27, 31, and 26 percent, respectively, for the previous 3 years.

During the past several years the peak incidence of diphtheria has not been as pronounced as in former years, but the number of reported cases has usually been larger during the fall months than for the other months. Since about September 1, near the beginning of the current school year, a total of 762 cases of diphtheria has been reported in the United States as compared with 1,002 for the corresponding period of 1952.

During the last few years a large proportion of the total diphtheria cases have occurred in the South Atlantic, East South Central, and West South Central Divisions. Beginning with the first week in September these 3 divisions have reported more than three-fourths (614 cases) of the total in the Nation. Decreases in the incidence of the disease have occurred in all divisions during the last 20 years, but the decline has been slower in the south eastern part of the country. About 10 States in this section of the United States have reported most of the cases since about Sep

tember 1, 1953. These States and the numbers of cases reported (last year's figures in parentheses) are as follows: Virginia, 24 (93); North Carolina, 49 (88); South Carolina, 71 (71); Georgia, 159 (91); Florida, 53 (38); Kentucky, 26 (22); Tennessee, 19 (27); Alabama, 99 (223); Mississippi, 25 (15); and Texas, 51 (87). The only apparent concentration of cases is in Jasper County, Georgia, where 20 cases were reported for the week ended November 7. One case was reported in this county the following week and 7 were previously reported in October. Another county, Burke, in the east central part of Georgia, has reported 12 cases since the first of September.

Since January 1, 1953, Puerto Rico has been reporting an average of 6 cases of diphtheria each week. The total to date (297) is 20 percent less than the 370 cases reported for the corresponding period of 1952.

EPIDEMIOLOGICAL REPORTS

Botulism

Dr. W. M. Talbert, Illinois Department of Public Health, reports a fatal case of what appears to have been botulism. The

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patient, a 58-year-old woman, became violently ill after tasting from a New York supply house, the same as that for birds several cans of home-canned corn. She noticed a peculiar taste recently involved in a case reported in Massachusetts. to the corn and discarded the contents of the involved cans by Dr. W. L. Halverson, Director, California Department of feeding it to chickens. It was reported that the chickens died Public Health, has reported 2 cases of psittacosis, both in adult following the consumption of the corn.

women. One had continuous contact with parakeets in a private Although no post-mortem examination was made, a hospital aviary. Diagnosis was confirmed by a positive complement test pathologist was able to secure some of the suspect corn and (1:32). The other patient had prolonged contact with pigeons inoculated 2 guinea pigs with the material. One pig was protected and myna birds. The complement fixation test was positive, 1:64. with botulinus antitoxin and the other served as a control. The Both patients had chills and fever, and showed pulmonary inprotected pig survived but the control animal died with symptoms filtration. of botulism. A further test was applied by heating the canned corn and inoculating a pig with the material. This pig survived. Rabies in man

Dr. R. H. Hutcheson, Tennessee Department of Public Health, Psittacosis

reports a case of rabies in a 41-year-old woman. The patient Dr. Mason Romaine, Virginia Department of Health, has was attacked by a fox, and was bitten on the legs, arms, and left supplied additional information on the case of psittacosis reported hand. The fox was killed and the head sent to the laboratory in an employee of a pet shop. The patient had normal chest where it was found to be positive for rabies. The patient's findings when first seen, but 2 days later had a diffuse light wounds were thoroughly cleansed and she was given antirabic infiltration in both lower lobes. There was a severe cough and vaccine, the first injection on the day she was bitten (October slight hemoptysis for a few days. Convalescence was slow. 14). Two doses of vaccine were given on each of the following A laboratory report indicated a positive complement fixation 2 days, then one daily until 27 doses had been given. The patient test of 1:1024. A history of virus pneumonia in July 1951 was became ill on November 8 with a tingling in the left hand and obtained. About that time she was working in a poultry packing arm. She developed typical signs and symptoms of rabies and plant. The pet shop where the patient recently worked was in a died 3 days later. Unfortunately no autopsy could be obtained department store. The parakeets sold by this store were obtained

Table 1. COMPARATIVE DATA FOR CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

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

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Symbole.-1 dash [-]: no cases reported; asterisk (o] : disease stated not notifiable; parentheses, [ ] in total; 3 dashes [---] : data not available.

: data not included Table 2. CASES OF SPECIFIED DISEASES WITH COMPARATIVE DATA: UNITED STATES,

EACH DIVISION AND STATE FOR WEEK ENDED NOVEMBER 21, 1953

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

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