Mortality Report

Vol. 2, No. 49

December 18, 1953

During the first 49 weeks of the current year, a total of 2,206 cases of typhoid fever was reported in the United States as compared with 2,331 cases for the corresponding period of last year. These figures exclude the report from New Hampshire, which was not received for the current week. Although cases were scattered throughout the country, more than a hundred have been reported in 6 States. They are as follows: Texas, 272; Pennsylvania, 127;; Arkansas, 118; Kentucky, 106; Ohio, 102; and New York, 101. During the summer months when the disease is most likely to occur or spread, only Texas and Louisiana reported 10 or more cases for a single week. In Texas, the weekly number was 10 or more for 6 different weeks. No concentration of cases was noted except in two instances when Jones County reported 10 cases for the week ended September 9, and Moore County, where 6 cases occurred for the week ended July 25. Ten cases of typhoid fever were reported in Louisiana last week, 8 of which were in Vermilion County. For 1 week prior to this the State reported more than 10 cases, but there was not concentration. No epidemiological information has been received from Texas or Louisiana to indicate whether or not the disease was concentrated in any particular locality.

Epidemiological reports of typhoid fever have been received from 6 States and New York City. In three instances only single cases occurred, but from 3 to 10 persons were affected in 8 outbreaks. In one instance, a child developed the disease after playing with inoculated mice in a private laboratory. Five cases occurred in persons who had traveled in Mexico, and 1 was in a person who visited several countries in southern Europe. One outbreak was in a family of 3 who came from Cuba, where a high incidence of the disease had been prevalent. At least one member of this family probably contracted the disease while on the Island. Five outbreaks involving 39 persons resulted from typhoid carriers or suspect carriers. Of these, 4 occurred among per-: sons who ate in a restaurant or in social groups at private parties where a carrier had prepared and/or served food. One outbreak resulted from a carrier who lived in a settlement where poor sanitary conditions prevailed. The source of infection was unknown for 1 single case, and for the first case in an outbreak involving 6 persons. The 5 subsequent cases resulted from contact with or from water contaminated by the first patient.

For the week ended December 5, there were 71 cases of measles reported in South Dakota. All the cases were attributed to an epidemic in a State institution during November.

Trichiniasis

EPIDEMIOLOGICAL REPORTS

Dr. L. M. Schuman, Illinois Department of Public Health, reports that early in October notification was received of several cases of illness resembling gastro-enteritis. The symptoms were diarrhea, abdominal cramps, fever, aching of arms and legs, and swelling of the face, particularly, around the eyes. An investigation revealed 13 cases with onsets during the first 2 weeks in October. Most of the patients had a marked eosinophilia, with one having as high as 54 and 57 percent on two occasions. Skin tests with Trichinella antigen were, however, negative for the few patients on whom the test was applied. Most of the

affected persons gave a history of having eaten summer sausage which was purchased commercially from a single source. The local grocer also was ill, but denied eating any of the sausage. Similar cases have been occurring in nearby communities, especially across the river in Missouri. Several of these cases are being investigated.

Salmonellosis

Dr. Dean Fisher, Maine Department of Health and Welfare, reports an outbreak of salmonellosis following a wedding reception. Eleven persons became ill from 3 to 10 days after attending the reception. Neither the vehicle nor the source of infection has been found. Many of the guests helped in preparing and serving the refreshments, of which turkey and pork sandwiches were the main items. Those who handled food have submitted stool and urine specimens. The meat was cooked at home and returned to a neighborhood store for grinding. No information is available as to the source of the turkeys. The diagnosis was confirmed by laboratory examination of specimens of 7 patients. The etiological agent was S. paratyphi B (phage type 3al).

Gastro-enteritis

Dr. N. H. Dyer, West Virginia Department of Health, reports an outbreak of gastro-enteritis in a family of 6 persons. An unwrapped cured ham was purchased about noon and was baked about an hour later. That evening the entire family ate ham for dinner without any apparent ill effects. The remainder of the meat was returned to the warm oven and left overnight. The next morning 5 persons had ham for breakfast and became ill 3 hours later. The sixth member of the family did not eat ham for breakfast but made a sandwich for lunch and became ill about 3 hours later. The source of infection of the ham was not found but it was thought to be a loose-handle knife. Laboratory examination showed the ham was contaminated with a large number of staphylococci.

Dr. C. M. Steward, County Health Officer, New York State Department of Health, reports an outbreak of gastro-enteritis among pupils in a school. During the period October 17 to November 9, 47 cases were reported. Most of the patients had abdominal pain, about half became ill with vomiting, and less than half had diarrhea. These symptoms lasted about 1 day, while nausea and malaise persisted 1 to 3 days longer. Laboratory examination of the water supply proved it to be sanitary. The handling of food was satisfactory. It was believed that this was virus gastro-enteritis, spread from person-to-person contact. Dr. Roy F. Feemster, Massachusetts Department of Public Health, reports an outbreak of gastro-enteritis in a private family, following a turkey dinner. Seven of 10 members became ill with cramps, nausea, vomiting, and diarrhea from 7 to 12 hours later. The turkey had been precooked. Information concerning the outbreak was not in detail but it was stated that the involved turkey farm has an excellent reputation for cleanliness. A rotiserie is used for cooking the turkeys. They are then frozen and sold. It is possible that the birds became infected at the home after they were thawed. However, bacteriological examination of a sample of turkey meat failed to reveal any pathogenic organisms.

No other specimens of food were submitted for examination. One stool specimen was negative.

Dr. A. C. Hollister, Jr., California Department of Public Health, reports an outbreak of gastro-enteritis involving 6 households in 5 different localities in 1 county. Of 39 persons eating cream or custard filled doughnuts, 23 became ill from 1 to 12 hours later. The symptoms were nausea, violent abdominal pains, vomiting, chills, diarrhea, weakness, fever, and prostration

in some cases. The doughnuts had been prepared by one bakery and were delivered by distribution trucks to some of the households; for others, they were purchased at local bakeries. However, 1 family purchased a half dozen sugar doughnuts from the same bakery, but no one eating them became ill. Laboratory examination of specimens of cream filling and dough revealed many gram positive cocci, hemolytic and coagulase positive. The same organisms were found in vomitus.