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Table 3. CASES OF SPECIFIED DISF1SES: SELECTED CITIES FOR WEEK ENDED

FEBRUARY 21, 1953-Continued
(Numbers after diseases are category numbers of the Sixth Revision of the International Lists, 1948)

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The number of deaths reported in the 106 major cities continues, for the eighth successive week, very much above the 3-year median. This excess mortality is associated with the current outbreak of influenza and other acute respiratory. diseases. For the 7-week period ended February 21, a total of 80,215 deaths was reported, 13 percent more than the total of 70,931 deaths for the 7 corresponding weekly 3-year medians. The excess for the current week, ended February 21, was 18 percent.

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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256 1,376

286 1,343

203 1,196

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32 78 133

1,858

Albany--
Buffalo--
Camden--
Elizabeth-
Erie--
Jersey City---
Newark, N. J.-
New York City--
Paterson --
Philadelphia-
Pittsburgh-
Rochester, N. Y.
Schenectady-
Syracuse-
Trenton-
Utica--
Yonkers-

56

44
157

30
(36)
21
83
125
1,877

42
524
156
112
29
64
63
26
36

26

572
196
119
22
64
62
43
31

245
536

862
12,965

297 3,593 1,272

760 189 424 376 218 213

24 16 16 80 21 43 104

38 211 57 88 45 42

14 18 91 32 53 153

55 169 40 81 41 27

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23

Birmingham-

Chattanooga281

Knoxville1,024

Louisville263

Memphis (274)

Mobile--233

Montgomery----
540

Nashville-
867
11,641

WEST SOUTH CENTRAL
301

Austin--3,521

Baton Rouge-1,271

Corpus Christi698

Dallas171

El Paso-371

Fort Worth349

Houston 208

Little Rock-
208

New Orleans-
Oklahoma City--

San Antonio-
423

Shreveport-
229 Tulsa-
5,005

MOUNTAIN
1,021
1, 445

Albuquerque---
723 Colorado Springs-
(421)|| Denver-
2,164 Ogden--

245 Phoenix-
261

Pueblo--
206

Salt Lake City275

Tucson-
(801)

PACIFIC
868
243 Berkeley--

166 Long Beach-
• 669

Los Angeles
365 Oakland-

Pasadena--
Portland, Oreg.

Sacramento--
367

San Diego-160

San Francisco272

Seattle-838

Spokane875

Tacoma444

Honolulu

176

79

Akron---Canton---Chicago--Cincinnati Cleveland Columbus DaytonDetroitEvansville Flint----Fort Wayne Grand RapidsIndianapolisMilwaukee-Peoria---South Bend Toledo--Youngstown

73
41
904
180
252
144
(74)
339
43
42
41
51

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2,482

265 257 254 315

33
13
46
(2)

10
144
18
20
20
51
(3)

235
115
951

91
187
117
385
(41)

743

88 156

79 286 (43)

380 23 42 28 39 125 161 43 18 141 72

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WEST NORTH CENTRAL

41

154

358 3,454

791 254 802 339 566

Des Moines
Duluth-
Kansas City, Kans.
Kansas City, Mo.
Minneapolis--
Omaha --
St. Louis--

20
57
501
100

37
lll
52
89
230
101
44
34
(25)

67 26 30 147 159

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408 213

290 1,080 1,076

565 2,034

1, 439

36 58 124 152

834 279 256

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1,700

(229)

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83.49 423

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March 6, 1953

Washington 25, D.C.

Vol. 2, No. 8

Provisional Information on Selected Notifiable Diseases in the United States for

Week Ended February 28, 1953

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The 105 cases of poliomyelitis reported in the United States is 18 more than the total (87) for the corresponding week of last year. Only 2 States reported significantly more cases for the carrent week than for the corresponding week of last year. They were (last year's figures in parentheses): California, 45 cases (15) and North Carolina, 5 (1).

The incidences of 3 notifiable diseases-measles, scarlet fever and streptococcal sore throat, and whooping cough-usually increase during this time of year and reach a peak sometime during the spring months. Of these, the incidence of whooping cough is reached last, usually the latter part of June.

For the "disease year," which began with the first week in September, a total of 89,135 cases of measles has been reported. This is less than half the number (196,046) reported for the corresponding period of the previous year. The median of the preceding 5 years is 122,390. Of the total reported for the current "disease year,” 31,339 cases were in the East North Central States. Other geographic divisions reporting large numbers of cases were: West South Central, 12,192; Pacific, 11,774; and the West North Central, 11,242.

The number of whooping cough cases reported for the "disease year,” which began with the first week of October, is 12,990 as compared with 23,617 for the corresponding period of last year. This is the third consecutive year in which the incidence of the disease has decreased from that of the previous year. For the current "disease year” the Middle Atlantic States have reported 3,808 cases. Two additional States, Texas and California, reported 1,362 and 1,254 cases, respectively. The total reported in these States represents about half of the total reported in the country as a whole.

The "disease yearfor scarlet fever and streptococcal sore throat began with the first week in August 1952, and since that time a total of 69,263 cases has been reported in the United States. This figure is much larger than the number (37,572) reported for the corresponding period of the previous year. The numbers of cases previous to 1952 are understated because many States did not include cases of streptococcal sore throat in their reports. In Texas and Arizona, where large numbers of cases have been reported, the incidence has been decreasing for the past 2 months. Since the first week of last August these States reported 12,484 and 2,933 cases, respectively. Other States reporting large numbers of cases since the beginning of the current "disease year" are: New York, 6,387; Ohio, 3,510; Michigan, 3,348; and California, 3,271. During the past 2 months significant increases have occurred in Connecticut, New Jersey, Pennsylvania, and Washington. For the current week these States reported 128, 145, 203, and 180, respectively.

Samples of paired sera from two cities have been examined by the Massachusetts Department of Health Laboratory and showed a marked increase in hemagglutination titer against influenza A-prime.

Dr. Sander Szittya, Chief Medical Officer, Cherokee Indian Hospital, North Carolina, reports that sporadic cases of influenza occurred during the first 10 days of January. A high incidence occurred between January 20 and February 10. A total of about 1,415 cases is estimated in the Indian population of 3,000. During the first half of the outbreak, the disease was mild with a short period of illness and few complications. As the epidemic progressed the disease became more severe, and 5 deaths occurred in cases complicated by pneumonia. Three deaths were of children under 5 years of age, and 2 were of persons over 60 years old.

The Virus Laboratory of the Washington State Department of Health reports the serologic identification of 4 cases of influenza A-prime (FM-1) antigen which occurred in the middle of February. W. R. Giedt, State Epidemiologist, reports that Whitman County (especially the town of Garfield) appeared to be more seriously affected than other areas. While only 76 cases of influenza were reported in this county, there were 54 cases of "virus pneumonia," and 148 of pneumonia. In the Garfield area, the several hundred cases of pneumonia were characterized by a leucopenia, generalized aching, and cough. All age groups were involved. In some patients streptococcal infections of the upper respiratory tract developed and were resistant to penicillin but responded to other antibiotics. In Pierce County, where a large number of infants apparently died suddenly of a virulent type of pneumonia late in 1952, investigation revealed only a slight increase as compared with previous years.

The number of deaths from influenza and pneumonia reported by 58 cities was 539 for the week ended February 21 as compared with 596 (corrected figure) for the previous week. The numbers reported for these cities by geographic division, with figures for the previous week in parentheses, were: New England, 41 (35); Middle Atlantic, 199 (200); East North Central, 106 (103, corrected figure); West North Central, 41 (61, corrected figure); South Atlantic, 54 (69); East South Central, 42 (53); West South Central, 19 (23); Mountain, 10 (21); and Pacific, 27 (31).

The WHO Regional Office (Pan American Sanitary Bureau) reports that a mild type of influenza was prevalent in Trinidad, British West Indies, during the month of January.

EPIDEMIOLOGICAL REPORTS

Endemic typus fever

Dr. H. Williams, Baltimore City Health Department, gives information on the case of endemic typhus fever reported in that city for the week ended February 7. The case was in a 60-year-old white man. Laboratory tests confirmed it as murine or flea-borne typhus. Rats were trapped in the area surrounding the patient's home and the disease was identified by laboratory tests of a rat caught in the back yard.

Influenza

The following reports have been received by the Influenza Information Center, N. 1. H., and the National Office of Vital Statistics,

Dr. Dean Fisher, Maine Director of Health, reported on February 25, that many cases of influenza were still occurring in a few communities of the State. Incidence in the State was also thought to be much in excess of the actual numbers reported.

Infectious hepatitis

Dr. H. Kleinman, Bureau of Indian Affairs Hospital, Red Lake Agency Minnesota, states that 16 cases of infectious hepatitis have been reported for January among a population of about 2,000. Since the first week in November 1952, a total of 65 cases have been seen water supply is from a drilled well, 128 feet deep, located in shale. The well is surrounded by cesspools and septic tanks. Attempts to trace the flow of sewage from cesspools and septic tanks to the well, by use of fluorescein, were unsuccessful. The investigation revealed that this outbreak was probably spread by contact and not by water

by physicians. Of these, only 4 were in adults. Most of the cases were in children of early school age.

Dr. J. R. Lewis, Bureau of Indian Affairs Hospital, Haywood, Wisconsin, reports a small outbreak of infectious hepatitis in rather mild form which has been present since September of 1952. Eleven patients were children 5 to 10 years of age. However, the age range was from 5 to 44 years. There were probably more cases in the area but they did not show up at the clinics.

Dr. S. Finkelstein, Bureau of Indian Affairs Hospital, Cass Lake, Minnesota, reports 3 cases of infectious hepatitis for January. All cases were in persons who live near the hospital. Seven more cases have occurred during February.

Typhoid fever

Dr. M. Lipari, District State Health Officer, New York State Department of Health, reports 6 cases of typhoid fever, bacteriophage type E., in persons living in a village. The source of infection of the first case was unknown. It was suspected that water was contaminated by a cesspool used by the first patient. The

Chemical food poisoning

Dr. H. C. Clare, Idaho Department of Public Health, reports 2 outbreaks of chemical food poisoning among 250 students who eat in a school dining room each day. The first outbreak involved 10 students. The second, which occurred about 2 weeks later, affected about 25 persons. In both instances the illness occurred among students who ate at tables where imitation grape jelly was served. Students who ate imitation strawberry and raspberry jellies, packed by the same company, did not become ill. The onset of illness in both outbreaks was less than 1 hour. Laboratory examination of samples revealed the presence of copper in the imitation grape jelly.

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

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

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4 203 386 132

7

3 264 606 162

July 1

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1,346

86

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Anthrax-----

--062

2 Botulism-

.-049.1 Brucellosis (undulant fever) -----044 24

29 Diphtheria--

--055 50

48 150 Encephalitis, acute infectious---082 21

20

14 Hepatitis, infectious, and serum----------

---092,N998.5 pt. 596 426 Malaria ------------- -----110-117

5

19 Measles -----

--------085 10,301 22,594 17,057 Meningococcal infections- ------057 154 112 101 Poliomyelitis, acute-------------080 105

87

87 Rabies in man-----

-094

1 Rocky Mountain spotted fever----104A

1

1 Scarlet fever and streptococcal sore throat---

--050, 051

3,291 2,646 Smallpox-----

--084 Trichiniasis-

----128

2 Tularemia

------059

6

9 Typhoid fever-

-------040 24

30

30 Typhus fever, endemic- -------101 Whooping cough-

---056 544 961

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196,046

2,079 28,327

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37,572

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21,661

4 27 135 247

17 9,432

174 250

2,032

Apr. 1 Apr. 1 Oct. 1

2,181

175 12,990

192

25 5,133

1, 604

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13,113

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

:

: data not included

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