January 16, 1953

Smallpox

EPIDEMIOLOGICAL REPORTS

Dr. E. A. Belden, Missouri Department of Public Health and
Welfare, reports a case of smallpox in a white male, age 19, in
Jefferson County. The patient, who attended college in Indiana,
left for his home by train 13 days prior to onset of the illness,
which was on January 1, 1953. He was vaccinated 12 years ago
and had chickenpox at the age of 3. Laboratory studies are under-
way. A delayed case of smallpox, with onset December 20, was
reported in Vernon County. No additional cases have occurred in
either locality.

Dr. R. H. Heeren, Iowa State Department of Health, gives
additional information on the case of smallpox reported for the
week ended December 13. This case occurred in Sioux City where
no smallpox has been diagnosed for several years. The source
of infection was not determined. The patient was a 11-year-old
boy who had a successful vaccination about 5 years ago. No lab-
oratory tests have been made which might confirm or reject the
diagnosis, consequently this case is reported as "not confirmed."

Influenza and other respiratory diseases

The following reports have been received by the Influenza
Information Center, National Institutes of Health, and by the
National Office of Vital Statistics.

Dr. A. P. McKee, of the Influenza Regional Laboratory, Iowa
City, Iowa, reports the isolation of 6 strains of influenza A virus
resembling the FM-1 strain, from cases in Iowa City. He has
also isolated influenza A strains from a military installation in
Missouri, similar to those previously recovered by Dr. M. R.
Hilleman from the same place.

Dr. Gordon Meikeljohn, of the Influenza Collaborating Lab-
oratory, Denver, and the Division of Preventive Medicine, United
States Air Force, reports an outbreak of influenza at a military
installation in Colorado, beginning January 4. Five paired serum
samples showed marked rise in titer to A-prime antigen, Cases
of influenza-like disease appeared earlier in the near-by civilian
population. Reports of an increased respiratory disease rate at
Air Force Bases in Texas and South Dakota have also been re-
ceived. The Division of Preventive Medicine, Department of the
Army and Dr. Jonas Salk, University of Pittsburgh, report that
4 pairs of serum from an outbreak of influenza-like disease at
a military installation in New Jersey show a significant rise to
influenza A-prime antigens.

UNIVERSITY OF Hatbreak
students of the University of Florida, in Gainesville. The outbreak
began on January 4, when students returned from vacation. Mate-
rial is being collected for a specific diagnosis.

The Army Medical Service Graduate School reports the
identification as influenza A-prime of a strain of virus recovered
by the Hawaiian Medical Laboratory at Tripler Army Hospital,
Hawaii. The patient became ill on the 21st or 22d of November
in Hawaii after leaving the Philippine Islands on November 19.
The antigenic characteristics of this strain are similar to strains
recently recovered in Missouri,

The Preventive Medicine Division, U. S. Navy, reports there
has been a definite increase in upper respiratory disease in a
military establishment in Maryland within the past week. A large
proportion are presenting a clinical picture of influenza.

Dr. L. E. Burney, Indiana State Health Commissioner, reports
a sudden outbreak of upper respiratory infection in De Pauw Uni-
versity. About 245 cases have been reported and material is
being collected for laboratory tests. Dr. M. I. Shanholtz, Virginia
State Health Commissioner, states that an outbreak has occurred
in Appomattox County in which malaise and bronchitis are common
symptoms. None of the cases have had pneumonia and no fatali-
ties have been reported. Dr. G. J. Van Heuvelen, South Dakota
State Health Officer, has been notified of an outbreak of an esti-
mated 5,000 cases of respiratory disease in Sioux Falls. Dr.
G. F. Mathews, Oklahoma Commissioner of Health, reports an
outbreak of 400 to 500 cases in Stephens County, and a high prev-
alence of cases in Washington County and Oklahoma City. A high
incidence of respiratory disease which began on December 29 is
also reported from a federal penal institution in Oklahoma. Dr.
G. W. Cox, Texas State Health Officer, reports that 14 counties
have reported 100 or more cases of influenza for the week ended
January 3. Areas of highest incidence are in western Texas and
in the Panhandle region, but localized areas of high incidence are
present in scattered sections throughout the State. Epidemiologi -
cal investigations are being conducted in several areas and pre-
liminary reports reveal that the clinical picture has been compati
ble with a diagnosis of influenza, but the disease is not of unusual
severity. Laboratory examinations are being conducted. Dr. E. A.
Belden, Missouri Department of Public Health and Welfare, states
that approximately 150 cases of influenza were reported by a
physician in Greene County. Widespread prevalence of respiratory
disease in the State is suggested. A small outbreak in Connecticut
has been reported by Dr. J. C. Hart. The cases, diagnosed clini -
cally as influenza began December 29. Laboratory tests on blood
samples are not yet available.

Dr. E. H. Lennette, Influenza Regional Laboratory, Berkeley,
California, reports positive serologic diagnosis for 3 cases of
influenza A, one in October, one in November, and one in the early
part of December, and two cases of influenza B, one in September
and one in November.

Dr. A. V. Hardy, Influenza Collaborating Laboratory, Florida
State Health Department, reports an influenza-like disease among

The above reports indicate widespread prevalence of respira-
tory disease in the central and eastern parts of the country.
Influenza A-prime was confirmed in 4 States, Iowa, Missouri,
Colorado and New Jersey. Other localized outbreaks have not yet
been identified as to type of disease present.

The number of deaths from influenza and pneumonia reported
by 58 cities was 291 for the week ended January 3 as compared
with 230 for the previous week. The numbers reported for these
cities by geographic division, with figures for the previous week
in parentheses, were: New England, 16 (17); Middle Atlantic, 103
(92); East North Central, 58 (43); West North Central, 32 (22);
South Atlantic, 30 (23); East South Central, 14 (7); West South
Central, 22 (12); Mountain, 6 (7); and Pacific, 10 (7).

Dr. C. H. Andrewes, World Influenza Center, London, reports
very little influenza A in the south of England. One case in Surrey
has been identified serologically as influenza A. A virus of the
A-prime type has been obtained from a fatal case in Kent.
The virus was closely related to the Scandinavian strains in
1950-51. There is no evidence yet of a widespread outbreak.
Dr. Andrewes is forwarding to Dr. Magill, of the Strain Study
Center, a recently acquired strain of influenza A-prime, A/Japan 5/51, which was serologically somewhat apart from other A-prime strains which were recovered during 1951.

Psittacosis

ies, pigeons, and chickens were found to be, or were presumed to be, sources of infection in humans reported to have the disease. Dr. P. E. Marks, Pittsburgh Department of Public Health, reports that a diagnosis of psittacosis was confir med following autopsy in a 57-year-old male. The original diagnosis was pneumonia with onset about November 10. At approximately the same time a daughter of this patient had a similar disease. A parakeet purchased by the family in West Virginia was found to be infected although not clinically ill.

In the 10-year period, 1942 to 1951 inclusive, the average annual number of cases of psittacosis reported was 23. The actual numbers varied from 1 in 1943 to 35 in 1949. During the early part of 1952, a number of cases were reported in which parakeets purchased in Florida were found to be the source of infection, Such cases were reported in Minnesota, Connecticut, and Colorado. Twenty-nine cases were found among employees of a packing plant in Texas in which turkeys were being processed. Information was received that a second epidemic occurred in the same plant later in 1952. The source of infection in each outbreak was considered to be turkeys. Information on psittacosis was received from 12 States in 1952. About 70 cases were reported by these States. In addition to parakeets and turkeys as sources of infection, canar

Dr. Morris Greenberg, New York City Department of Health, has reported that an adult male was admitted to a hospital in New York City late in November with pulmonary finding suggestive of psittacosis. Laboratory confirmation of the diagnosis was obtained. The patient had recently purchased 2 parakeets from a store which had obtained a large supply from California. Blood obtained from the 2 parakeets when tested by the complement fixation test was found to be anti-complimentary.

These provisional data are based on reports from State and territorial health departments to the Public Health Service. They give the total number of cases of certain communicable diseases reported during the week usually ended the preceding

Saturday. When the diseases which rarely occur (cholera, dengue, plague, typhus fever-epidemic, and yellow fever) are reported, they will be noted under the table above.