The chart shows the number of deaths reported for 108 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 3 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 with a weekly average of 50 deaths, 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. EPIDEMIOLOGICAL REPORTS-Continued sauce offered ample opportunity for incubation of pathogenic organisms. The California State Department of Public Health has reported an outbreak of gastro-enteritis among 44 persons in a labor camp. Fifteen persons became ill with gastric discomfort (diarrhea and weakness) immediately after breakfast. The very short incubation period, a few minutes to 1 hour, suggested a chemical type of poisoning, but the investigation revealed no probable source. None of the food was available for laboratory tests. A review of the meals served the preceding day indicated that the outbreak was most likely related to the morning meal. The California State Department of Public Health reports an outbreak of gastro-enteritis among persons who ate in a restaurant. About 150 individuals became ill with vomiting, diarrhea, chills, fever, and cramping from 1 to 24 hours after eating food served at various times. None of the food was available for bacteriological examination, but stomach washings yielded staphylococci. Dr. J. E. McCroan, Georgia Department of Public Health has reported an outbreak of gastro-enteritis involving 6 persons who ate lemon-cheese coconut cake. The cake was from a local bakery but probably was infected when first cut. Staphylococcus aureus, coagulase-positive, was found in a remaining piece of cake. June 8, 1956 Provisional Information on Selected Notifiable Diseases in the United States and on Deaths in Selected Cities for Week Ended June 2, 1956 The number of poliomyelitis cases reported for the current week (121) is only 8 percent greater than for the previous week (112), but is slightly less than half of the total for the same week last year. For the same week in the previous 5 years, the numbers of cases reported were 115 in 1951; 119 in 1952; 247 in 1953; 224 in 1954; and 248 in 1955. For the current week, 32 cases were reported in Texas, 19 in California, 10 in Florida, 9 in Illinois, 8 in Louisiana, and 6 in Iowa. No other State reported more than 3 cases. The number of poliomyelitis cases reported for the current week, disease year, and calendar year are shown below. Dr. J. D. Martin, Louisiana State Department of Health, has reported that Salmonella typhosa phage type 35 was identified for the first time in the State in April 1956. The organism was isolated from a stool specimen from a 39-year-old man from whom S. typhosa "untypable" had been isolated in the past. This man was examined at the time of an investigation of his 7-year-old son who was suspected to be the source of infection of a child in Nevada. The Louisiana boy had spent 2 months in Nevada with a child who became ill 1 week following the boy's return to Louisiana. Investigation of the Louisiana child's family uncovered 4 persons, including the child, from whose stools S. typhosa was isolated. None of these persons gave a history of antecedent typhoid fever. Louisiana has 142 typhoid carriers under surveillance at the present time. Organisms being excreted by each have been phage typed for all but 16. The majority of those typed are E1 (34), W form (21), and C (19). Eleven other types, including "untypable," have been identified. Connecticut has reported 5 cases of typhoid fever since January 1, 1956. The sources of infection for 4 patients were traced to their grandmothers as carriers. The other patient probably contracted the infection in the Caribbean. Streptococcal disease. Dr. D. S. Fleming, Minnesota Department of Health, has reported 2 outbreaks of streptococcal disease. One occurred among 505 girls in a school. Of these, 207 had fever and a follicular tonsillitis or pharyngitis. Moderate lymphadenopathy was noted. Recovery was prompt with oral penicillin therapy. A sharp rise in incidence indicated a common source of infection, but the investigation was made 3 weeks later and no extensive bacteriological or food surveys were made. A secondary peak incidence in day students occurred about 5 days later than the first. This indicated a secondary infection and probably was not related to food as about two thirds brought their lunches. Cultures from 3 individuals showed no characteristic organisms. The other outbreak was in a rural area in the southwestern part of the State where an unusual incidence of acute glomerulonephritis was reported. There were 6 cases in children, ages 7 to 11. Each case was connected with 1 or more other cases through association in school, on a bus, or through family visiting. Bacteriological studies were undertaken and 91 throat cultures, including those from cases, were taken. Beta hemolytic streptococci was recovered in 7 instances. Further study showed 2 of these were group A, one a type 12. Trichiniasis Dr. Richard L. Wenzel, Columbus (Ohio) Department of Health, has reported 2 cases of trichiniasis. A housewife and her 8-year-old daughter both sampled a ground pork preparation prior to cooking it, the mother eating the larger quantity. Approximately 2 weeks later the mother noted extreme malaise and puffy eyelids. This was followed by extreme generalized myalgia, headache, fever, and progressive periorbital and facial edema until the face had a moon-like appearance. Five days after the onset of illness a blood count showed leukocytosis with an eosinophilia of 65 percent. Two days after onset of symptoms in the mother, the child developed similar symptoms but of a milder degree. Her blood count showed 11 percent eosinophilia. The meat had been purchased from a local market, but no samples were available for laboratory examination. Newcastle disease The Maine Department of Health and Welfare has reported a human case of Newcastle disease. This is a disease of poultry that occasionally is transmitted to man. The disease is known to be widely prevalent among Maine poultry flocks but the number of cases of human infection is not known. The patient was employed for 10 years eviscerating chickens at a poultry plant. He wore rubber gloves which, when through work, he cleaned with bare hands under running water. Symptoms of the disease first consisted of redness, swelling and stiffness of hands, followed by exfoliation. Later, manifestations appeared on elbows, back of neck, ears, feet, and knees. The Communicable Disease Center, PHS, reported the neutralization index on 2 sera as 9 in the first and 70 in the second. These results were stated to be "compatible with recent infection with Newcastle disease virus." The Division of Animal Industry of the Maine Department of Agriculture reports wide usage of a vaccine in dust form for immunization of poultry flocks. A case has been reported in a man who used the vaccine dust and who developed conjunctivitis and severe respiratory symptoms. Whether this represents real infection or an allergic reaction is uncertain. The disease in man is said to have a short incubation period and usually to manifest itself by an influenza-like illness or by superficial conjunctivitis with or without preauricular lymphadenitis, headache, malaise, chills, and fever. In children, the disease may present itself as a mild meningitis. Gastro-enteritis of unknown etiology The California Department of Public Health has reported an outbreak of gastro-enteritis among persons in a labor camp. Approximately 70 persons developed an illness characterized by abdominal cramps and diarrhea during a 7-day period. The details obtained in the investigation suggested that this outbreak was an infection of unknown etiology, most probably spread by person-to-person contact. The majority of men in camp had been working there about 2 weeks, but additions to the work force had been made during the preceding week. It was concluded that infection may have been introduced by one or more of the late arrivals. An investigation of the food service facilities revealed an excellent operation with no significant deviations from accepted food-handling techniques. Other facilities in the camp were considered adequate with the exception of unprotected privies and the presence of flies within the sleeping quarters. The water supply was from a protected source and Continued on page 8 Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: CONTINENTAL UNITED STATES (Numbers after diseases are category numbers of the Sixth Revision of the International Lists, 1948) |