Provisional Information on Selected Notifiable Diseases in the United States and on During the first 8 weeks of 1956 there has been little increase in the reported incidence of infectious hepatitis. In previous years, large increases were reported during this period. For the current week, 504 cases were reported as compared with 400 for the last week of 1955. However, the incidence has not shown a continuous rise during this period. The total for the 4-week period ended February 25 shows a 22 percent increase compared with that for the last 4-week period in 1955. Increases for the corresponding periods of 1953-54 and 1954-55 were 71 and 32 percent, respectively. (See accompanying chart.) indicate an organism of high virulence. Only one of the 20 cases had ever been immunized. Epidemiologic investigation has shown that in addition to a grouping of cases geographically, there was a family relationship in many of the cases. It was also learned that family members had attended the funeral of a 7-year-old child on February 11 who had died of bronchopneumonia and laryngospasm. Although cultures from the child were found to be negative, the physician feels that this was a case of diphtheria. Some cases appear to have been milk-borne infections. Raw milk from a one-cow dairy was given to relatives in the city, and 2 members of the family were shown to have positive throat cultures. The ages of the patients ranged from 14 months to 63 years, but the majority were under 10 years. The 63-year-old patient was a baby sitter in a family where a child had diphtheria. Influenza The following reports have been received by the Influenza Information Center, NIH, and the National Office of Vital Statistics. The California Department of Public Health Influenza Surveillance Report of February 20 states that a "large number" of influenza-like illnesses have occurred in Tehama County. Symptoms consist of fever, myalgia, headache, stiff neck, nausea, and some vomiting. One local school was closed for 3 days. Specimens of blood are being obtained for serologic study. Laboratory reports of specimens collected throughout the State indicate that only 2 of the 225 specimens examined have shown a fourfold rise in antibody level in influenza A, and in 1 there was presumptive evidence of influenza A infection. Dr. Eleanor Whitney, New York State Department of Health, has reported serologic evidence of influenza A in a single case, clinically diagnosed as pneumonia, which occurred at Little Falls, New York. Dr. Gordon Meikeljohn, University of Colorado, has identified a moderate outbreak of influenza A (FM1-1947) at a military establishment in Colorado. Dr. Wm. S. Jordan, Western Reserve University School of Medicine, Cleveland, Ohio, reports that all 5 members of a family under study showed fourfold or greater rises in titer of antibody against one of the strains, A/Cleveland/2/56, isolated from the family. The ministry of Health, United Kingdom, has reported influenza-like outbreaks from various areas in England, a number of which have been identified as due to influenza A. The cases continue to be clinically mild. Erythema infectiosum (fifth disease) Dr. James R. Enright, Hawaii Department of Health, reports a rather widespread outbreak of an atypical exanthem which appeared late in January 1956. Preschool and lower grade children appear to have made up a great majority of the cases, although a few cases were reported in adults. The disease began suddenly with a normal temperature or a low fever and a rash of bright red maculopapular spots, which coalesced and gave the child an appearance of having heavily rouged cheeks. The eruption also spread to the extensor surfaces of the arms and legs, but usually the trunk escaped. The rash lasted over a week and when fading, caused considerable itching. There were no swollen glands, sore throat, nor any sign of an exanthem. The disease was typical of erythema infectiosum (fifth disease). Reports show that it was present on the Island of Hawaii, where it was first reported, and simultaneously in rural Oahu. The disease has become widespread in Honolulu, pediatricians reporting that they had seen several cases every day. In many cases, adults in the family noticed the rash on themselves first, but usually attributed it to "hives" or "allergy." On the basis of a diagnosis of erythema infectiosum, children were excluded from school for 5 days after the appearance of the rash. No exclusions were being required for contacts. There have been no complications. Rabies in man Dr. Henry A. Holle, Texas Department of Health, has reported a case of human rabies-the second for the year. Early in January the victim, a 12-year-old boy, was admitted to a hospital. His chief complaint was a diffuse headache of 3 days duration, fever, and excessive thirst. The patient had experienced nausea and vomiting of 1 day's duration. On admission to the hospital, the child had a maniacal thrashing behavior, and a tentative diagnosis of rabies was made. Attempts at sedation were unsuccessful. Marked emphysema of the face, neck, and chest developed a few hours after admission, and the patient expired later during the day. Post-mortem examination showed Negri bodies in the hypocampal gyrus of the brain, and the diagnosis was also confirmed by animal inoculation. A vague history of a dog bite 3 weeks earlier was obtained, and it is reported that the dog is still alive and healthy. An investigation was made of the dog population in the vicinity of the patient's home, but no evidence of possible rabid animals was found, and the source of infection could not be determined. Rabies in animals During the first 45 days of 1956, the California Department of Public Health has reported 49 cases of rabies in animals. Of these, 41 were in dogs from Los Angeles (26) and Orange (15) Counties. The remainder were in skunks. Tuberculosis in zoo animals Dr. James O. Wails, Oklahoma Department of Health, has forwarded information on an investigation by Dr. M. L. Peters of tuberculosis among primate animals in a city zoo. In April 1955, 4 orangutans were recieved from New York, 1 of which 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) Table 2. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES, EACH DIVISION AND STATE, ALASKA, HAWAII, AND PUERTO RICO, FOR WEEKS ENDED FEBRUARY 26, 1955 AND FEBRUARY 25, 1956 (By place of occurrence. Numbers under diseases are category numbers of the Sixth Revision of the International Lists, 1948) Table 2. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES, EACH DIVISION AND STATE, ALASKA, HAWAII, AND PUERTO RICO, FOR WEEKS ENDED FEBRUARY 26, 1955 AND FEBRUARY 25, 1956-Continued (By place of occurrence. Numbers under diseases are category numbers of the Sixth Revision of the International Lists, 1948) |