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November 9, 1956

Vol. 5, No. 44

NOTICE. A WHO Influenza Study Program in the United States has been in operation since 1948. In this program, there has been an Influenza Information Center located in the National Institutes of Health which has developed the present system of reporting outbreaks of the disease. The National Office of Vital Statistics has collaborated in this program and has published information on influenza in the Communicable Disease Summary. This year, all activities of the Influenza Information Center will be located in the National Office of Vital Statistics. All reports of outbreaks of influenza and confirming laboratory reports from collaborating laboratories should be sent promptly to Dr. C. C. Dauer, Influenza Information Center, Public Health Service, Washington 25, D. C. All reports of outbreaks in local areas should be sent by or through State health officers to the Influenza Information Center. Another part of the Influenza Study Program is an International Influenza Center for the Americas, located in the Virus and Rickettsia Section of the Communicable Disease Center in Montgomery, Alabama, under the direction of Dr. Keith Jensen. This center will study strains of the influenza viruses submitted by laboratories, particularly untypable and unusual strains.

It is also requested that epidemiological reports be made when any outbreak of acute respiratory or influenza-like disease has been confirmed as an adenovirus infection. The report should contain information on the same items included in a report of influenza (clinical characteristics, estimates of amount of illness, etc.). Confirmation of diagnosis should be based on isolation and identification of the type of adenovirus causing the outbreak or appropriate serologic tests on acute phase and convalescent serum specimens.

The numbers of reported cases of poliomyelitis by type for the United States for the current week, disease year, and calendar year are:

For the last 14 weeks, with the exception of 1 week, the number of deaths reported in selected cities has exceeded the 3-year median (see chart on p. 6). That exception was the week erded October 13 when many of the registration offices were closed on Friday, Columbus Day. As a result, the number of death certificates received for that week was low and the number for the following week was high. In the 14-week period ended November 3, a total of 135,830 deaths was re

ported, about 5 percent more than the total of 129,457 deaths for the 14 corresponding weekly medians. The largest percentage excess of deaths has been reported by the cities in the West South Central Division (11.8 percent), followed by the cities in the Mountain (9.4 percent), in the South Atlantic (8.1 percent), and in the Pacific (7.7 percent).

EPIDEMIOLOGICAL REPORTS

Acute upper respiratory illness

Dr. D. P. McMahon, District Health Officer for the New York State Department of Health, has reported the occurrence of an acute upper respiratory illness during October in various areas of his district. Many of the cases have been accompanied by gastro-intestinal symptoms. In one village the reported incidence was high. Because of the rapid rise in the number of cases, a common source was suspected. However, an investigation of possible sources including water and milk supplies failed to confirm this supposition. Numerous stool specimens were also collected, but all were negative for the common gastro-intestinal organisms. After this investigation it was found that influenza-like illnesses had occurred in other areas. By the end of October very little illness of this type could be found. Staphylococcal infections in nurseries for the newborn

Dr. F. H. Wentworth, Ohio Department of Health, has reported 2 outbreaks of staphylococcal infections in nurseries for the newborn in different hospitals. In one, there have been 25 post partum breast abscesses in mothers, 16 breast abscesses in babies, 8 cases of staphylococcal pneumonia in infants, and numerous cases of superficial and deep abscesses in infants and adults. Staphylococcal aureus, phage type 42B/44A/47C/ 52/81, has been obtained from 7 of 8 cases of pneumonia, 6 of 8 post partum breast abscesses, and 4 of 5 infant breast abscesses cultured. Repeated culturing of the nursery staff has revealed that 35 percent of the staff of the premature nursery and 11 percent of the full term nursery staff are nasal carriers of this organism. The organism was apparently introduced into the nursery sometime during late April or early May, and infection continued until antibiotic prophylaxis was introduced on August 1. In the other hospital, 82 babies were delivered during June, July, and August. S. aureus, phage type 52A, has been obtained from 4 of 5 post partum breast abscesses which occurred in mothers during these months. The same organism has been obtained from 7 of 9 cultures from infants who developed pustular dermatitis or subcutaneous abscess. This organism is sensitive to aureomycin, bacitracin, chloramphenicol, dihydrostreptomycin, erythromycin, and penicillin.

Typhoid fever

Dr. F. H. Wentworth has reported a foodborne outbreak of typhoid fever in Ohio. An investigation revealed that all the patients had consumed food prepared and distributed by a single caterer. Salmonella typhi, phage type J, were isolated from specimens from 6 patients and from the caterer. One secondary case has been diagnosed by blood culture but has not as yet been phage typed.

THE LIBRARY OF THE

NOV 2 0 1956

UNIVERSITY OF ILLINOIS

Leptospirosis

Dr. P. R. Schnurrenberger, Veterinary Epidemiologist, Ohio Department of Health, has reported a presumptive case of leptospirosis in a dairy farmer. The diagnosis was made on the basis of clinical signs and a rise in titer. The patient had handled an aborted fetus with his bare hands. The aborting cow was found positive 1:1024 for Leptospira pomona. Thirteen days later the farmer became ill with a severe parietal headache, malaise, depression, anorexia, and weakness. He consulted a physician who diagnosed the illness as influenza, and administered penicillin. Since the patient did not respond to this treatment, a broad spectum antibiotic was substituted. Nine days after onset of illness a serologic test was negative for all Leptospirae tested. Specimens collected 4 weeks after onset were positive for L. pomona in a dilution of 1:512.

Trichiniasis

Dr. Wm. J. Dougherty, District Health Officer, New York State Department of Health, has reported an outbreak of trichiniasis following a cocktail party attended by 32 persons. Of these, 19 developed clinical symptoms of trichiniasis. These were headache, nausea, diarrhea, myalgia, periorbital edema,

and fever. Eosinophil counts ranged from 10 to 62 percent. Of blood specimens from 17 persons submitted for flocculation and complement fixation tests, 14 were positive. The meal was prepared by a public caterer and consisted of liver paste, egg salad, ham salad, and crab salad. None of this food was available for laboratory examination.

Dr. E. J. Witte, Pennsylvania Department of Health, has reported a case of trichiniasis in a 14-year-old girl. She became ill with lassitude, loss of appetite, persistent fever, and some loss of weight. These symptoms continued until she noticed definite puffiness of the face and generalized muscle pain. When admitted to a hospital her eosinophil count was approximately 20 percent. Trichinella larva was demonstrated by muscle biopsy. The girl gave a history of ingesting raw pork on numerous occasions.

Gastro-enteritis

The Los Angeles City Health Department has reported an outbreak of gastro-enteritis in a hospital. Of 46 persons eating ham and turkey sandwiches, 37 became ill from 11⁄2 to 71⁄2 hours later. Their illness was characterized by vomiting, nausea, Continued on page 8