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November 30, 1956

Vol. 5, No. 47

The 2 cases of anthrax in California were in a veterinarian and his helper who autopsied 2 cows.

Of the 42 cases of diphtheria reported this week, 14 were in Michigan, 5 each in Kansas and New Jersey, and 4 in North Carolina. Since January 1, 1956, Michigan has reported 128 cases, compared with 50 for the corresponding period of 1955. Almost half (62) of the cases in the State have occurred since the first of October. Only Texas has reported more cases (169) than Michigan, but in 1955 the corresponding number was 197. The numbers of reported cases of poliomyelitis by type for the United States for the current week, disease year, and calendar year are:

Dr. Charlotte Silverman, Maryland State Department of Health, has supplied information on cases reported as "botulism" in last week's report. The provisional diagnosis of botulism was quickly changed to arsenic poisoning when the cases were investigated. Two young children and the father have died, and other members of the family are being treated in a hospital. The source of the infection appears to have been water from a cistern into which arsenic had been introduced. The cistern was located on the premises occupied by the family. The source of the arsenic is under investigation.

Rabies in bats

The California State Department of Public Health has reported the finding of 2 rabid bats in Shasta County this year. One was a hoary bat, Lasiurus cinereus. Negri bodies were detected in its brain; the confirmation was made by animal inoculation. The second was a Mexican free-tailed bat, Tadarida mexicana, which was found paralyzed in a downtown shop. Microscopic examination of this bat's brain was negative for Negri bodies, but mice inoculated with brain material developed rabies in 7 days. Four other rabid bats have been found in California-1 earlier this year, 2 in 1955, and 1 in 1954.

Psittacosis

The California State Department of Public Health has given epidemiological information on 6 cases of psittacosis reported in the State since January 1, 1956. Three of these were confirmed by fourfold rises in complement fixation titers, 2 by

titers of 1:16 and 1.64, and the other by X-ray findings and clinical symptoms. One of the patients had been doing research on psittacosis, and the others had had contact with psittacine birds.

Leptospirosis

Dr. James R. Amos, Missouri Department of Public Health and Welfare, has reported a case of leptospirosis in a packinghouse worker. About 10 days prior to onset of his illness the worker had cut his right elbow on a slaughter chute. The lesion healed without incident. The illness was characterized by sudden onset of shaking chills and fever of 105 degrees. These symptoms were followed by nasal congestion and persistent frontal headache. Serologic tests for typhoid fever, brucellosis, and tularemia were negative. Leptospirosis was suspected, and a specimen sent to the PHS Laboratory in Chamblee, Georgia, showed a titer of 1:512 for Leptospira pomona. The patient responded favorably to a combination of streptomycin and penicillin.

Disease of unknown etiology

Dr. J. P. Garen, District Health Officer, New York State Department of Health, has reported a disease characterized by low fever, headache, and a nonpruritic maculopapular rash. Ten cases were reported in a village of 900 inhabitants. The rash usually developed on the second day of illness and lasted about 2 days. It began on the face and became generalized. Adenopathy was not prominent.

Histoplasmosis

Dr. Martin P. Hines, North Carolina State Board of Health, has reported 2 cases of histoplasmosis among persons who repaired an old house. Approximately 3 weeks after the work was finished both persons became ill with fever, malaise, and a cough. Roentgenographic findings revealed pulmonary infiltration, and blood studies demonstrated high titers to histoplasmosis. Histoplasma capsulatum was isolated from one of the patients. One patient has recovered, but the other also has pulmonary tuberculosis and is convalescing.

The house in question was old, contained wasp nests (muddauber type), was a roosting place for bats and was exceedingly dusty. Samples of bat droppings, dust, and plaster have been sent to a laboratory for examination but no report of the tests has yet been received. Since renovation, the house has been occupied by a family. There has been no illness among the occupants, although the majority are reactors to the histoplasmin skin test.

Dr. R. Bacorn, District Health Officer, New York State Department of Health, has reported an outbreak of gastroenteritis in a hospital. Forty-three persons developed a mild illness characterized by fever, abdmoinal cramps, and diarrhea. No common source was found, and no enteric bacterial pathogens were found in stool specimens. Presumably this was an outbreak of viral gastro-enteritis.

Dr. James R. Amos has reported also an outbreak of gastro-enteritis among members of 2 families in Missouri. Six persons became ill with fever, cramps, vomiting, diarrhea, nausea, and headache from 10 to 14 hours after a barbecue. Foods served at the barbecue were hamburgers, potato salad, bread, and homemade ice cream. The ice cream was made from pasteurized and some raw milk. Laboratory examination of the milk revealed nothing that would have contributed to the outbreak. Of the foods examined in a laboratory, the ice cream and potato salad revealed the presence of Arizona paracolon organisms.

The California State Department of Public Health has reported an outbreak of gastro-enteritis among 74 persons following a wedding reception. Of these, approximately 30 became ill with abdominal cramps, diarrhea, and mild prostration

from 9 to 13 hours later. Bacteriologic examination of ham served at the reception revealed the presence of gram-positive coccus, but this did not satisfy the criteria for implication in the outbreak. The ham, cooked and already sliced, was delivered from a local market.

The California State Department of Public Health has reported another outbreak of gastro-enteritis involving 9 of 13 persons in a private residence. Canned ham was suspected to be the vehicle of infection, but on bacteriologic examination no pathogens were found. Symptoms did not appear until after the second time the ham was eaten. From 5 to 12 hours after the second serving, all developed nausea, headache, vomiting, diarrhea, abdominal discomfort, and weakness.

The Los Angeles County (California) Health Department has reported 2 small outbreaks of gastro-enteritis among persons who ate in restaurants. Eight persons became ill-5 after eating roast beef sandwiches and 3 after eating turkey sandwiches. No food from either restaurant was available for bacteriologic examination. One of the restaurants was found to be extremely unsanitary, and there was evidence of mice infestation.