Table 4. DEATHS IN SELECTED CITIES FOR WEEK ENDED DECEMBER 15, 1956 Ref. December 28, 1956 Washington 25, D. C. Vol. 5, No. 51 Provisional Information on Selected Notifiable Diseases in the United States and on Deaths in Selected Cities for Week Ended December 22, 1956 The incidence of poliomyelitis in 1956 continues to be lower than in 1955, and also lower than for any other year since 1947. The 47.5 percent reduction in number of cases for the first 50 weeks in 1956 as compared with the same period in 1955 is about twice as great as the reduction between 1954 and 1955. The proportions of paralytic, nonparalytic, and unspecified cases of the disease shown in the provisional weekly reports were quite different in 1956 as compared with 1955. For 1956, the percentages were 43.5, 38.3, and 18.2, respectively; and for 1955, they were 36.2, 38.1 and 25.8, respectively. The smaller proportions of nonparalytic and unspecified cases for the present year probably are due in part to differences in reporting by physicians, that is, more accurate judgment of the type of disease when the report was made. Not all States reported a reduction in number of cases in 1956 as compared with 1955. Nine States reported increases varying from about 5 to 174 percent. The nine were distributed equally among the north central, southern, and far western sections of the country. The estimated death rate for poliomyelitis in the first 9 months of 1956 based on a 10-percent sample of all deaths is approximately 30 percent below that for the same period of 1955. Since the number of deaths in the sample is relatively small, the amount of reduction in the death rate from one year to another must be viewed with caution. The numbers of reported cases of poliomyelitis by type for the United States for the current week, disease year, and calendar year are: northern hemisphere except in Japan. A mild but widespread epidemic began early in December in Japan, affecting mainly school children. Influenza viruses of both type A and B have been isolated. Suspect smallpox Dr. A. L. Marshall, Indiana State Board of Health, has supplied information found in the investigation of a suspect case of smallpox. The patient, a female 40 years of age, developed a "skin rash" on November 7, which was reported as smallpox. At the time of investigation, the woman was recovering rapidly, all lesions were dry and scabs could be brushed off easily. No materials could be obtained for laboratory examination. The patient had visited with friends in Kentucky 3 weeks prior to her illness. One member of the group visited developed herpes zoster at about the same time that the rash appeared in the suspect case of smallpox. When the latter was vaccinated on December 5 there was a vaccinoid reaction to smallpox vaccine. The last previous vaccination of the patient was when she started to school as a child. In view of the concurrent illness of herpes zoster in a contact and a vaccinoid reaction to vaccination in the patient, the Indiana health authorities have concluded that this was a case of chickenpox. Diarrhea of the newborn The Illinois Department of Public Health has reported an outbreak of diarrhea in a hospital nursery for premature infants. There were 16 cases of mild diarrhea with no deaths. Recovery was usually rapid. No carriers have been found nor has the mode of spread been determined. Investigation is still in progress. Anthrax The California State Department of Public Health has supplied epidemiological information on the 2 cases of anthrax reported for the week ended November 24, 1956. The cases were in a veterinarian and his helper. While laboratory tests on lesions of both men were negative, there was sufficient evidence to substantiate a diagnosis of anthrax. It is believed that medication received prior to the tests accounted for the negative results. Of 311 head of cattle transported by truck to a ranch, 4 have died. When the first 2 cows died, anthrax was not suspected. The third was autopsied by the veterinarian who developed a skin lesion the following day. The findings of this autopsy apparently were inconclusive. However, autopsy specimens from the fourth cow were reported positive for anthrax. The source of infection was not found, but the truck in which the cattle were transported is considered to have been contaminated. Malaria Dr. D. N. Wysham, Washington State Department of Health, has provided information on a case of malaria in which two types of plasmodia were found in blood smears. The patient, a merchant seaman, had been in various areas of the South Pacific, Borneo, Indonesia, and Singapore. Symptoms which appeared several weeks prior to admission to a hospital in Seattle were daily chills, fever, and profuse sweating. Diarrhea developed ES LIBRARY OF THE or to admission to the hospital. Both JAN 7 1957 UNIVERSITY AN liver and spleen were enlarged. Typical malaria organisms of Plasmodium vivax and P. falciparum were noted in original blood smears. Treatment consisted of 1 gram of chloroquine followed by an additional course of chloroquine and primaquine. Chills continued for 2 days after initiation of treatment. Tularemia Dr. E. J. Witte, Pennsylvania Department of Health, has reported a case of tularemia in an adult male who had shot and cleaned a wild rabbit. Onset of symptoms occurred 4 days after exposure. An ulcer developed on one of his fingers and his axillary glands became enlarged. Diagnosis was confirmed by agglutination tests on the patient's blood serum, the titer rising from zero to 1:320. Treatment with tetracydine compounds was followed by a gradual improvement in his condition. Gastro-enteritis The California State Department of Public Health has reported an outbreak of gastro-enteritis in a school. Of 250 persons eating a meal in the cafeteria, 65 became ill with nausea, vomiting, abdominal cramps, and diarrhea from 2 to 5 hours later. Turkey and dressing were suspected to be the vehicles of infection but none was available for bacteriologic examination, The meat had been stored in a refrigerated box which was opened frequently. The California State Department of Public Health also has reported 4 cases of gastro-enteritis among persons eating in a public dining room. All developed nausea and vomiting from 3 to 5 hours after eating. This was followed by diarrhea. One patient, an 84-year-old woman, reportedly had a cardiovascular disease and died about 18 hours after onset of her illness. An investigation revealed that baked ham and rice custard were common to all 4. There appeared to be little opportunity for contamination of the ham. Thus, the most probable vehicle was the rice custard which was made early in the day. It had been placed in serving dishes and kept on the counter next to the steam table. None of the food served that day was available for laboratory tests. 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 DECEMBER 24, 1955 AND DECEMBER 22, 1956 (By place of occurrence. Numbers under diseases are category numbers of the Sixth Revision of the International Lists, 1948) |