over the numbers reported in 1955 were noted in Minnesota, from 32 to 64; North Carolina, 9 to 75; Tennessee, 3 to 23; Texas, 13 to 33; Washington, 9 to 25; Oregon, 6 to 45; and California, 40 to 56. In the Pacific States, Oregon experienced an outbreak associated with turkeys; and a few persons living in the other 2 States also contracted the disease from this source. Although only 45 cases were reported through the normal channels in Oregon, other cases were found during the epidemiological investigation. Some of these were not confirmed by laboratory examination, but there was substantial evidence that 86 cases occurred in this outbreak. Texas also reported cases with probable contact with infected turkeys. In the other States mentioned above, there was no indication of outbreaks but rather of single cases associated with pet psittacine birds. However, in Minnesota there were 7 cases reported to have occurred from contact with Easter chicks. No virus was isolated from any of these birds. In Virginia a duck farm was implicated, but at least 12 of the 18 cases reported in the State had contact with parakeets. With the exception of those cases in Oregon, most of the cases reported were from contact with parakeets.

Typhoid fever

During the first half of the year a widespread outbreak of typhoid fever occurred in the general population of several North Central States. These States-Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, and Wisconsinreported 60 percent more cases during the first 6 months than during the last 6 months of the year. A total of 297 cases was reported for the year compared with 127 for 1955. Epidemiological investigation ruled out the possibility of food being the common source of infection, but did not determine definite other sources. Early in the year Maine also had more cases of typhoid fever than usual. In 3 areas of the State 9 cases were reported during March and April, representing small family outbreaks probably caused by carrier contacts. Aroostook County in the northern part of Maine reported 11 cases for the year, the highest concentration in the State. Carriers

or contact with cases from across the Canadian border where the disease is known to exist may have been the source of these cases. In general, for other States, the numbers of cases in 1956 were less than for 1955. The combined totals for all of the States in 1956 and 1955 remained constant.

Tuberculosis

The total of 90,465 newly reported cases of tuberculosis in the continental United States for 1956 reduced by 8 percent the 1955 total of 98,860 cases. Approximately three-fourths of the newly reported cases were classified as active or probably active. Over the past decade there has been a gradual decline in tuberculosis incidence.

The time series presented in this report is not one of incidence of disease alone, but it also reflects changes in casefinding and reporting practices. Due to the change in tuberculosis morbidity reporting rules initiated as of January 1, 1952, data for the years 1952 to 1956 are not strictly comparable with data for previous years.

Venereal diseases

During the calendar year 1956, there were 131,763 cases of syphilis in all stages reported in the continental United States. This represents an increase of 7.1 percent over the 123,004 cases reported a year earlier and is the first year since 1946 that the number of reported syphilis cases exceeded the number reported during the previous year. Included in the above total were 26,598 cases of early syphilis (primary, secondary, and early latent) which is a slight increase over the number of cases in this category during the previous year. The 233,593 cases of gonorrhea reported represent a decline of 4.4 percent from the 244,279 cases reported a year earlier.

The data on venereal diseases published in this report will in many instances vary from morbidity data available from the Venereal Disease Branch of the Communicable Disease Center since this report includes military cases reported to the State health departments.

No cases reported (1 dash)---

Disease stated not notifiable (1 asterisk)-No report made by State (2 asterisks)-Data not available (3 dashes)--

Table 1. REPORTED CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES, 1947-56

(Numbers after diseases are category numbers of the Sixth Revision of the International Lists, 1948)

--------049.1

17

16

18

18

18

1,300

1,444

1,823

Dengue--

--090

2

1

6

39

44

46

17,048

2,624

12,166

Hepatitis, infectious, and serumLeprosy--

092,N998.5 pt..

---060

19,234 52

31,961

75

2,606 50,093 56

1,935 33,700

1,912

1,123

1,135

903

730

785

17,428

7,349

2,820

2,027

709

60

57

57

44

41

63

1,092 56

For 1947-51, figures from Agricultural Research Service, U. 8. Department of Agriculture.
These cases do not fulfill the generally accepted criteria for a diagnosis of smallpox.
For 1947-51, figures (civilian cases only) from the Venereal Disease Program, Public Health Service.

Table 2. REPORTED CASES OF SPECIFIED NOTIFIABLE DISEASES BY MONTH: UNITED STATES, 1956

(Numbers after diseases are category numbers of the Sixth Revision of the International Lists, 1948)

1Cases not tabulated by month included in "Total," but not distributed. 2Includes 950 cases resulting from a waterborne outbreak in Utah.

Reports received by quarters.