Weekly Mortality Report Morbidity and Mortality HEALTH DEPARTMENT DUCATION USA AND WELFARE U. S. Department of HEALTH, EDUCATION, AND WELFARE Public Health Service UNIVERSITY.Sed States and on Provisional Information on Selected Notifiable Diseases in the Typhoid fever Deaths in Selected Cities for Week Ended February II, 19560/S EPIDEMIOLOGICAL REPORTS Since the first of January 1956, there have been 48 cases of typhoid fever reported in the East North Central and the West North Central States. Twenty-three of these have occurred in 3 States-15 in Minnesota, and 4 each in Michigan and Wisconsin. Twelve of the Minnesota cases had onsets between January 9 and 17. Six of the 15 cases in Minnesota were in Minneapolis and 2 were in St. Paul. The remaining cases in this and other States have been scattered, Phage type E1, S. typhi has been isolated from 8 of 12 cases in Minnesota, from whom cultures have been obtained. The Enteric Bacteriology Laboratory, CDC, has reported that 3 cultures from Wisconsin, 2 from Iowa, and 1 from Illinois, have also been typed as E1. This is a common type found in the United States. While no relationship between cases in the various States has been established, the possibility of some interstate vehicle of infection is being investigated. Influenza The following reports have been received by the Influenza Information Center, NIH, and the National Office of Vital Statistics. Dr. S. S. Kalter, New York State University at Syracuse, reports that a hemagglutinating agent has been isolated from 1 of 3 patients with clinical evidence of influenza. Further studies are now in progress. The Preventive Medicine Division, OSG, Department of the Army, has reported on serologic tests on 31 paired specimens of blood. Antibody against influenza A was demonstrated in 1 specimen, and influenza B in another. These were obtained from personnel stationed in California. No significant increase in respiratory diseases has been noted in the units from which these specimens were obtained. Infectious hepatitis The Illinois Department of Public Health has reported an outbreak of infectious hepatitis in an institution in the northeastern part of the State. The first case was in a child who was taken to a nearby hospital where she spent 4 weeks. Following her discharge, she was isolated in the institution for 2 weeks. Subsequent to this, 16 cases have been diagnosed. The physician administered gamma globulin, which seemed to relieve their abdominal symptoms quickly. They were placed on a high carbohydrate diet and kept on bed rest in isolation. The children have close contact with the athletic director of the institution who was ill at Thanksgiving time. His illness was diagnosed as infectious hepatitis. All the 200 children in the institution and 44 adults have been given gamma globulin prophylaxis. Milk and water were not implicated in this outbreak. The California Department of Public Health has reported 4 cases of infectious hepatitis among members of a high school football squad. All had jaundice, fever, loss of appetite, dark urine, and icteric sclerae. The icteric index varied from 26 to 60 units. The members met during the football season for lunch in the gymnasium. The lunch consisted of a sack lunch from home or food purchased from the school cafeteria. They followed the standard procedure of showering and suiting up in the home gymnasium. However, on one occasion (about a month before illness), they used gymnasium facilities of another school. Water bucket and towel practice during games was considered to have possible significance, but this was not proven. An examination revealed that the 2 water buckets were in a filthy condition. As a result of the investigation and recommendations, school authorities replaced the buckets with a portable positive pressure aeroator water fountain cart. Gamma globulin for prophylaxis was dispensed and/or administered to household contacts, to members of the squad, and also to the coaching staff on request. Cryptococcus Dr. Mason Romaine, Virginia Department of Health, has reported a case of cryptococcus in a 50-year-old man. The patient was admitted to a hospital, complaining of diffuse headache which started about 10 days earlier. Various drugs including several antibiotics were tried but without effect. At times he was mentally clear, and sometimes very stuporous. On one occasion he collapsed with vomiting, profuse sweating, rapid heart beat, and labored breathing. Finally he lapsed into a coma, and his temperature gradually went up, reaching 105.4 degrees at death. No autopsy was made but the final impression was cryptococcus infection of the nervous system. Rabies in man Dr. G. D. Wallace, Alabama Department of Public Health, reports that a 26-year-old woman died of rabies early in January. Preliminary information revealed that she had been bitten on the right thumb by an unidentified stray dog, May 4, 1955. The dog was later killed, but was not submitted for laboratory examination. Information as to the amount of antirabies treatment administered subsequent to the bite is not yet available. Negri bodies were demonstrated in brain tissue of the deceased. The post-mortem examination was performed after the patient was embalmed and no mouse inoculation was possible. Rabies in a cat Dr. A. M. Washburn, Arkansas State Board of Health, has given information on an investigation made to determine the advisability of administering rabies vaccine to 2 young children who had been bitten by their house cat. The cat was placed under the care of a veterinarian and began to exhibit symptoms compatible with rabies. Three days had elapsed since the lesions were inflicted on the children's hands and the physician advised administration of rabies vaccine promptly. Later, the cat was found dead and it's brain was submitted for laboratory examination, but no Negri bodies were found. Material sent to the Communicable Disease Center for animal inoculation was positive for the disease. The physician who treated the children was concerned about the composition of human antirabies vaccine, since one of the children was sensitive to horse serum. To date, no un toward reactions have been reported, and it is hoped the rabies infection has been prevented. Psittacosis Dr. J. S. Palmer, Veterinary Public Health Service, Utah Department of Health, has reported a case of psittacosis in a 79-year-old man. The patient became ill with a respiratory condition in November 1955. Toward the end of the year, he collapsed and was hospitalized. A chest X-ray showed consolidation, and a tentative diagnosis of psittacosis was made. The diagnosis was confirmed by complement fixation test which was 4+ at a dilution of 1:128. Three other adults live in the same house and 2 of them had symptoms suggestive of psittacosis within the past 3 months. Two parakeets were implicated in this outbreak-one from New Mexico, and one from a local store. At the time of the tentative diagnosis of psittacosis in the patient, both birds were killed and placed in an outdoor trash can, contrary to instructions of the physician. Although in a state of disintegration, the locally purchased bird was obtained for laboratory examination. The results are pending. Dr. Stanley H. Osborn, Connecticut Department of Health, has provided information on 2 cases of psittacosis reported recently in the State. The first was in a 26-year-old woman who became ill with chest pain, cough, and fever during the third week of January. Psittacosis complement fixation tests have not been performed. However, she owned a parakeet, purchased in December 1955, which died 3 days after onset of her illness. This bird was submitted to the Virus and Rickettsial Laboratory in Montgomery, Alabama, where psittacosis virus was isolated. The parakeet was bred in Connecticut, and a 10-percent sample has been taken from the aviary there and sent to Montgomery for testing. The second case was in a 54-year-old man who became ill with pain in legs, cramps, chills, and fever during the second week of January. The attending physician has made a clinical diagnosis of psittacosis, but a blood specimen was negative for psittacosis. The patient was exposed to a parakeet, purchased in December. The bird appeared healthy but was killed and sent to Montgomery for tests for psittacosis. This bird was Continued on page 8 Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: CONTINENTAL UNITED STATES Reported in Massachusetts. Frequencies are too small. Addition: Kentucky, week ended February 4, 1 case. *Deduction: Arkansas, week ended February 4, 1 case. Table 2. CASES OF SPECIFIED NOTIFIABLE DISEASĘS: UNITED STATES, EACH DIVISION AND STATE, ALASKA, HAWAII, AND PUERTO RICO, FOR WEEKS ENDED FEBRUARY 12, 1955 AND FEBRUARY 11, 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 12, 1955 AND FEBRUARY 11, 1956-Continued (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 12, 1955 AND FEBRUARY 11, 1956-Continued (By place of occurrence. Numbers under diseases are category numbers of the Sixth Revision of the International Lists, 1948) |