JAN 23 1956

Vol. 5, No. 1

January 13, 1956

NOTICE.-Beginning this week, several
changes have been made in the list of notifi-
able diseases shown in this report. The new
list was recommended by the Second Con-
ference of State Epidemiologists and approved
by the Association of State and Territorial
Health Officers. Diseases dropped from the
list for weekly reporting on the national level
are: Rocky Mountain spotted fever, scarlet
fever and streptococcal sore throat, trich-
iniasis, tularemia, and whooping cough. There
is one addition, namely, other types of men-
ingitis.

Only 41 cases of diphtheria were reported this week as
compared with a high of 104 for the week ended December 10,
1955. Almost half (17) of the cases were reported in the West
South Central States. These and 2 Southern States, Alabama,
(8 cases) and Florida (4), accounted for all but 12 of the total

cases.

EPIDEMIOLOGICAL REPORTS

Plague in a rodent

Mr. Frank M. Prince, Chief of the San Francisco Field
Station, PHS, has reported that tissues collected from a female
rat, Rattus alexandrinus, found dead in Hawaii, were positive for
plague. The specimen was obtained within the endemic area of
the Hamakua District, Kukuihaele area, Hawaii.

Typhus fever

Dr. A. C. Hollister, Jr., California Department of Public
Health, has supplied final information on the case of typhus fever
reported for the week ended October 15. At that time the case
was suspected to be of the louse-borne type. However, labora-
tory tests done later at the Walter Reed Army Medical Center,
Washington, D. C., indicate the infection was probably of murine
type rather than epidemic.

Leprosy

Dr. W. R. Giedt, Washington State Department of Health,
has reported a case of leprosy in a 23-year-old man. The pa-
tient was born in a foreign country and had lived in the United
States only 4 years, part of which was in New York. He has had
no known exposure to leprosy. In 1952 he noted a persistent
numbness of the right. arm. During the latter part of December
1955, he developed fever, malaise, and nodules which were scat-
tered over the extensor surface of the body. A physical exam-
ination revealed anesthesia of the right ulnar area. The patient
had nasal obstruction, a chronic ulcer over left elbow, and
inguinal adenopathy. The "nodules" were covered by patches
of reddened skin, many or most of them appeared to be "raised
macules" varying between 1 and 2 cm. in diameter. The diag-
nosis was supported by laboratory examination of smears from
cutaneous lesions, lymph nodes, and nasal discharges.

Rabies in animals

For the period January 1, 1955, to January 3, 1956, a total
of 406 cases of rabies in animals was reported in California.
While the majority of cases were in dogs, approximately a third
(138) were in skunks. Among other wild animals, rabies were
in foxes (20 cases), bobcats (3), bats (2), and a raccoon (1). The
remaining cases were in domestic animals as follows: cows (9),
cats (2), and a goat (1).

Epidemic meningitis

Dr. A. A. Jenkins, Utah Department of Health, has reported
2 cases of epidemic meningitis among 7 young children in one
family. The patients were comatose on admission to the hospi-
tal, but are making satisfactory progress toward recovery. All
members of the family have been treated prophylactically with
sulphadiazine. There are no known previous cases or subsequent
cases. All contacts have been notified and are under close sur -
veillance by State and local health departments.

Leptospirosis

Dr. R. H. Heeren, Iowa State Department of Health, has
given preliminary information on a case of leptospirosis. The
patient became ill early in November about 12 days after being
bitten by the family dog. The dog was sick and icteric. The
patient's illness was characterized by malaise, fever, chills,
and severe headache. Complement fixation titers on blood spec-
imens from the patient were as follows: Leptospira icterohem-
orrhagiae, 1:128; L. canicola, 1:512; and L. pomona, 1:128. No
illness has occurred among other members of the patient's fam-
ily, which includes her husband and 3 children.

Psittacosis

Dr. Mason Romaine, Virginia Department of Health, has
reported 3 cases of psittacosis, 2 of which occurred in one city.
Blood specimens were collected from the 3 patients but no lab-
oratory reports have as yet been received. Two were store
clerks who came in contact with laboratory confirmed infected
parakeets. The source of one bird was New York City, and that
of the other was North Carolina. The third patient owned 2 ca-
naries (not sick) and 2 parakeets. One of the parakeets appar-
ently became sick and was let out of the house. This bird was
caught and eaten by the family cat which later died of "pneu-
monia." The patient's wife and son have not been ill but blood
specimens collected showed complement fixation titers of 1:64
for psittacosis.

The California Department of Public Health has given epi-
demiologic information on 4 cases of psittacosis. Two cases
were confirmed by fourfold rises in complement fixation titers
for psittacosis. Of these 2 patients, 1 had no known exposure to
psittacine birds, and the other had shot 4 doves on a hunting
trip. The other 2 patients were associated with psittacine birds.
No laboratory tests were made on these birds nor on the doves.

ent sinusitis with bronchitis and coughing, with a duration of from 2 to 5 days. Fever is considered uncommon. Antibiotics have been used quite extensively, but without effect, so far as terminating the condition or relieving the symptoms.

Poliomyelitis-like illness

During August of this year, a number of poliomyelitis-like illnesses were reported by health officers in Marshall County, Iowa. Recovery in most instances was complete in 7 to 10 days, and no paralysis developed. The illnesses were characterized by a sudden onset of severe headache, fever, nausea, vomiting, stiff back and neck, retrobulbar pain, and dizziness. A number of the patients also complained of sore throat. An investigation on a random sampling basis revealed an estimate of 500 cases. Stool specimens collected from patients were negative for poliomyelitis virus isolation. However, the stool suspensions caused degeneration of monkey kidney tissues, and further, upon inoculation into infant mice, these suspensions caused illness and paralysis, These findings are compatible with Coxsackie virus infection, probably the group B. Microscopic examination of the monkey tissues showed the degeneration in muscle bundles. Lesions were observed in the brain as well. Over 50 percent of the stools examined so far show these findings.

Coccidioidomycosis

Dr. S. H. Osborn, Connecticut Department of Health, has reported a case of coccidioidomycosis in a 29-year-old veteran who saw service in California, Burma, China, and India. He was admitted to one of the State tuberculosis sanatoriums in May of 1955, complaining of recent hemoptysis. A lesion in the left upper lobe was found on X-ray. Studies for tuberculosis were negative. Coccidioides immitis was found in his sputum and in sections of lung tissue when his left upper lobe was removed in September. He was discharged from the sanatorium in October 1955 and is apparently doing well.

Pasteurellosis

The laboratory of the Connecticut State Department of Health has recently isolated Pasteurella multocida from a sputum culture. Investigation revealed that the patient is a 67-year-old dairy farmer. The patient has been hospitalized on numerous occasions since 1943 with bronchiectasis. His right middle lobe was removed in 1943, and the lingula of the left upper lobe was removed in 1949 because of bronchiectasis. Numerous sputum cultures have been done throughout the years. Only the most recent, collected in a hospital on November 28, 1955, was reContinued on page 8