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TETANUS – Reported cases, by age group, United States, 1984

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Of the 74 tetanus cases reported in 1984, 39 (53%) occurred in persons 60 years of age or older. This is consistent with serosurvey results indicating that one-half to two-thirds of persons over 60 years of age have inadequate levels of circulating antitoxin. Health-care providers should ensure that their elderly patients complete their tetanus and diphtheria vaccination schedules and should adhere to current recommendations for tetanus prophylaxis during the management of acute wounds. Two cases of tetanus (California, Texas) occurred in neonates. both born to mothers with no known history of prior immunization.

TOXIC-SHOCK SYNDROME – Cases, by month of onset, United States, 1979-1984

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As of June 1, 1985, 262 cases of toxic-shock syndrome (TSS) with onset in 1984 had been reported to CDC. This brings to 2,815 the total number of cases that have been reported; with 890, 586, 399, and 321 cases occurring in 1980, 1981, 1982, and 1983, respectively. Of these, 2,669 cases were in females, and 146 were in males. Cases have been reported from all 50 states. Of the 1984 cases, 2.7% were fatal, as were 2.8% in 1983 and 1982, 3.2% in 1981, and 4.7% in 1980. Nonmenstrual TSS accounted for 27% of the reported 1984 cases, up from 7% in 1980. TSS continues to be reported primarily among women and among white non-Hispanics.

TOXIC-SHOCK SYNDROME Cases of menstrual (M) and nonmenstrual (NM) toxicshock syndrome, by month and year of onset"

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Total
242 27
812 60

469 98

287 88 'Excludes cases with unknown or indeterminate menstrual status and cases with unknown month of onset.

TRICHINOSIS - Cases, by year, United States, 1950-1984

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In 1984, 68 cases of trichinosis were reported through the MMWR morbidity surveillance system. Written case reports were submitted by 13 states for 65 cases fitting the CDC case definition. Seventy-five percent of the cases occurred in five states: New Jersey reported 17 cases (26%); Texas, 11 (17%); California, eight (12%); Connecticut, seven (11%); and Massachusetts, six (9%). Other reporting states were New York (four), Pennsylvania (four), Alaska (three), Hawaii (one), Maine (one), North Carolina (one), Utah (one), and Virginia (one). The male/female ratio of these 65 cases was essentially equal. The mean age of patients was 34 years, with a range of 3-73. The infective meat item was identified in 60 of the 65 cases. Pork was incriminated in 53 cases (82%), and bear meat in six (9%). Sausage was the most frequently implicated form of pork (43%). In 22 cases, the implicated meat was obtained from a commercial outlet such as a supermarket or butcher shop; in 11 cases, it was obtained directly from the farm; and in seven cases (involving the ingestion of feral swine and bear meat), through hunting. Eight common-source outbreaks were identified, involving a total of 40 cases. Of note was an outbreak among a group of Laotians living in Texas, which involved 12 people. One death was attributed to trichinosis, the first reported since 1981.

TUBERCULOSIS - Reported cases and deaths, United States, 1953-1984

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'Case data for years subsequent to 1974 are not comparable to those for prior years because of changes in reporting criteria that became effective in 1975. + Mortality data subsequent to 1978 are not comparable to those for prior years because of changes in classification that became effective in 1979. Late effects of tuberculosis (e.g., bronchiectasis or fibrosis) and pleurisy with effusion (without mention of cause) are no longer included in tuberculosis deaths.

In 1984, 22,255 cases of tuberculosis were reported to CDC, for a rate of 9.4 cases/100,000 population. This represents a 6.7% decrease from the number of reported cases in 1983, and a 7.8% decline in the case rate. From 1968 through 1978, the average annual decrease in the number of tuberculosis cases in the United States was 5.6%. From 1978 through 1981, when there was a large influx of Southeast Asian refugees, the average annual decline was only 1.4%. A 6.8% decrease in the number of cases in 1982, a 6.6% decrease in 1983, and the 6.7% decrease in 1984 indicate that the previous downward trend has resumed. Contributing factors to the decline in 1984 include 1) participation of almost all states in a new national case reporting system, requiring more accurate verification of cases and 2) a decline in the actual number of indigenous cases.

Final mortality data on tuberculosis for 1982 show 1,807 deaths. This is a 6.7% decrease from 1981, when 1,937 deaths were reported. The mortality rate in 1982 was 0.8 deaths/100,000 population.

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