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TABLE III. (Cont.'d). Cases of specified notifiable diseases, United States, weeks ending

June 30, 1984 and July 2, 1983 (26th Week)

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Mortality data in this table are voluntarily reported from 121 cities in the United States, most of which have populations of 100,000 or
more. A death is reported by the place of its occurrence and by the week that the death certificate was filed. Fetal deaths are not

included
* Pneumonia and influenza
+ Because of changes in reporting methods in these 4 Pennsylvania cities, these numbers are partial counts for the current work. Com-

plete counts will be available in 3 to 6 weeks.
+1 Total includes unknown ages.
§ Data not available. Figures are estimates based on average of past 4 weeks.

Rubella Vaccination - Continued 4. Banatvala JE, O'Shea S, Best JM, Nicholls MWN, Cooper K. Transmission of RA27/3 rubella vac

cine strain to products of conception (Letter). Lancet 1981;1:392. 5. Furukawa T, Miyata T, Kondo K, Kuno K, Isomura S, Takekoshi T. Clinical trials of RA 27/3 (Wistar)

rubella vaccine in Japan. Am J Dis Child 1969;118:262-3. 6. Bernstein DI, Ogra PL. Fetomaternal aspects of immunization with RA27/3 live attenuated rubella

virus vaccine during pregnancy. J Pediatr 1980:97:467-70. 7. O'Shea S, Parsons G, Best JM, Banatvala JE, Balfour HH Jr. How well do low levels of rubella anti

body protect? (Letter). Lancet 1981;II: 1284. 8. Balfour HH Jr, Groth KE, Edelman CK, Amren DP, Best JM, Banatvala JE. Rubella viraemia and anti

body responses after rubella vaccination and reimmunization. Lancet 1981;1: 1078-80. 9. CDC. Congenital malformations surveillance report January-December 1980. Atlanta, Georgia. Cen

ters for Disease Control, 1982:24. 10. CDC. Unpublished data. 11. Desmond MM, Montgomery JR, Melnick JL, Cochran GG, Verniaud W. Congenital rubella encephali

tis. Effects on growth and early development. Am J Dis Child 1969;118:30-1. 12. Ziring PR. Congenital rubella: the teenage years. Pediatr Annal 1977;6:762-70. 13. CDC. Rubella vaccination during pregnancy United States, 1971-1982. MMWR 1983;32:429

32, 437. 14. ACIP. Rubella prevention. MMWR 1984;33:301-10, 315-18.

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Abortion Surveillance: Preliminary Analysis – United States, 1981

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A total of 1,300,760 legal abortions were reported to CDC for 1981 from 50 states and the District of Columbia. This is less than a 1% increase over the number reported for 1980 (Table 2). The national abortion ratio decreased slightly from 359 legal abortions per 1,000 live births in 1980 to 358/1,000 in 1981. Since 1980, the national abortion rate decreased from 25 legal abortions/1,000 women aged 15-44 years in 1980 to 24/1,000 in 1981.

As in previous years, women obtaining abortions in 1981 tended to be young, white, and unmarried and to have had no live births (Table 2). Sixty-three percent were under 25 years of age; approximately 70% were white; and 78% were unmarried at the time of abortion. Fiftyeight percent of the abortions were obtained by women who had had no live births.

Curettage (suction curettage, sharp curettage, and dilatation and evacuation) accounted for 96% of abortion procedures in 1981. Slightly less than 3% were performed by intrauterine instillation, and less than 1% were performed by hysterotomy and hysterectomy. In 1981, more than half of all reported legal abortions were performed in the first 8 weeks of gestation; and 90%, in the first 12 weeks of gestation.

Eleven deaths associated with abortion were reported for 1981. Of these, three were associated with spontaneous abortion; one, with illegal abortion; and seven, with legal abortion. The death-to-case rate for legal abortions in 1981 was 0.5 per 100,000 procedures, compared with 0.6/100,000 for 1980. Reported by Pregnancy Epidemiology Br, Research and Statistics Br, Div of Reproductive Health, Center for Health Promotion and Education, CDC. Editorial Note: This report presents a preliminary analysis; a more in-depth analysis of 1981 abortion data is forthcoming. Because of annual variation in the number of states reporting data on the specific abortion characteristics (Table 2), temporal trends based on these summary data should be viewed with caution. An analysis of temporal changes for areas that have reported specific abortion characteristics for each year since 1974 is under way.

Since 1969, when CDC began collecting information on legal abortions, the reported number of women obtaining abortions has increased yearly. Part of the increase from 1969 to 1973 is attributable to an expanded surveillance system. It is noteworthy that the annual percentage increase in numbers of abortions has continuously declined since 1976, with the lowest percentage increase being reported for 1981.

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prarteristic varies from year to year, temporal comparisons should be made with caution.

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Abortion Surveillance Continued

In 1981, for the first year since CDC began abortion surveillance, there was virtually no increase in the number of abortions reported, and for the first time, the abortion rate and abortion ratio declined. Examination of the national abortion surveillance system for 1981 suggests that the lower abortion rate and abortion ratio are real rather than an artifact of changes in completeness of reporting. In 28 reporting areas, the number of abortions reported for 1980 exceeded the number reported for 1981; in 24 reporting areas, more abortions were reported for 1981 than for 1980. Differences in the reported number of abortions between 1980 and 1981 exceeded 3,000 in only six reporting areas, and for these, there was a net increase of 6,725 abortions. Moreover, the sources of abortion data were identical in both years, with the exception of two states; for one, 2,746 more abortions were reported for 1981 than for 1980; for the other, 4,435 fewer abortions were reported for 1980 than for 1981.

Through the 1970s and into the 1980s, curettage steadily increased as the primary method of abortion. In 1981, virtually all first-trimester procedures were performed by curettage; moreover, in the 13- to 15-week interval, more procedures were performed by curettage than by all instillation and other procedures performed at any gestational week during the second trimester.

The 11 abortion-related deaths (legal, illegal, and spontaneous) reported in 1981 are the fewest reported since CDC's surveillance of abortion deaths began in 1972. Previous experience shows that 64% of abortion deaths are reported to CDC during the 12 months after the death and 96% within 3 years of the death. CDC investigates all reports of abortion-related deaths and uses late reports of confirmed abortion-related deaths to update data for previous years.

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On December 28, 1983, a group of 11 children in Corpus Christi, Texas, were exposed to dead bats. Due to extremely cold weather, 29 Mexican Free-Tail bats roosting under a bridge had frozen and fallen to the ground in the early morning. They were discovered by the children, ages 4-14 years, about noon. The bats were partially thawed, and several had blood draining from their mouths. One or more of the children, emulating a popular singer, put a bat in the mouth and pretended to bite it. There ensued a free-for-all in which the children threw bats at each other. All 11 children were hit by bats.

Later that day, the Corpus Christi-Nueces County Department of Public Health was notified of the incident, and by that evening, the Director of Public Health had discussed the situation with the nine families involved. It was not possible to determine which children were exposed to the blood and/or saliva of bats. Because of the possibility that all the children had some exposure of mucous membranes or scratches in the skin, the health director recommended complete postexposure rabies prophylaxis for all 11 children; all 11 received it, and all have remained well. Only four of the 29 bats were examined by the fluorescent antibody technique, and they were negative. However, a 1983 sampling of approximately 600 south Texas bats had revealed a positive test rate of 15%. Reported by CMG Buttery, MD, RM Rodriguez, MD, G McLerran, T Villarreal, J Green, Corpus ChristiNueces County Dept of Public Health; O Sieber, MD, Driscoll Foundation Children's Hospital, TL Gustaf. son, MD, CE Alexander, MD, State Epidemiologist, Texas Dept of Health; Viral and Rickettsial Zoonoses Br, Div of Viral Diseases, Center for Infectious Diseases, CDC. Editorial Note: This episode illustrates two issues frequently faced by public health professionals with regard to bat rabies: (1) the persons involved often cannot agree about the actual sequence of events in such episodes; (2) the bats involved are frequently unavailable for laboratory study. Thus, in this case, the critical decisions regarding prophylaxis rested on questionable histories provided by children and incomplete or unsatisfactory laboratory speci

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