Table 3. CASES OF SPECIFIED DISEASES: SELECTED CITIES FOR WEEK ENDED (Numbers after diseases are category numbers of the Sixth Revision of the International Lists, 1948) The chart shows the number of deaths reported for 106 major cities of the United States by week for the current year, and, for comparison, the median of the number of deaths reported for the corresponding weeks of the three previous calendar years. (The median is the central one of the three values arranged in order of magnitude.) If a report is not received from a city in time to be included in the total for the current week, an estimate is made to maintain comparability for graphic presentation. The figures reported represent the number of death certifi cates received in the vital statistics offices during the week indicated, for deaths occurring in that city. Figures compiled in this way, by week of receipt, usually approximate closely the number of deaths occurring during the week. However, differences are to be expected because of variations in the interval between death and receipt of the certificate. While week-to-week changes in the total number of deaths reported for all major cities generally represent a change in mortality conditions, this may not be true for variations in weekly figures for each city. For example, in a city where 50 deaths are the weekly average, the number of deaths occurring in a week may be expected to vary by chance alone from 36 to 64 (d ± 2Vd, where d represents the average number of deaths per week). The number of deaths in cities of the same size may also differ because of variations in the age, race, and sex composition of their populations, and because some cities are hospital centers serving the surrounding areas. Changes from year to year in the number of deaths may be due in part to population increases or decreases. Provisional Information on Selected Notifiable Diseases in the United States for A total of 88 cases of meningococcal infections was reported in the United States for the current week. More than half (48) of these cases were reported in the East North Central and South Atlantic States. The incidence for the current week is much higher than that for the corresponding week of last year, when 65 cases were reported. However, for the "disease year," which began with the week ended September 5, the cumulative total is 575 as compared with 553 for the corresponding period of 1952. The incidence of poliomyelitis decreased about 20 percent for the current week, from 1,031 (corrected figure) last week to 835 this week. States reporting more than 50 cases for the current week were: California, 142; New York, 94; Ohio, 79; Michigan, 64; and Pennsylvania, 58. In Alaska, where there has been an unusually high incidence of measles this year, a total of 84 cases was reported for the current week. Since the first of June, 1,470 cases have been reported as compared with only 58 for the corresponding period of 1952. EPIDEMIOLOGICAL REPORTS in the same neighborhood a little later, but because he appeared harmless was released and disappeared. Tularemia Epidemiological information has been received on a case of tularemia which occurred in California. The disease was in a man who killed and skinned a rabbit 10 days prior to the onset of his illness. The patient developed lesions on his fingers first; then fever, malaise, and gradually enlarging tender epitrochlear POLIOMYELITIS CASES BY WEEK OF ONSET FOR TWO AREAS GIVING MASS IMMUNIZATION NUMBER OF 30 Under 15 years MONTANA Rabies in animals Dr. J. H. Steele, Veterinarian, CDC, Public Health Service, states that information has been received from the Department of Health in Colorado that 5 cases of rabies in animals have been reported in 2 counties-El Paso (3) and Morgan (2). In addition, 2 clinical cases have been reported in Logan County. The disease in animals is rare in Colorado with only 2 previous cases having been reported this year, 1 in May and 1 the first part of October. During 1952 no rabies in animals were reported in the State. Statistics as to the protective levels attained in the respective areas will be made available to all veterinarians in the State as soon as they are tabulated. Rabies in bats Dr. E. J. Witte, Public Health Veterinarian, Pennsylvania Department of Health, reports that rabies infection in a bat was confirmed in the laboratory of the State Bureau of Animal Industry. On September 29 the bat made an unprovoked attack on a woman living in the south central part of the State. The bat was captured and submitted for examination. The brain tissue showed "suspicious" signs of rabies, and animal inoculation confirmed the diagnosis. The person bitten has no signs of the disease up to the present time. After removal of the bat's brain the carcass was destroyed, so no determination of the species could be made. Studies are in progress to ascertain the extent of bat rabies in the area where the bat was caught. Rabies in man Dr. U. P. Kokko, Kentucky Department of Health, reports a human case of rabies in a 5-year-old boy. The boy was knocked down by a small running dog. No one saw what actually happened and the boy himself did not know either. The few bloody marks on the boy's face were so nontypical that it was impossible to conclude with any degree of certainty whether they were dog bites or scratches. Since the nature of the lesions was questionable, no antirabies treatment was given. The first symptoms of the disease occurred 3 days later and consisted of itching and pain on the injured side of the boy's face. The dog was caught NOTE. -Fourteen of the 15 cases in Park County were reported from the city of Livingston (1950 population, 7, 683), and 24 of 29 cases in Custer County were in Miles City (1950 population, 9, 243). The above chart shows the number of cases of poliomyelitis, in certain counties where mass immunization with gamma globulin was administered. Arrows indicate the week when mass immunization, limited to children under 15 years of age, was given. Final conclusions regarding the efficacy of this measure cannot be drawn until additional detailed data have been collected and studied. It is to be noted that a shift in age distribution of cases from younger to older ages has been found in the progress of other outbreaks, including an observation by Frost in 1916. and axillary nodes. A blood specimen collected 2 weeks after the onset was positive for tularemia in a dilution of 1:5120. Influenza and acute respiratory infection The following reports have been received by the Influenza Information Center, NIH, and the National Office of Vital Statistics. The Preventive Medicine Division, SGO of the Army has received reports of 4 cases of serologically diagnosed influenza B among Australian troops which just arrived in the Far East Theatre. The onsets were September 19 to 21 and seemed to be related to the occurrence of influenza B in Australia during August and September. Dr. Reinaldo A. Ferrer, Department of Health, Puerto Rico reports that final studies performed by United States Army laboratories show that the strains of influenza virus recovered in Puerto Rico in the spring of 1953 were similar to those isolated earlier in the year in the United States. This is the third successive year that outbreaks of influenza have occurred in Puerto Rico in the late spring, due to the same type of virus prevalent during the winter in the United States. Dr. G. A. Spendlove, Director, Utah Department of Health, states that during the first 3 weeks of October respiratory in fections with influenza-like symptoms were reported in small numbers from different parts of the State. Reports of throat washings and blood specimens which have been collected for laboratory examination are not yet available. Fish poisoning Dr. J. R. Enright, Hawaii Department of Health, reports that 4 persons in one family became ill with severe vomiting, diarrhea, thready pulse, and acetonuria from 10 to 30 minutes after eating fish. The fish were given to this family by a fisherman who brought some red snappers from near Palmyra Island. This fisherman was with a party of 42 who went to the island. Enroute, everyone was briefed on the poisonous fish in the waters. Some of the fish in the area are edible but the red snappers are known to be poisonous at times. In spite of these warnings one of the fishermen brought back some red snappers. Part of these he gave to a neighbor, but when informed of the illness he buried the remainder. None of the fish were available for laboratory tests. On questioning all 4 patients gave the typical symptoms of ichthyotoxism; numbness and tingling of the lips and tongue, paresthesia of the arms and legs, and temperature-sense reversal, i.e., cold water felt extremely hot to the mouth and hot soup gave a sensation of extreme coldness. Table 1. COMPARATIVE DATA FOR CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES Colorado, 3 cases. *Deductions: North Carolina and New Mexico, week ended July 25, 1 case each; Indiana, week ended September 5, 3 cases; South Dakota, week ended October 24, 1 case. Kentucky, 1 case. Addition: Ohio, week ended October 17, 46 cases. SOURCE AND NATURE OF DATA These provisional data are based on reports from State and territorial health departments to the Public Health Service. They give the total number of cases of certain communicable diseases reported during the week usually ended the preceding Saturday. When the diseases which rarely occur (cholera, dengue, plague, typhus fever-epidemic, and yellow fever) are reported, they will be noted under the table above. Symbols.-1 dash [-]: no cases reported; asterisk [+] disease stated not notifiable; parentheses, [) : data not included in total; 3 dashes [---]: data not available. |