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1 WEEKLY G REPORT NATIONAL COMMUNICABLE DISEASE CENTER « EE Vol. 19, No. 9 1 WEEKLY g REPORT = For == Week Ending g March 7, 1970 U-S. DEPARTM ENT OF H E A LTH , EDUCATIO N, AND W ELFARE / PUBLIC HEALTH SERVICE ^HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION ^1970 -^rA3y_ANTA, GEORGIA 30333 EPIDEMIOLOGIC NOTES AND REPORTS CONTENTS MENINGOCOCCAL INFECTIONS Epidemiologic Notes and Reports Fort Leonard Wood, Missouri Meningococcal Infections — Fort Leonard Wood, Missouri 89 1Q*7A Measles *n Previously Immunized Children — In the period Jan. 1 - March 9, 19Ta totalMA^3 Ar^yJ t/fU Scott-City, K a n s a s ..............................................................................90 recruits and one military dependent at Fort Leonard Wood, S a lm o n e llo sis — L os A n geles, C a lifo r n ia ......................................92 T ularem ia — K ing C ounty, W as h in g to n ............................................94 Missouri, became ill with meningococcal i^NcEoEfcCthteb;3RARifollow-up Tularemia Outbreak — Verm ont .................................. 94 these patients died. Neisseria meningitidi^y^'^'fplated n _ T u lare m ia — U nited States 1960-1968 ............................................ 94 from so percent of the patients with clinical evidence of v.UOO'Epizootic of Bovine Cysticercosis — C alifo rn ia......................100 Hieningococcal infections. All of the isolates from blood or International Notes Follow-up Influenza — United States and cerebrospinal fluid were serogroup C sulfonamide-resistant E nglan d and W a l e s ...................................... 92 drains. The 33 cases in recruits exceeded the total number of Cases annually reported from this base during previous Several recent culture surveys for nasopharyngeal years; 1967, 17 cases; 1968, 25 cases; 1969, 26 cases. carriage of N. meningitidis in recruits have been conducted 0nly °ne death from meningococcal infection was reported at this base. In February 1970, an increased nasopharyngeal r°m 1967 through 1969. Eighteen of the 33 cases in re­ carriage rate of serogroup C organisms, over previous cruits in 1970 occurred in February, more than double the months, was noted in recruits who had received 6-7 weeks ^URiber of cases for any of the preceding 5 months (Table 1). (Continued on page 90) TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES (Cumulative totals include revised and delayed reports through previous weeks) 9th WEEK ENDED CUMULATIVE, FIRST 9 WEEKS M EDIA N DISEASE March 7, March 1, M ED IA N 1965 - 1969 1970 1969 1970 1969 1965 - 1969 25 32 29 257 268 249 5 7 4 22 16 30 JPhtheria___ 15 2 2 78 22 25 primary: EncpnhPiOC' *}orrie & unspecified 21 11 19 180 177 195 Henaf'»a 'post-infectious DOSt.irfpr.Mnns 8 3 17 60 38 92 serum ....................... 112 106 1,086 881 G a u l i s , 843 7,286 ^aiaria infectious .............. 1,232 993 9,814 7,816 80 59 51 603 417 325 MenfÍ!?_(rul^eola)®ning0c, 1,293 531 2,834 8,967 3,740 18,885 occal infections, total 86 86 605 723 717 2 vilian 68 Military 63 83 83 577 677 659 5 3 13 p UmPs 28 46 50 D'iorny elitis 2,704 2,369 22,579 19,840 total 1 1 2 «Ü5S& ..................... 1 1 2 T e tanus m a n m e a s l e s ) 1,922 1,180 11,121 6,096 ï^areniia ................... 2 2 2 12 16 18 6 2 12 21 21 4 3 6 41 36 44 fiabis« tick-b°me (Rky. Mt. spotted fever) . — 1 Ssjn animals 6 78 94 94 ___ 212_ TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY Cum. Cum. BnÌhrax: . r „ ul“sm: " Psittacosis: ............................................ j Prosy; / ■ ■ 1 R a b ie s in Man: ...................................... 14 R u b e lla co ng e nital s y n d ro m e :.......... Plaguefirosis:' 13 9 Trichinosis: Conn.“l, N.Y. Ups.-l 11 Typhus, murine: Hawaii-1 .............. 1 elayed rePorts: Leptospirosis: Okla. 1 (1969), Colo. 1 90 Morbidity and Mortality Weekly Report MARCH 7, 197° MENINGOCOCCAL INFECTIONS - (Continued from front page) Table 1 Table 2 Cases of Neisseria meningitidi s Infection in Recruits Serogroup C, Neisseria meningitidis Fort Leonard Wood, Missouri Nasopharyngeal Carriage Rates in Military Recruits Sept. 1, 1969 — March 4, 1970 Fort Leonard Wood, Missouri December 1969 — February 1970 Year Month Total Number of Cases Deaths Serogroup C, N. meningitidis Carriage 1969 Sept. 0 0 Oct. 2 0 Rate (Percent) __ Nov. 4 0 Stage of Training ___ Time of Survey Dec. 5 0 After First 4-8 Weeks After 1970 Jan. 7 0 On Arrival 6-7 Weeks of Completion of Feb. 18 3 at Fort Basic Training Basic Training,, March 1-9 8 0 Dec. 1969 0 31 32 Jan. 1970 2 31 28 of training (Table 2). This increased carrier rate of sero- Feb. 1970 2 58 2 4 ___ group C organisms may have been directly associated with the increased number of cases. Serogroup B N. meningitidis MC USA, Commander, Fifth US Army Medical Laboratories, was carried by 6 percent of recruits on arrival and 2 to 11 St. Louis, Missouri; Lt. Col. Phillip E. Winter, MC USA, percent after 6-7 weeks of training. However, in recent Epidemiology Consultant, and Col. Robert H. Quinn,■ »I f months serogroup'B strains have not been associated with USA, Chief, Communicable Disease Branch, Preventii>e clinical disease. Medicine Division, Office of the Surgeon General, USAi Currently, the investigational group C meningococcal Washington, D.C.; Malcolm S. Artenstein, M.D., Chief, &e' polysaccharide vaccine (1) is being offered a proportion partment of Bacterial Diseases, Walter Reed Army InstitvM of the Fort Leonard Wood recruits, on a voluntary basis. of Research, Washington, D.C.; E. A. Belden, M.D., Sto^e In February 1970, 800-1,000 recruits were immunized with Epidemiologist, Division of Health, Missouri Department of this vaccine. Health and Welfare, Jefferson City, Missouri; Helen Brace, In 1970, through March 9, for the state of Missouri, M.D., Acting Director, Communicable Disease Section there has been no significant increase in the number of Melvin Tess, M.D., Health Commissioner, City of St. LoUlS civilians with meningococcal disease compared with the Division of Health, St. Louis, Missouri; and the Bacterid same time period in the previous 2 years. To date, in 1970, Reference Unit, Special Bacteriology Laboratory, and five cases have occurred in civilians compared with six in Bacterial Immunology Unit, Laboratory Division, NCDC-) the first 2 months of 1969 and four in 1968. More than 10 cases of meningitis, due to other etiologic agents have also Editorial Comment In recent years serogroup C sulfonamide-resistant been reported in 1970. In St. Louis, in 1969, seven persons were treated for meningococcal infections out of a total N. meningitidis has become the predominant type of meWn of 26 patients in whom meningitis, of all etiologies, was gococcus isolated from military recruits. A parallel trend diagnosed. Since January 1968, isolates of N. meningitidis has also occurred in the civilian population, and sud1 from Missouri civilians submitted to the NCDC have been strains have now become the predominant type isolated fronl predominantly serogroup C sulfonamide-resistant strains. civilian cases throughout the United States (MMWR, Vol- 1 ’ Two additional patients, from Illinois, were also No. 16). The monthly incidence of meningococcal diseaSe treated in St. Louis hospitals. One of these became ill on in both civilian and military populations shows a similar March 4, 2 days after contact with a Fort Leonard Wood seasonal variation, with peak incidence rates generally serviceman. None of the other six civilians (the five from occurring in the late winter and early spring months; ° ut breaks of meningococcal infections are most likely to be Missouri and the one from Illinois) with meningococcal dis­ reported at that time of the year. ease in 1970 were known to have been directly associated with Fort Leonard Wood. Reference (1) Artenstein, M. S., Gold, R., Zimmerly, J. G., VVyle, F- (Reported by Lt. Col. Gilberto Varela, UC USA, Chief, Schneider, H., and Harkins, C. Prevention of meningococ0^ Preventive Medicine, General Leonard Wood Army Hospital, disease by group C polysaccharide vaccine. New E ng Fort Leonard Wood, Missouri; Lt. Col. Philip D. Stansifer, 282: 417-420, 1970. MEASLES IN PREVIOUSLY IMMUNIZED CHILDREN - Scott City, Kansas Between Jan. 20 and March 5, 1970, 47 cases of mea­ rubeola. Nearly all patients had a 2- to 3-day prodrome 0 sles occurred in residents of Scott City, Kansas, a town fever (102-104°F.), associated with cough, coryza, lacrin18 with a population of 4,600 people. Fifteen of these cases tion, and a generalized rash of 4- to 10-days durati°n' were in previously immunized children. All of the 47 cases Koplick spots were noted in several patients. The were clinically and epidemiologically compatible with complication occurred in a 4-year-old boy who develop0 MARCH 7, 1970 Morbidity and Mortality Weekly Report 91 Figure 1 MEASLES CASES BY DATE OF ONSET SCOTT CITY, KANSAS - JAN. 19-MARCH 7, 1970 10 □SCHOOL AGE PRESCHOOL AGE 1 I-- 1 I I I I T— I I I ' .LQ19 21......23 25 27 n29 nm r9 II 13 15 21 23 25 27 2Q\ I 3 5 JAN. FEB. MAR. DATE OF ONSET secondary otitis media. The index patient (Figure l).w as attack rate for measles susceptible children was 10.4 per­ an unimmunized 7-year-old, second grade boy from whom cent, while that for previously immunized children was t-hree generations of spread (35 cases) could be documented. 2.0 percent. The attack rate in the 5- to 9-year age group Hi s presumed source of infection was contact at the local for immunized and unimmunized children was 2.6 and 26.7 bowling alley with children from neighboring communities percent, respectively.
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