Document 2Jn45N7r4XV1LvLGg7mLKjBjR

Monsanto (HAMl D. Wood - B2SD - 262 3 ir>w I'lifihf i October 15, 1979 RfllRI NCF Karen Newman Rocky Mountain Journal-Oct. 12th TO : R. C. Isham - BIND F. Provorny Karen is covering the Lafayette Therminol FR1 incident and had been given my name by Bob Harding, Denver EPA. Q. when did Monsanto phase out of PCBs? A. Started in 69-70. Final sales of dielectric grades in 77, Q. When did Monsanto become aware that PCBs might be a problem? A. Related Swedish work in 67-68, Yusho, confirmation of presence in U.S. environment leading us to begin phase out in 69. ~ -~ Q. Do we believe that PCB is as dangerous as EPA do? __ A. Different EPA representatives seem to have widely varying perceptions of the hazards associated with PCBs, often depending on how close they have been to the regulatory evolution. While we at Monsanto believed that the persistence of PCBs and the accumulation in the environment were good reasons to replace them in industry the hazards of PCBs are frequently overstated. Q. We understand you talked to Wayne Darling. He reported that he had been told by Monsanto that PCB could not cause cancer. Is that true? A. We told Mr. Darling that PCBs had been identified by the scientific community as 'suspect carcinogens in test animals' but that the most recent study on Aroclor 1254 carried out by NIH hqji indicated that Aroclor 1254 was not a carcinogen, and that tests in Atlanta had shown Aroclor 1242 to have less effect than 1754 on test animals. Epidemiological studies to date had shown no causal relationship between PCB and cancer in humans. I did not believe myself that PCB was a carcinogen. Q. Does PCB cause birth defeets? A. In the Yusho incident babies had been slightly lower than average weight at birth and in some cases skin pigmentation occurred. These symptoms had rapidly disappeared. We are not aware of any other birth defects related jflo PCB. DW :pb IN 10 ' HtV p '77 ) HONS 210047 CENTER FOR DISEASf CONTROL September 28. 1979 / Vol 28 / No 38 MORBIDITY AND MORTALITY WEEKLY REPORT MXWe IHii.i i i HilfiWiXiiiw iaimm Epidemiologic Notes and Reports Epidemiologic Notet and Reports 449 PotycMorinaitd Biphenyl Exposure -- ide^o. Montana 450 Blaiiomycoiis m Canoeim -- WisCont.n 451 OipMhent -- CtMorni* 457 Summer Mraslet -- Los Angeles Courtly Polychlorinated Biphenyl Exposure -- Idaho, Montana CDC is currently analysing data from 2 surveys to determine the level of human ex posure to polychlorinated biphenyls (PCBs) caused by a leak in an electrical transformer in a Montana meat-packing plant. Meat meal produced at the plant became contaminated In mid-Juno, however, the meal was used in chicken and hog feed distributed in several northwestern states over the next 2 months The extent of distribution of the contami nated meat meal, and of products made from the subsequently contaminated chickens and eggs, is being investigated by the Food and Drug Administration (FDA) and tire U S Department of Agriculture (USDA). ` ' The contamination was discovered when samples of chicken fat from a PjovB. Utah, slaughterhouse were found to contain elevated PCS levels after being tested routinely by USDA. The contaminated chickens had been bought from a large cgg-prolu^f$ form tn Franklin, Idaho USDA and FDA investigated the Franklin farm in Augustjnd found PCB levels of 36 67 parts per million (ppm) in chickens and 1.9-3 S ppm m eggs- FDA officials then traced the source of the feed used at the faun and discovered that contaminated meat meal had come from the Pierce Packing Company in Billings, Mon tana. A non opei ating transformer in that plant was found to have leaked about 200 gallons of PCBs Into a dram line used in the company's rendering operation, where wastes were processed into animal meal. The leak had gone unnoticed, affecting many ship nicnts of animal feed Meanwhile, tests of other farm products forced the destruction or qua'antme of millions of eggs, hundreds of thousands of chickens, and large quantities of processed foods. To dctcnnmc the degree of human exposuic to the PCBs, state and CDC personnel conducted a community-based survey in Franklin, where most of the population had eaten contaminated eggs. No illness attributable to PCBs had been reported On Septem ber 19, 105 volunteers from the area answered an epidemiologic questionnaire, which included questions on egg consumption and occupation Blood specimens weie diawn fiom all volunteers, and samples of bieast milk weie obtained from B lactating mothers These will be analyzed for PCOs at the Idaho state laboratory and compared to dccu- mcnlccl levels of PCBs in the general population An invrstigiition o! the workers in the Prcice Packing Company plant was elm under taken by CDC and the Occupational Safety and Health Administration on September 20 Seventeen woikm weie considered to have had potential exposuie to PCHs, 16 weie interviewed, and their 'kin was examined foi chloracne Blood samples for PCBs wen' drawn fiom these men and fiom 1C matched, unexposed employees Blood lipid and Iwc lunclion to<ts weie also peiloimcd on the potentially exposed workns Serum PCB levels will be analyzed at CDC. U.S DEPARTMENT OF HEALTH, EDUCATION, AND WrL r AflE / I'USUir HEALTH SEIWU HONS 210048 ` -> f t '-j \ 450 MMWR Stpcembtr 26, 1979 Polychlorinated Biphenyl Exposure - Continued Reported by C Brokopp. DrPH, B Cannon, FR Dixon, MD, Stan Fpidemiolognt, FS Gallagher, MO, JA Mather, MD, Idaho State Dept of Health and Welfare, MO Skinner, MD, State epidemiologist, Montana State Dept of Health and Environmental Sciences R Swanson, emergency and CpiOenuolo gicaf Operations Be, FDA; H Traybosh, DVM, Residue Evaluation and Surveillance Div, Food Safety and Ouahty Service, USDA, H Hutton, Occupational Safety and Health Administration, Toxicology Br, Clinical Chemistry Div, Bur of Laboratories, National Institute of Occupational Safety and Health, Special Studies Br, Chronic Otseases Div, Field Services On>, Bur ol Fpidamrology, CDC Editorial Note: PCBs are synthetic, 2-ringed phenyl compounds with varying degrees of chlorine substitution. Commercial PCB formulations are mixtures of many isomers and are classified according to weight percent chlorine in the preparation They are in soluble in water, but soluble in oil and many organic solvents. Their dielectric properties make them useful as insulators and heat-exchange Bgents in capacitors and transformers. Many commercial PCB preparations also contain small amounts of highly toxic chlorinated dibenzofurans and naphthalenes. PCBs may enter the body by ingestion, inhalation, and percutaneous absorption. They tend to accumulate in body lipids and are poorly metab olized, especially the more highly chlorinated Isomers. Hydroxylated metabolites may be produced by direct enzymatic transformation or by the formation of arene oxide inter mediates (/), The tatter are generally carcinogenic and mutagenic. In the U.S. population, background PCB levels arc 5 20 parts per billion.(ppb) in serum and 500-5,000 ppb in adipose tissue f/,2). In human exposure studies, serum PCB levels of 50-350 ppb have been associated with chloracne (a specific skin lesionT, hyper pigmentation, elevated serum triglycerides, and abnormal liver function indiots. Children born to mothers exposed at this level are of tow birth weight, may be hyperpigmented, and may develop chloracne from PCBs in their mother's milk (5|, "- Bccause of the above dangers, federal legislation in 1975 mandated that manufacture and distribution of PCBs in this country cease within 2'/i years, and that all non-enclosed use of the chemical be banned. However, since much equipment containing enclosed PCBs is still in use, exposures such as tha present one in Montana may still occur, Rt/erences t. National Institute tor Occupational Safety and Health Criteria lor a Recommended Standard Occupational Exposure to Polychlorinated Biphenyls (PCBil (DIIEW iNIOSH] Pub No 77 225) Washington, Government Priming Office, 1977 2, MMWF1 27 99 100, 105, 1978 3 Goto M, Higuchi K; The svmpiomatologv of Vuslio Ichlorobiphenyls poisoning) in dermatology Fukuoka Acta Medice 60.409 431,1969 .4 Lavy BSB, Meyer CR, Lowry L, Smallwood A Health Hazard Evaluation Determination Report (No. 76 52-366). Cincinnati, US Dept Health, Education, and Welfare, National Iniiituic lor Occupational Safety and Health, April 1977 6. Yoshimura T' Epidemiological study on Yusho babies born to mothers who hed consumed oil contemineted by PCB Fukuoka Acta Medica 65 74-80,1974 -1 i .1 Blastomycosis in Canoeists -- Wisconsin -i In late July, 1979, 3 members of a southeastern Minnesota family developed level, chills, night sweats, anorexia, weight loss of 6-14 lbs, headache, and pleuritic chest pain. Cough was present in only 1 individual. The diagnosis of pulmonary blastomycosis was made, based on pulmonary infiltrates and sputum cultures positive for tilnstomyccs ' dermalitidis. Subsequent epidemiologic investigation revealed that the 3 patients were pari of a group of 8 wjjo had taken a canoe trip on a northwestern Wisconsin rivei near Hayward on July 2 A common exposure may have occurred when the giotip slopped at a campsite along the nvci and gathered wood to build a hro md cat lunch. HONS 210049 Sapltmbtr 28, 1979 MMWR 451 Blastomycosis -- Continued Seven of the 8 group members had chest X-ray changes consistent with those seen in pulmonary blastomycosis; 4 were ill. Sputum from 3 of the symptomatic individuals and 2 of the cases with a positive X ray grew B dermatitidis. Serologic testing loi blasto mycosis, using complement-fixation and immunodiffusion methods, has been negative thus far in the 6 Individuals tested, There has been no evidence of dissemination beyond the pulmonary tract in any of those infected, and the disease process is resolving without specific therapy, Environmental specimens obtained from the suspect campsite on August 28 are being cultured. Reported by NS Brewer, MD, KH Rhodes, MD CD Roberts, PhD. JE Roienblart, MD. end RE Van Seoy, MD, The Mayo Chnic, Rochester, Minnesota, J Uti. MD, Georgetown University Medical School, Washington, D C,; JP Devil. MD, Stete Epidemiologist, Wisconsin Slate Dept of Health end Social Services. Field Services Div, Special Pathogens Br, Bacterial Diseases Div, Bur of Epioennologv, CDC Editorial Note: North American blastomycosis is a granulomatous fungal infection that occurs sporadically in parts of the central and southeastern United States The disease may be limited to respiratory symptoms, or it may be disseminated. Cases can be fatal if untreated, but the acute respiratory syndrome has been noted to resolve without specific therapy {1}. This unusual outbreak of blastomycosis was notable for the high attack rale, the non-specific nature of the symptoms, and the brevity of the apparent common expo sure. A previous outbreak at Big Fork, Minnesota, in 1972 also demonstrated the fust 2 features, but was associated with exposure to a site over the course of several months (7). The incubation period of approximately 30 days is consistent with that seen in a laboratory-acquired case (2). The low sensitivity of serologic testing has als'o fSeVfnotcd previously (/}. -- Further studies arc in progress to investigate the possibility of other cases associated with the Wisconsin site, and to rule out other sites where exposure may hive occurred Suspected cases of blastomycosis in persons who reside m or have visited the areu around Hayward should be rcpoited to the Wisconsin State Department of Health and Social Services, to other appropriate health departments, or to CDC. References 1 Toil) TE. Hammerman KJ, Weeks RJ, Serosi GA A common source epidemic ot Norlli American btestomycosis. Am Rev Respir Dis 109 525 529, 1974 2. Beum GL, Leiner PI. Primary pulmonary blntomycous. A laboratory acquncd intccpon. Ann Intern Med 73 263, 1970 Diphtheria -- California On May 10. 1979, a 68-year-old man with no history of diphtheria immunization was seen at a Los Angeles County Health Department clinic with a sore thioat, When a pharyngeal membrane was noted, a throat cultuio was taken, and the patient was telcrred to a hospital with a diagnosis of diphthciia. A physician in the ear, nose, and throat clinic of the hospital stiipped the membiane and sent it lor Culture, made a diagnosis of pharyngitis, and sent the patient home on oral penicillin The next day, the county health department again referred the patient to the hospital because ol the suspicion of diphtheria, but he was sent home with no change in the diagnosis or treatment. Coryncbactenunt diphthenae was cultured from the throat membrane fiagments, and guinea Pigs were inoculated to test fnt toxigcnicitv When the tost was fuund to be positive on Juno 1, the county health department was inlonncd of the culiuie results HONS 210050 452 Diphtheria -- Continued MMWR Eaptembai 26, 1979 The patient, whose thioat had healed, was hospitalised on June 4 An electrocardiogram showed a right bundie branch block which had not changed from the patlern a year earlier The patient was discharged without parenteral penicillin or antitoxin tiealment Two throat cultures taken during admission were reported as negative on June 12 and 13 On June 25. the patient returned to the hospital with trouble swallowing and a nasal quality to his voice. He was admined with a diagnosis of diphtheritic bulbar neuropathy and was put on tube feeding for the dysphagia At present, he has a neurologic deficit Involving the muscles of the soft palate. On June 4, the county health department cultured the throats of 20 family members, all of whom had been well. The culture of a fl year-old granddaughter, who had been pie- viously immunized, was positive for C diphthenae, that culture was also toxigenic The granddaughter received 10 days of oral penicillin, end a booster dose of tctanus-diphthei ia toxoid was given. The immunizations of all family members have been brought up to date, and all remain well. Because the index patient had made a trip to Albuquerque, New Mexico, 4 weeks before the onset of illness, the New Mexico State Health and Environment Department was notified about the case All family members in New Mexico who were visited by the patient were followed up for immunizationspall have remained well, _ (Continued i pjete aas 7) TABl E I. Summary - casesof specified notifiable diseases. United Status (CumuhUvi totftf inctvdt fiviteddtitytd rtpofU through prevtotrs week* } -- -~ HUM Aacptiv iMnlnptrt Vructtyodi CNffJitpM Ch (Pithed* nc*pli*l<ii| eflnuiv ftvtrKDporfbtviMft totel'Mil liap.tifrt, Ymal Type I Mtrtl 1m* Tfp* tMt|cM Mdilff frvbtolj) M*r^nfococul 9*id CwItMl Mump* rpiwMt 4M<t*<Y ht<b|M IfitM mtdlll 1*1nM 9*bP**4wil* TwfMflH* 9yphpJC 1ff*1 1ypNi|(|T|r Ml VMHfll PVM Mthfwy CypHWi p4fm#iy fb wc*rtrt-*y Mi *nh*#h CwNi#n Military IfftTith 27 mi toe 4 m t l 41 i 2*1 4*9 29* 2T 49 24 24 * *0 90 90 1 90* 9 10 21 70,707 912 490 4 10T l*yfundi 7) 902 4 910 1 44 9 219 449 1?* 12 TJ 27 72 100 44 44 1 491 9 10 29 29i779 911 9>l 17 49 Ml OfAN 14741411*' 1*2 4 910 I 97 4 27S 411 144 19 at to 19 1*4 47 94 1 491 9 10 20 cuMiumivc Pr.ftn 3i nm Wte4*i72 I Spl'flit'iJj I M**i4)* 1070 | an* I io-4 tors" 1 |0I* 114 171(490 4] 494 m 10*947 71199 T *474 90* 12.1*9 1 iHl l.*W 10 11 ,1IP 1 *007 20,717 51 20.401 144 950 *44 4,227 190 174,447 40 Itfl 147 10,*44 20r*4 4,071 947 24,01* 1 *45 1,472 79 19,574 1.942 14*70 40 71.51* *1 911 17 2i 494 2M 174,447 174 *41 1** 10,*17 74,774 4,064 1,2*0 lain 71 X7,t7 1,141 14.*0 2 40 22* 9 41 104 7V0 797 21,771 4St 9Jt to 44 721i*T4 70.OM 17 *451 27* 9,475 . 724,7*1 r.iiu 714 7 974 77*.7*1 1*1*41 tli124 71V 7,146 TABLE H Notifiable dutatet of tow frequency, United Si Met ^" ' *' ' cum it;i tUM |H Dnkiiitffl IClhi t( Dwlci* Cdnymitri ,vb*fU iyMi*flu t C4* 11 ler^wainlHi 11 l*+\* * * 9oPnHTnr*lil, Told 79 1C t` dvhc 70 1 hiliiiMe 7* u KiMi m #** 7 114 9 nthino.il In J 1} MO 9) 1yiJiv, Iwf' 4*>i.e Irndr*.* mutmelllr..* 1 T(. 4] 4r '(VLa,|J rH.HiS l( c r-Hl . yrjl |U IK * hj-a -< *>> i fast yrai s wn-My * '(.It'd *t>' ln> D'ma'tfH1, . i *% ih f*t a., i.-w^i . dat, ls>' 10 ft <0 ' tHa* IfdViryMtf drt*tH,l i*|W.i w.'i !* i.l *i-i*d mi t+* ypl r ii.|r f iiii.iAai ,c tot >i V .nn <1 *T HONS 210051 jAU*1 '** "*1' **'" - September 28, 1979 MMWR TABLE IH. Caret of ipecihed notifiable diteotei, UnlieO State*, weoki ending September 22, 1979, and Septombof 23,1976 (38tb week} 453 ....................... -- ...............- -- > :> PC. V* 1 rr Vk NC 1C 0* ftk 1 ICEMtHAl Tvmn. VAl4tCENTftAi Tm M I l* M to I1f0 IT 4 to Tt I I* tl I 0 I MM to t mountain 10 1 1* 4 i N. Mc1 AIhrAil It I AN 1 frArC.nIFiIC It tIlt 11 14 14 4 o 4 1 CM 0* Ala*i 1 I 4 Tt 11 10 If 11 10 41 II 1 t1 * I1 tl 24 I I T > > I It II 14 II *0 IT It T 44 4t _1 10 4 tl1 I t 14 TI If t4 l 1 44 10 4) t l 11 IT 41 1 14 t I $ I 1 4 119 40 II tJ4 4 t1 10 I 10 I 10 4* 214 Oum at Mi mt I VI Inll T*t | 44 44 Hi t Hi. H4 HA Hi 1 4H4i M HA Ni Hi NN Nol *OrlTtO 1^11 *H\ tl*H n>1 3 Fftciit*H. im*y HA Nui IvjHkltH I. tgjft ** rvt W*<wn btil iw 'Ml v* *>lf bn'rMH trrt m nrhi ***. i pw J*u*r h>i#h Awt Tm Tl ' tM *73 tnrtM* 'f*d *7 hfi` V * ? lien A nrl ruWn* trn*A h m `t C*"" -1 P* - t 'd 10 *' * 1 'o** Mi'll* ,1 A t>V <4 V# *| NMu ij Hv|i unn> Lr~ Lo> VI - I + * HONS 210052 4W MMWR September 28 1979 TABLE III (Coni.'d) Cetes of tpeclfred noufreble drieiset, Urnled Sum, wookt ending September 22, 1979. end September 23,1970 (38ih week) AirORUMG AM A NfUlttlAVliOUl CUM ITU mi CUM. titr uwtnuiiAits WlW (NOLAND Iflatna 1 N-H t Vt Com 1 MiD AILANttC UpkUtt N Y MY Ort HI t p*. f_N CENTRAL OUt fed t n Mch H t *> lit ITJ Hi 010 * 2IT 114*4 IT 1*314 -- $z 4T - 11* IT 13 241 -- 102 ' 4 31* f It 512 Ifl 72 * 4*1 1,101 9 m Ml T4 - 4j IH if It 140 10,041 - *4* 4T4 1 let 102 it iMit 1,0*0 1 III T41T 4 447 ll440 Hr N CENT HAL Hfwt Ha H CMk. 1 Ook N*k llHL K. ATLANTIC Dot W DC Vi Hr Vk MC tc 04 ru. T 1* 2 1(214 -- l* - 4l> 20 *2 ** 1 44 1*0 I* IT * 1*1 * *0 14 1,414 1*004 - 14 -- 1* 12 * 40 1 270 2,021 44 1,041 JW II* 1 m l*T T 417 10 0 770 744 CENTRAL *Y Tma Aik H Hr A CENTRAL Aik. U 04 la Tl mountain Mwit Id** Wya Cola N Hu. Aria IM Mur, PACIFIC Horfv, T O.of CAT AJmLa 0 104 IT ) oo 14 - 14 2 002 0 24T * 21 2 *14 1 211 IT 21 14 2 4 m It l 11 10 * 11 * 2,2*0 * 1*114 to 41 f *40 IT l 44 1,413 11* *4* 101 244 1,001 1* >47 10 001 20 104 1 20 to 44 1* 44 14* 144 121 1 7 NENMCQCQCCAlIRHCnQNl TOTAL HIT CUM | COM 1171 | mi' 14 M4T 1 *441 1 101 101 1T - *4 42 1 31 41 T If * 4| 24 4 101 2** 2 101 *4 T! 41 - 70 10 4 t> 72 to0 101 244 *i 44 V 40 41 2 14 70 14 90 * 14 II . 07 49 11 |l * to - 20 24 * 11 e- 2 0 * ** 0* 4 405 411 * 22 42 2* t 1 1 *0 01 * 1 II to1 Tfr l 1* 24 1 TO 40 > I** 120 to0 140 140 2* 21 1 44 07 to 24 4! * 40 11 0 114 2 TO 1 IT It A !U 112 to 27 14 2 144 121 .. 70 41 % 1 74 to 1 to 9 1 to 0 7 toto 1ft 15 *1 11 4 2 2*7 2*1 44 44 * 21 20 1 102 ITO * 44 10 2 muwn tf7| | CUM. 1171 00 (win 401 1 142 4 10 - 04 1 14 2 1*0 1,0*4 11? * It* 7 014 1 214 It 4,201 1 1,747 1 271 2 40 1 11 11 1(00* 4 417 1 11 731 to| 1** 1 T 7 2 200 10 179 1 40 2 107 2 2 40 - 01 1 Tt 2 1T - 10* 11 1(311 14 1*107 l 71 HO 4 1(144 - 400 04 to 4 30 0 27# 10 1 * -- 2 7t to If 1 0* *4 1 14 IT T07 1 1* 1 10 11 110 * *0 PlAtUfM rut >0 1 1 * - 2 1 1 - T * 1 3 2 1 4 4 * * * - *to t1o 1 1 * 2 1 1 2 1 1 * * . to * -. to to to to - > 1 to 2 to " UftLlA tllAKUS CUM CUM mi It7l Jo 0, MT *1 1 If 41/ 1 - 41 127 141 2 411 1 214 lftOI i.oia 2 5* 121 244 1 f 1 4 1 1 7 2,401 0 Iff f to1 T2T to1 190 2 1,104 1 0 210 1C 441 2 to2 41 * 02 2 44 1 11 0 W 4 *4 1 1, 22-1 0 t 1 - 1- 1 101 1 J 04 to 1 >?r o to42 to11 1 ir. 4 2*0 4 41 1 I *4 . 44 0 *t 1 4 7*1 10 44 1 f* 2 21 . 1 1 Tf 0 t 014 * 1 tf * - 1*0 -- toto 44 * It 1 112 * * 10 > - 2- 14 ft 111 2 0 1*1 to 101 10 1* Ilf 2 1 to 1 21 Ogm Ml T 20 PA1 V^ to* 141 144 * HI 4 4 Pc Tiuil Tan 1 Hi 7 0*4 - to1 1 HA * NA HA 9 74 S3 1 1 Hi, 11 HA HA i 2 fci 00 NA HA HA Net MplabH _ 4 DrHtni !', r*ikrd Io< 1*7* rl rx i ^mre U-W-* bwl uu<l I* iM >l fri< im**it *** n>m*(*t J*t*Te 11 Hf lotto4r4ye4 *fvx>,<l <(( I* rrilf.tfd tft *kl wiv*.1 tiMailsttvr Mc#Mt Wu - I W*>l '? C*e Tt lc*f 11 Mv*to4 N<l 11 to 4.P*c T Tt,f J loHuilrt li lrt 11 HwMU U*xk "I Nil <1 NJ 11 4 to01 . 1- Com ? |<hJ 'I *e * tr/k>JT" T" HONS 210053 September 28. 1979 MMVYR 455 TABLE III (Coni'd) Cases of specified notifiable dilutes. United Slates, weeks ending -- ofiontme aa(a T ;.n September 22,1979, and September 23, 1978 (38th week) Tl'H l<l aa*n CUM JIM muoto ITfHCfJ I [VIA (BUS? I mt [ | CUM HU 1111 CUV JUI mt v<M(Rit eniAsm adllt C4MMN1A [UM 1 INI | ClfM mi* CYPWLIEIHh A toll ltd CUM 1 cum mi mi* Ail'd Aimh) CvM mi WHIP ftl ATlt too 20,411 IS4 19 194 ! 44 20,202 72 l a 0 Ti 724.701 450 u,*n 19.914 >,*73 WE tr [NOLAND M.H. r Vl Ml Conn. *4 i ft II ro * 40 10 24 909 91 w - * 14 *1 - 0 *2 -4 Mtp ATLANTIC II **Hf 1 91 L4*1#n N-T t A >09 1 - to NY Crtr 20 1*144 - > 27 WJ 1* 402 - * 2* N. ft 42 - - 1 inetNiRAt ft 9*094 . - 29 Chi* 1* 944 * > 1ntf. >1 914 * - 111 44 1*212 - -a 7 M*dv Wrt.1 u 750 * - U 1 us " - 4 1 9*9 - 44 - - 14 - 17 -- 4 194 1a - 10 4 244 * 94 2*719 21 102 1 050 * 9 140 - 4 907 17,001 1*747 444 4 7*041 1,441 T.034 70*211 Malll 21.*47 Dl?|4 20,027 11**71 1,404 or i 490 *270 1,170 4,400 74,110 1M)1 2*,79* 14.723 20,410 12 393 4)7 - 10 T - it s - 1 ft T w Iff 249 12 i 119 1S4 II 1*410 1,019 10 Ml tM 49 1,904 1,979 20 159 24) 4 110 22* 40 24 1 * 10 2 1 41 43 - 1 il 1 IT 1.140 1U*002 110*440 *9 2*340 1*710 >21 m 20 771 10*444 IliOOi 19 4*7 111 27 2 490 9*?i; 11*004 9 149 III *1 1 11 1*70* 99*292 24.904 29 i19? l.Otl no - * 994 24*494 29.990 10 939 191 12 ' 1 HA 0*794 0,020 NA 44 40 11 N CIWTMAL MlMl. Iprt M* N-O* I. UL Itofar Karo. It 1 - 10 * -- 2 2 44 2* lit m 94 - *72 20 14 * 42 * 1* 2 9 - _ w 1f*t -4 -0 a- -- w * 1 *1 . 49 922 * 2 1 - 11 129 * If 429 *- u * 41 1 79 - I** 99.710 9*011 4*240 19.994 104 1*205 2-ftlf ft. 404 04. Ill 7 114 *20 - 714 4.219 41 139 * >92 4.010 1 24 *1 'll? 14,217 4 104 ^01 '219 *73 - t ' 2 5* i.m 2,47T - ft1 * _ 7# 'll 9*044 - 20 1 * 97 1 ATLANTIC M Mil PC V*. 1 n v* N.C.1 OC. Qa. ru.t 09 4*42* * . *9 1 9? - - * 9*6 * - t 1 2IY c - 1 NA 940 1 * 4 9 no - * 11 tii * * 1 21 *40 1 - 24 t*4 4 2 ** 1*290 - - 14 19 909 4*010 - * 90 T 40 1.04* 2 402 1 01 ft- 0 loo 970 92 720 1 71 194 79 0* 1 t NA 174.224 2*909 21 *4l 11*971 14-#41 2,194 29*141 14,141 91*124 44*419 1 Ft* 2*T 2*491 . 11*931 17*010 2-4*4 tl604 17* 44* *4,121 44,22* 9 4,192 4.04* " to; 21 r 4 m *07 >27 9 - 11 *40 96T 19 * 41 15 ft44 *ft 410 14 214 20* 192 41 i.m 1,011 !4t NA 1*4*1 1,410 44 CCCrVTAAl Kv lWk All Mlb 44 1*1 to 4tr 29 *4* tl 441 - 401 14 2 U * - 1 10 *9 ft 1 -2 1 124 1*409 1 10 270 - 72 440 - IT *00 4 14 so* 41.014 0.200 2*,1*0 10*914 12*970 42*214 1,1*1 21.0*9 IT,*04 19,220 47 1*141 121 24 404 7 *19 11 *27 too *91 101 71 270 tl 1*4 4) 211 1 ftLCCNTIUU. Arlu U OhM. To. 10 >*401 t 219 9t 91* 9 244 41 i*4r 44 42 4 12 4 4 97 ** -4 ---- 4 41 4 94 2,100 1 19 140 - 1 4*0 1 91 >74 - 19 1*9*1 91,144 7,12* 14*911 9*002 40*241 9t*>27 ?1*2 15,1ST 0*90* 49* 9ft* 7# 9*2*2 2,410 1,374 4 10# 14 271 11 707 >14 *1 1 40 72 21 41 *,240 1**14 *44 MOUNTAIN MawLl lYr*. Colo tt MlT Mi, IM Nor. 11 41* *4 . 11 20 _ - - 10 1 _ 1 4m 10 12 V w 1 12 * 110 4 - 4 9 *02 - 1 IS 0 * 47 * * 2 1 1* 444 1 * 44 a- 2 90 w 40 a. 4 140 1 00 - . >44 - 1 > - 1 01 29*077 1,494 1, *14 04 7,444 9,419 0,197 1,076 4,944 27.420 21 *92 >14 07 1*971 4 11 1.1*1 4ft 21 i; 7 9 0 7,447 T| 10 29 1,042 14 Tt 47 34 4,94 9 liSIt - 04 1 41 19 11 T 4,024 s 74 12 - rAcinc WnK 0", CNtt. AltAi H*mI II 9 . 104 1 >*** 111,104 119*970 99 ft* 125 3,220 29* 2 102 * ft w - 174 10,114 9. *92 NA 19* in - > 1*0 1 - |T| 7,421 0,090 9 120 114 11 40 2. T92 2 * to 1 9 2,104 04.494 02*074 90 1,731 2,002 2>0 -- so - 1 - 04 ,f M 1,474 _ 21 7 2 240 * 7 * * 74 2,242 2*009 2 71 *0 ' Owtflll MA 4T mMA NA NA t N 9 214 - 4 - * ft; VL MA 1 Ml 1 ftA - HA fat liwM Tm 1 KA 21 - KA - HA - HA MA ^ 71 1*924 1 29 70 01 1.499 144 147 NA 11 NA HA _ 900 4 l 'MrrH ,*,&,rr,,<d In 1P7I not >< Ivlon ImI air uk>4 |o*rvltt ini ft*1'* <mvLI|> and cdiwtiixK lalati Ml*tnt<a^ rarwU *>M< <p ( OHnuUlnf lAT'i'f It N tt *J Md -J NT -3 fit -2 f-r If l#rt *4 CC f* -- 3 Ftt Ir Ttff <33 SyiImIii Mont 2 An uin U,i NY 1 I Md ZB N Mt * l 147 14 AMS _ 14 - Va>-I HONS 210054 I*--1* 456 -^mt *-** vt ak4 nn^Tr'`i> ii MMWR TABLE IV, 0thl (n 121 U S titin,' week ending Seplember 22,1979 (3Bth week) September 28, 1979 H tflc4jw t *n in4)lr<t U>nJl lh+"rf 4 Hi 4 WI nn\l 4 *M*t tfxtt Avtnttnf HE (9ti>iU fiH 11*4 cwrrrn r<t*i|iVi * * - / j-" HONS 210055 / 1 S*f>lmb*r 28, 7979 MMWfl 457 Diphtheria -- Continued 1 Reported by S Fennin, MD, Los Angeles County Health Ocpt, J Chin MO, State Epidemiologist, California Dept of Health Services, RE Hoffman, MD, Acting State Epidemiologist, Now Mexico State Health and Environment Dept, Immunisation Die, Bur of State Services, Field Services Div, Bacterial Diseases Div, Bur of Epidemiology. CDC j r Editorial Note. The number of reported diphtheria cases h3s declined since 1975, with fewer than 100 cases reported annually in 1977 and 1978, The mortality (ale from diph theria h3s also declined since 1970, However, the case fatality ratio for noncutaneous diphtheria has remained unchanged at 5%-10% since 1920 (7), Diphtheria is likely to be more severe or fatal in individuals with no or unknown histories of immunization Though the incidence rate of noncutaneous diphtheria decreases with age, adults and children under 5 are less likely to be adequately immunized, This case ilustrates the importance of keeping adults up to date with recommended immunizations and of considering the diagnosis of "childhood" diseases In unimmunized adults, Persons with suspected or proven diphtheria should receive both parenteral penicillin and diphtheria antitoxin after their skin has been tested lot hypersensitivity (2) In addition, asymptomatic, unimmunized household contacts should be managed by (1) either benzathine penicillin or a 7-day course of oral erythromycin, with cultures before end after treatment; (2) vaccination with diphtheria toxoid; and (3) daily surveillance for ' 7 days for evidence of diphtheria, Where close surveillance is impossible or unreliable, diphtheria antitoxin should be given (3), __ References 7- 1, CDC' Diphtheria Surveillance Rcporf No t2. Issued July 197B, p 2 4 2, American Academy of Pediatrics' Report of tha Commuteo on Infectious Diseases 1 Bits eif Evanston, Illinois, AAP, 1977, p 62 ___ 3 Public Heelih Service Advisory Commit lee on Immunization Practices Diphtheiia and tetanus toxoids end pertussis vaecmc MMWR 26 401-402, 407, 1977 ' ' ^ ' ` , i 1 'll Summer Measles -- Los Angeles County In a joint effort between the Acute Communicable Disease Control Unit of the Los Angeles County Department of Health Services (LACDHS) and the Immunization Assistancc Program for Los Angelos County, every reported case of measles this summer in Los Angeles County has been fully investigated. Forty-eight cases of suspected measles were reported to the LACDHS from July 16 through August 30 (disease weeks 29 34). Twelve of these eases were repoited through tho established surveillance system, 36--which presumably would otherwise have been unreportod--were uncovered by calling private practitioners and by inveshgabng cases, Dunng the similar petiod in 1978. only 2 cases of measles were reported. Twenty-two of the 4B reported cases (15 male, 7 female) weie clinically confirmed as measles. Of the remaining 2G cases, 17 were confirmed as not being measles, and 9 eithoi could not be located oi refused to be interviewed Seven house-to-house searches were conducted in aicns surrounding the confirmed measles cases. The total number of household members visited was 328 The ptopoilmn of these persons 10 years old and under who had proof of measles immunization ranged from ?B% to 95%. In the aiea whcie 28% provided documentation of measles vaccination, the 3 neUihhoting public schools had nicnslcs immunization levels ol 91%. 95%, and 99% in icrcni audits. M0NS 210056 491 MMWR September 2B, 1979 Summer Measles - Continued Except for 1 19-year old patient, all of the confirmed measles cases were m preschool ers (i e., less than 5 years old). Seven of the patients were less than 1 year of ege. Nine of the confirmed measles cases could be traced to known cases, 4 were imported from other countries, and 9 cases could not be traced to a known case. Though all 22 patients reported having seen a physician, only 11 were subsequently reported as cases to local or state health departments. Two major outbreaks, otherwise unreporled, were discovered during the case investi gations One outbreak of 6 cases occurred in 2 adjoining apartment complexes inhabited by immigrants from Mexico, whose length of residence in the United Slates ranged from 6 months to 2 years. All of the cases could be linked to a single case, who transmitted the disease to the neighboring children while they were playing in the courtyard. The second outbreak of 4 cases occurred as a result of a swimming pool party held by a large extended family. This collaborative surveillance effort will continue throughout September. Reported by S Fannin, MD, Lot Angeles County Health Dept; J Chin, MD, State Epidemiologist, California Dept of Health Services, Field Services Div, Bur of Epidemiology. Immunisation Div, Bur of State Services, CDC Editorial Note: This investigation corroborates the findings of the recent measles sur veillance effort in Georgia-namely, that in the summer the predominant age group fn measles transmission may be children under 5, and that children less than 12 months of age continue to be at high risk (/). The Los Angeles cases also demonstrate that, though an area may have a high total immunization level, as shown by audits of school records of kindergarten through 12thgrade children, there may still be significant pockets of susceptible people, especially preschool children. In this instance, these subgroups included immigrants, both legal and illegal, and the poor--groups that ore often unaware of existing preventive health care programs and that can continue to act as reservoirs for measles. l, MMWR 28 425-427, 1979 la HONS 21005? j h'm! 1 - i I'-'-*-* $p1emb*r 20, 1579 ijfcj i MMWR 459 Addendum, Vol. 28, No, 35 p413 In the article "Gastroenteritis Associated with Lake Swimming -- Michigan," the following names were inadvertently excluded from the credits. NB Keon and J Weber, MPH, both with the Michigan State Department of Public Health. Tit* Morbidity and Mortality Weekly Report, circulation B7.B03, is published by the Center for Disease Contiol, Atlanta. Georgia. The data m this retmit are provisional, based on meekly tde graphs to COC by state health departments. Tha repoilmg week concludes at close of business on Trrday. compiled data on a national twsu are officially released to ihr public on tlie succeeding Friday. Hie editor welcomes accounts of interesting cases, outbreaks, environmental hazards, or other public healni ptolilems of current mteicst to hralth official! Send rcportl to Center for Disease Control. Attn Editor, Mnihidity and Mortality Weekly Report. Atlanta, Georgia 30333 Send mailing hit addihflhs deletions, and addicst changes tn Censor for Disease Control. Atuv Dismfiution Services GSO, t SR 30, Atlanta Georgia 30333 When requesting changes be suio to give your loimer addicts, including rip cotk' and mailing list code numtiet. or send an eld address >obel. HONS 210058 460 MMWR Sopternbor 20, t879 U S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE / CENTCF1 FOR DLSFASE CONTROL ATLANTA, GEORGIA 30333 OFFICIAL BUSINESS Director, Center for Dlftiu Control William H Focgc, M D Director, Buicau of Epidemiology Philips Bracnmm, M.D. Cdtior Mtthaer B Gregg, M.D, Managing Ctfltot Anne 0. Mallter, M.A. f>0fl*g ftftd Fee* Paid U S. Department of HEW HEW 396 63166HCDONPU03713979004X)t* oAtii D MuDC*NALU ^\ f[ '-1ffifciri^ HfW Publication No (CDC) 79 0017 RfiltslrHtuUoP usmg itidrcii is illrgnl MONS 210059 H ' PCB levels .Vanklin Residents' Blood in Franklin Said Free of PCB Contaminant^ below norm BOISE, ~rd*ho (API -- No denied levels ol ihf banned ehentlc.il PCB were found In blood (ample* from IDS residents of Franklin, the Southeastern Idaho town where PCB contamination forced chickens and eggs to be deafrejed, the slate Department ol HeaKhand ttelfaresald Dr, Edward S Gallagher, stele health orticer, said Thursday the report was based on preliminary results and more information on the l`CB levcli wilt be retea sed nex t w eek The PranHln residents were tested Her Rilcwood F.gg Co, the town's major Industry, was forced to destroy more than 3D0,Nffl laying hens and one million eggs because PCB contamina tion Th* PCB was traced to a Bill- lues, Mont, packing plant which had sold the Franklfn poultry hrm a supply of chicken feed Poullry and livestock feed produced by the Montana plant has been sect to poulrry and livestock reeding openIons in sevtral states, and federal tnsoec- tors said PCB Contamination was found 17 dates,Canada and Japan The analysts ot blood samples drawn from residents of the Franklin area are completed, but tests on breast mtlk samples w)u not be fin (shed until early nexl week, Gallagher said Early reports fndiclate that all per sons tested have PCB levels below t parts per billion Background levels of PCB found In the general U S popula tion range from & to 20 parts per bil lion The Center tor Disease Control In Atlanta, Ga, also Is testing some sam ples from Franklin residents, but re sults of those tests are not yet avalfa- blc.Gallagher taid PCB, in large doses, has caused tu mors In laboratory animals, killed cat tle and caused skin diseases Its pro duction is how banned in the United Slates, but it Is found in old electrical equipment, where It was used as a coolant, / ' \ W. Avsoclnlcrt Press s ftmdth'ntfc erf FtimUm who utre fvc^mly tested by tieaPtb tiTficj.iK sJiosvod tower liiaiip ti\*riij4c IruK of PCI**, u cancer cpuviip, chemknl that Conf.rrtiP.imeO chickens and c^s *1 0 form In th-* town PmS summer Dr. r<iwrxj S. Gnlljphir. chief health officer of the BLilio IVpMfi* n>eni of Itojlih rmd WciUtt, mcJ early reports Mdicnle all persons hive PCB fevefs l*low $ p rrls per button fijLk^roiind levels of PCiis found In the *nerwl U S popu Jalion rnn/t from S t2Up.irU per bib lion, Gliaborsatd The Center for Dheuse Control In Alania also ts (esriff some samples from fruuklm residents, and results of iluise tests arc expected next week. Gallagher sold hJ* report k tusd upon firchnifiitiry results, #nd nore InforriiHrlon on (lie PCB levels will 60 reJcmsed next week. - The Fif<n((h resident* tabled for PCB after Rflevtood I.jjr-Co . hie town4*? major Industry, w .i^XortA-d to destroy more ih*>n 3UMk>Plti) tn^ heix irnd f million epfp btcnuvr PCB levels were detected In the foods UJS Food nod Druj* AdminKir#* tkm officials said bs many ns Ifi mil lion DCB-conbtminoled eg^s Hire Sold to the public by Rucwood before the Bun slopped sales Sepf 3 Health officials v/ere concerned that those who Jived near end worked t die poultry Unn had Invested high levels Of PCBs The only do l on human etpoKurv to (lie highly toxic chemical nnK from Ci cotilfkiTiinjiUin Incident in Japan tn 196S, In which victim* dovet- oklii" tustos und Illness from massive doses of PCBs* and o Midi! gM experiment Jn which rn.hpiinon Showed tro III effects from eof triys f ish contaEninft ppm of tfie substance. The Ritewood PCBs were traced tpa fNllir>p4s, Mt>n{ 4 pork processing plant wluclt hod sold tlie f<rm w supply. t llip 4ttmtys[$ of blood drawn from residents of llie l ran^bn area are comptiitd. but tests on brrhsi milk sim'iplrs will not be fin ished uiibJ curly next week. Cal* logherwud y+ /tf's/? t V MONS 210060