1964 — June 27-Oct 3, St. Louis Encephalitis Epidemic, Houston/33; elsewhere/24[1] — 57
— 57 Blanchard tally based on State breakouts below.
Colorado ( 2) (Some cases of Western Equine Encephalitis, some of SLE)
— 2 July 20-Sep 18. Outbreaks in Adams Co. (suburban Denver), LaJunta, Fort Collins.[2]
Illinois ( 3)
— 1 Edwardsville-Alton area, northeast of St. Louis. CDC. MMWR, 13/41, 10-16-1964, p. 365.
— 2 McLeansboro, Hamilton County, between July 29 and Sep 11. Both over 70 years-old.[3]
Indiana ( 2)
— 2 Southern IN (probably Evansville in Vanderburgh County), Aug 21-Sep 30.[4]
Kentucky ( 1)
— 1 Danville, Aug-Sep. CDC. “Encephalitis Surveillance Summary,” MMWR, 13/41, 10-16-64.
New Jersey ( 8)
–~15 South. Phalon. “Encephalitis Found Cause in Rutgers Student’s Death.” NYT, 8-14-75.[5]
— 8 Camden vic. Beadle. “Epidemics of Mosquito-Borne Encephalitis in…[US], 1960-1965.”[6]
— 6 Camden and Burlington Counties border area. CDC MMWR, 13/41, 10-16-1964, p. 363.
— 5 Camden and Burlington Counties border near Philadelphia. CDC MMWR, 13/40, 10-9-64
NJ & PA ( 8)
— 8 Camden and Burlington Counties, NJ and contiguous areas of PA.[7]
Philadelphia area, PA (2)
— 2 Beadle. “Epidemics of Mosquito-Borne Encephalitis in the [US], 1960-1965.” Dec 1966.
Tennessee ( 1)
— 1 Memphis, Aug 20-Sep 21, elderly black person. CDC. MMWR, 13/41, 10-16-1964, p. 365.
Texas (38) (June 17-Oct 3)
Houston ( 33)
— 33 CDC. “Encephalitis Surveillance Summary — State Reports — Texas.” MMWR, 13/41, 364.
— 32 CDC. “Encephalitis,” MMWR, Vol. 13, No. 38, 9-25-1964, p. 329.
— 32 Phillips and Melnick. “Community Infection with St. Louis Encephalitis Virus.” P. 207.
— 32 Sullivan, Walter. “Encephalitis.” New York Times, 10-11-1964.[8]
— 31 CDC. “Encephalitis — Texas.” MMWR, Vol. 13, No. 37, 9-18-1964, p. 32.[9]
— 27 CDC. “Encephalitis Texas Harris County,” MMWR, Vol. 13, No. 36, 9-11-1964, p. 314.[10]
— 27 Kohn (ed.). Encyclopedia of Plague and Pestilence…(Revised Edition), 2001, p. 143.
— 22 As of Aug 25. CDC. “Encephalitis Texas — Houston, MMWR, Vol. 13, N. 34, 8-28-1964.[11]
— 19 Beadle. “Epidemics of Mosquito-Borne Encephalitis in the [US], 1960-1965.” Dec 1966.[12]
Hale County & vic. ( 5) (Western Equine Encephalitis)
— 5 Hale County & vicinity. All serologically confirmed as Western Equine Encephalitis.[13]
— 4 South Plains Area, Western Encephalitis principal responsible agent.[14]
— 3 All infants. CDC. “Encephalitis — South Plains Area.” MMWR, 13/35, 9-4-1964, p. 303.[15]
— 1 2-months old. CDC. “Encephalitis Texas — Houston, MMWR, Vol. 13, No. 34, 8-28-1964.
Narrative Information — General
Beadle: “The year 1964 was a record-breaker for droughts, and it also broke records for widespread dispersion of urban St. Louis encephalitis. The two largest outbreaks of SLE occurred in Houston, Texas, and the Camden area of New Jersey. Outbreaks of lesser magnitude occurred in Memphis, Tennessee; Danville, Kentucky; McLeansboro and Alton, Illinois; and Evansville, Indiana. There were mixed outbreaks of rural SLE and western encephalitis in the High Plains area of Texas and in eastern Colorado. During 1964 the first recognized epidemic of California encephalitis was reported.
CDC, Sep 12: “A total of 115 cases of primary encephalitis was reported for the week ended September 12. This brings to 2,139 the cumulative total recorded during 1964….
“An outbreak of 30 suspect cases of St. Louis Encephalitis is under investigation in Danville, Kentucky…Most of the cases have occurred during the past 4 weeks in the urban area.
“Twenty-five suspect cases of encephalitis are also being studied in Colorado. There is serological evidence of both Western Encephalitis and St. Louis Encephalitis among these cases.” (CDC. “Encephalitis,” MMWR, Vol. 13, No. 37, 9-18-1964, p. 321.)
CDC, Sep 19: “A total of 113 cases of primary encephalitis was reported for the week ended September 19. This brings to 2,278 the cumulative total recorded in the United States during 1964….68 suspected cases of encephalitis have been reported to date from the Texas Panhandle region and 34 suspected cases from Colorado. Of the Colorado cases, 7 were confirmed as Western Encephalitis and 3 confirmed St. Louis Encephalitis.
“Thirty suspected encephalitis cases are under in investigation in Boyle County, Kentucky. At present, there is only presumptive evidence that this is St. Louis Encephalitis.” (CDC. “Encephalitis,” MMWR, Vol. 13, No. 38, 9-25-1964, p. 329.)
CDC, Oct 3: “A total of 71 cases of primary encephalitis was reported for the week ended October 3. This brings to 2,426 the cumulative total reported in the United States in 1964. This total includes cases of encephalitis of unknown etiology and cases of arthropod-borne encephalitis. “Although the outbreaks reported in Texas, Kentucky, Illinois and Colorado have ended or are on the wane, a new outbreak believed to be St. Louis Encephalitis has been noted in New Jersey. A total of 64 cases including 5 deaths of encephalitis-like illness has been reported from New Jersey. The cases are geographically clustered along the border of Camden and Burlington Counties near Philadelphia. The initial cases developed in mid-August; the outbreak appears to have reached its peak in mid to late September. The majority of the cases have occurred among females over the age of 40. Preliminary laboratory results indicate that at least some of the cases are due to St. Louis Encephalitis virus. Further studies including mosquito collections and ecologic studies are in progress.” (CDC. “Epidemiologic Notes — Encephalitis,” MMWR, Vol. 13, No. 40, 10-9-1964, p. 349.)
Colorado
CDC Oct 16: “A total of 40 cases of suspected encephalitis including 2 deaths has been reported from Colorado. The onset dates range from July 20 through September 18. Though scattered cases have occurred in several areas of the State, small discrete outbreaks have occurred in Adams County (Suburban Denver), LaJunta and the Fort Collins area. Available data suggests no predilection for any age group. Confirmatory or presumptive serologic evidence of Western Equine Encephalitis has been obtained in 12 cases. Five cases show confirmatory or presumptive serologic evidence of St. Louis Encephalitis….” (CDC. “Encephalitis Surveillance Summary — State Reports,” MMWR, Vol. 13, No. 41, 10-16-1964, p. 365.)
Illinois
CDC, Oct 16: “Two outbreaks of St. Louis Encephalitis have been reported from southern Illinois. In addition, a singe case of serologically confirmed Western Equine Encephalitis has occurred in central Illinois.
“1) Eleven cases of confirmed SLE, including 2 deaths have been reported from McLeansboro. The dates of onset ranged from July 18 to September 3. Nine of the 11 cases occurred in persons over age 60. Dr. Robert Kokernot, Director of the Zoonoses Research Center of the University of Illinois reports that 31 of the first 50 pools of Culex pipiens studied to date have yielded SLE virus. SLE virus has also been recovered from the blood of 3 wild birds (2 sparrows; 1 catbird).
“2) A total of 11 serologically confirmed cases of SLE including one death, have been reported from the Edwardsville-Alton area (northeast of St. Louis). The onset dates ranged between August 22 to September 24. …” (CDC. “Encephalitis Surveillance Summary — State Reports — Illinois.” MMWR, Vol. 13, No. 41, 10-16-1964, p. 365.)
Indiana
CDC, Sep 30: “A total of 19 cases of suspected encephalitis including 2 deaths have been reported from southern Indiana. Fourteen of the cases occurred in Vanderburgh County (Evansville) and 5 cases were from adjacent counties (Warrick, Gibson, and Posey). The onset dates of the cases ranged from August 21 through September 30. A peak occurred during the first half of September. Most of the cases (including both deaths) have occurred in persons above the age of 40. Thus far, 8 cases have been serologically confirmed as SLE….” (CDC. “Encephalitis Surveillance Summary — State Reports — Indiana.” MMWR, V. 13, N. 41, 10-16-1964, p. 366.)
Kentucky
CDC, Sep 22: “Thirty-two cases of suspected encephalitis, including one death, were reported in Boyle County )Danville) during August and September. A peak incidence occurred in early September. The most recent case became ill on September 22. To date, sera from 13 cases show presumptive evidence of recent SLE infection. SLE virus has been recovered from one mosquito pool of Culex pipiens. An additional 10 cases of suspected encephalitis, including one with presumptive serologic evidence of SLE, have been reported from adjacent counties.” (CDC. “Encephalitis Surveillance Summary–State Reports–[KY].” MMWR, 13/41, 10-16-1964, p.366.)
New Jersey (Camden area) — Philadelphia, PA vicinity
Beadle: “….The outbreak of urban SLE in the Camden-Philadelphia area was unique in that it constituted the first record of SLE virus for any State east of the Alleghenies with the exception of Florida. The occurrence of a major epidemic of SLE at 40 ° north latitude was quite unexpected. The outbreak involved 115 cases and 10 deaths (94 cases with 8 deaths in New Jersey). The majority of cases — nearly two-thirds of the New Jersey patients — occurred in females over 40 years of age. The SLE virus was isolated from five pools of mosquitoes, of which four were Culex pipiens. (Goldfield et al., 1965).”[16]
CDC, Oct 14: “The New Jersey State Department of Health has reported the occurrence of 80 cases, including 6 deaths, of suspected encephalitis, which have occurred since early August…a sharp increase in incidence occurred during early September reaching a peak during the weeks ended September 20 and 27 when 20 and 21 cases respectively occurred. All cases reside in either Camden or Burlington Counties, most in close proximity to the Delaware River. Of these, 51 have thus far shown serologic evidence of St. Louis Encephalitis infection…the majority of cases have occurred among females over the age of 40.” (CDC. “State Reports – New Jersey,” MMWR, 13/41, 10-16-1964, p. 363.)
Phalon/NYT: “That epidemic [1964], stretched in an almost nationwide crescent from Houston, through parts of the Middle West into an 80-by-10-mile segment of South Jersey, where it afflicted 97 persons. There were about 15 deaths in what was the first reported epidemic of its kind in New Jersey…. Dr. Goldfield[17] said that “On average” only one out of a very 50 people bitten by the culex pipiens contracts St. Louis encephalitis. ‘The older you are,’ he continued, ‘the more likely there is to be an invasion of the brain, so that by age 65. the ratio is considerably higher than one in 50.’ The survival rate for older people, Dr. Goldfield said, is ‘three or four out of five,’ a considerably higher level than with eastern encephalitis, which is caused by a different kind of virus and is comparatively uncommon in the northeastern states….
“The public health physician said St. Louis encephalitis, named after an epidemic that swept St. Louis in 1933 and killed 200 people, is transmitted by “an unknown mechanism” from wild birds to the mosquito.
“Not all culex pipiens who pick up the virus from birds are themselves infected by it, but carry the organism for their entire life span — a life span that can be extended from hours to weeks by high humidity and the ability to find blood meals.
“There are no vaccines against the infection. Its initial symptoms are headache, drowsiness, fever, vomiting and stiff neck. ‘We don’t want any hysteria,’ Dr. Goldfield said. ‘Anybody who gets it will be seriously enough ill to know that they are ill and sick enough to be admitted to a hospital.’” (Phalon. “Encephalitis Found Cause in Rutgers Student’s Death.” NYT, 8-14-1975.)
Pennsylvania
CDC, Oct 16: “Two reported cases of encephalitis, one serologically confirmed to be SLE have recently occurred in Bucks County. Both cases reside directly across the Delaware River from the epidemic area in New Jersey.” (CDC. “Encephalitis Surveillance Summary — State Reports — Pennsylvania.” MMWR, Vol. 13, No. 41, 10-16-1964, p. 365.)
Tennessee
CDC, Oct 16: “Four cases of suspected encephalitis, including one death, have been reported from Memphis. The dates of onset were between August 20 to September 21. All occurred among elderly Negroes living in one sector of the city. Thus far, one case has been serologically confirmed as SLE. SLE virus has been recovered from 2 mosquito pools of Culex quinquefasciatus-pipiens collected in Memphis during the period September 8 through 11.” (CDC. “Encephalitis Surveillance Summary–State Reports.” MMWR, 13/41, 10-16-1964, p365.)
Texas
Beadle: “….Houston’s first recognized epidemic of arboencephalitis included approximately 300 valid cases of SLE with 19 confirmed deaths — a fatality rate of about 15 percent. The largest number of cases and deaths occurred in lower socioeconomic areas. There was a preponderance of cases among males, and among Negroes the attack rate was twice as great as among whites. The SLE virus was isolated from 22 pools of Culex pipiens quinquefasciatus (the southern house mosquito) and from four birds: bluejay, pigeon, domestic goose, and mockingbird. The highest incidence of SLE antibodies was found in the house sparrow, pigeon, bluejay, and mockingbird. It was postulated that permanent resident passerine birds were the principal source of the virus (Anon. 1965).[18]
CDC: Editorial note to article on St. Louis Encephalitis in Baytown and Houston, TX in the summer of 1986: “Harris County has been the focus of numerous SLE epidemics. In 1964, an outbreak centered in Houston involved over 1,000 cases….
“The epidemiologic characteristics of this outbreak followed a typical pattern. Attack rates rose with advancing age, and the risks for illness and mortality were highest for the elderly…. The highest attack rates in Baytown were associated with old, impoverished neighborhoods in the center of the city. This pattern was also similar to that for the 1964 Houston outbreak, i.e., the epicenter of epidemic activity was downtown Houston, and risk declined in direct proportion to distance from the center of the city.
“The association between risk and dwellings poorly sealed against mosquitoes as well as the absence of an association between risk and the number of hours spent outdoors suggests that exposure may have occurred indoors or in a peridomestic setting outside. The present case-control study confirms an earlier report from serologic surveys that risk of infection is associated with inadequate screening or the absence of air-conditioning….
CDC, Sep 12: “….Of the cases reported during the past week [115], 53 were from Texas. The Houston epidemic has been waning since the peak incidence during the week ended August 29….Twenty cases were reported from Kansas. These cases are scattered in many counties and have been occurring over the past month. No laboratory confirmation is available yet.” (CDC. “Encephalitis,” MMWR, Vol. 13, No. 37, 9-18-1964, p. 321.)
CDC, Sep 19: “….Of the cases reported during the past week [113] 45 were from Texas….Through September 21, a total of 692 suspected cases of St. Louis Encephalitis, including 32 deaths, has been reported from Harris County (Houston), Texas….In addition, 68 suspected cases of encephalitis have been reported to date from the Texas Panhandle region and 34 suspected cases from Colorado. Of the Colorado cases, 7 were confirmed as Western Encephalitis and 3 confirmed St. Louis Encephalitis.” (CDC. “Encephalitis,” MMWR, Vol. 13, No. 38, 9-25-1964, p. 329.)
CDC, Oct 10: “Through October 10, 1964 a total of 711 suspected cases of encephalitis, including 33 deaths, have been reported from the Houston metropolitan area. The epidemic appears to be essentially terminated with only 10 cases reported with onsets of illness since September 19….Thirty-one of the 33 deaths have occurred in individuals over 50 years of age. Serologic study has been performed on 547 cases thus far. Of these, 225 are classified as presumptive or confirmed SLE, 49 are negative and 273 are inconclusive, thus Far. SLE virus has been recovered from 10 mosquito pools of Culex quinquefasciatus and from the blood of 2 wild birds (1 bluejay; 1 mockingbird.).” (CDC. “Encephalitis Surveillance Summary — State Reports — Texas.” MMWR, 13/41, 10-16-1964, p. 364.)
Kohn: “Houston Encephalitis Epidemic of 1964 — Largest of several St. Louis encephalitis (SLE) flare-ups that broke out across the United States in the summer of 1964. The Houston epidemic’s extent exceeded that of the 1954 Rio Grande Valley, Texas, and 1962 Tampa Bay, Florida, outbreaks, but not that of the 1933 epidemic in St. Louis, Missouri. By August 1964, a Houston health officer recognized that over the summer an encephalitis epidemic had been underway because 60 human deaths due to nervous system infections had occurred. Lab testing confirmed the St. Louis virus, which had never penetrated Houston before. State and federal agencies organized a strategy for assessing and controlling the disease. Each hospital reported cases of encephalitis, aseptic meningitis, and meningoencephalitis. Doctors were to report all outside cases. During the epidemic, from the 243 cases, 27 people died. The 15-week epidemic was thought to have begun June 27, peaked on August 29, and occurred last on October 3.” (p. 143)
“The St. Louis encephalitis virus was isolated in St. Louis (thence the name) by Dr. Ralph W. Muckenfuss in 1933.” (p. 144)
Phillips and Melnick: “During the summer of 1964, the city of Houston experienced a major epidemic of St. Louis encephalitis (SLE), the first recorded appearance of arbovirus encephalitis in the city. More than 700 clinical cases and 32 deaths were suspected of being caused by SLE….It is well known…that during outbreaks of St. Louis virus encephalitis the inapparent infection rate far exceeds the clinical cases of encephalitis and that this inapparent infection rate is higher in those persons who have been in close contact with persons with encephalitis….”
Riggs, Smith and Phillips: “….The outbreak of St. Louis encephalitis in Houston during the summer of 1964 was recognized first in patients at the Ben Taub General Hospital. Between June 30 and Oct 13 care was provided by the medical service for 149 persons who were suspected of having a viral infection of the central nervous system. One or more serum specimens from 75 of these individuals were tested for hemagglutination inhibition (H1) and complement fixation (CF) antibodies using the antigens of St. Louis encephalitis (SLE), Eastern equine encephalitis, and Western equine encephalitis virus, and the broadly reactive group B antigen of Australian X (Murray Valley) encephalitis….of the 119 patients whose sera were tested, 67 (56%) were considered to have confirmed SLE viral infection….” (p. 284)
CDC: “Saint Louis encephalitis virus (SLEV) is transmitted to humans by the bite of an infected mosquito. Most cases of SLEV disease have occurred in eastern and central states. Most persons infected with SLEV have no apparent illness. Initial symptoms of those who become ill include fever, headache, nausea, vomiting, and tiredness. Severe neuroinvasive disease (often involving encephalitis, an inflammation of the brain) occurs more commonly in older adults. In rare cases, long-term disability or death can result. There is no specific treatment for SLEV infection; care is based on symptoms. You can reduce your risk of being infected with SLEV by using insect repellent, wearing protective clothing, and staying indoors while mosquitoes are most active.”
Sources
Beadle, Leslie D. “Epidemics of Mosquito-Borne Encephalitis in the United States, 1960-1965.” Mosquito News, Dec 1966. Accessed 9-13-2016 at: https://archive.org/stream/cbarchive_115567_epidemicsofmosquitoborneenceph1966/MN_V26_N4_P483-486_djvu.txt
Centers for Disease Control and Prevention. “Encephalitis,” Morbidity and Mortality Weekly Report, Vol. 13, No. 37, 9-18-1964, p. 321. Accessed 9-13-2016 at: https://books.google.com/books?id=VPvPAAAAMAAJ&printsec=frontcover#v=onepage&q&f=true
Centers for Disease Control and Prevention. “Encephalitis,” Morbidity and Mortality Weekly Report (MMWR), Vol. 13, No. 38, 9-25-1964, p. 329. Accessed 9-13-2016 at: https://books.google.com/books?id=VPvPAAAAMAAJ&printsec=frontcover#v=onepage&q&f=true
Centers for Disease Control and Prevention. “Encephalitis — New Jersey and Pennsylvania.” Morbidity and Mortality Weekly Report (MMWR), Vol. 13, No. 43, 10-30-1964, p. 381. At: https://books.google.com/books?id=VPvPAAAAMAAJ&printsec=frontcover#v=onepage&q&f=true
Centers for Disease Control and Prevention. “Encephalitis — South Plains Area.” Morbidity and Mortality Weekly Report (MMWR), Vol. 13, No. 35, 9-4-1964, p. 305. Accessed 9-13-2016 at: https://books.google.com/books?id=VPvPAAAAMAAJ&printsec=frontcover#v=onepage&q&f=true
Centers for Disease Control and Prevention. “Encephalitis — Texas,” Morbidity and Mortality Weekly Report (MMWR), Vol. 13, No. 36, 9-11-1964, pp. 314-315. Accessed 9-13-2016 at: https://books.google.com/books?id=VPvPAAAAMAAJ&printsec=frontcover#v=onepage&q&f=true
Centers for Disease Control and Prevention. “Encephalitis — Texas.” Morbidity and Mortality Weekly Report, Vol. 13, No. 37, 9-18-1964, p. 32. Accessed 9-13-2016 at: https://books.google.com/books?id=VPvPAAAAMAAJ&printsec=frontcover#v=onepage&q&f=true
Centers for Disease Control and Prevention. “Encephalitis — Texas — Houston,” Morbidity and Mortality Weekly Report (MMWR), Vol. 13, No. 34, 8-28-1964, p. 290. Accessed 9-13-2016 at: https://books.google.com/books?id=VPvPAAAAMAAJ&printsec=frontcover#v=onepage&q&f=true
Centers for Disease Control and Prevention. “Encephalitis Surveillance Summary — State Reports,” Morbidity and Mortality Weekly Report (MMWR), Vol. 13, No. 41, 10-16-1964, pp. 363-366. Accessed 9-14-2016 at: https://books.google.com/books?id=VPvPAAAAMAAJ&printsec=frontcover#v=onepage&q&f=true
Centers for Disease Control and Prevention. “Epidemiologic Notes and Reports. St. Louis Encephalitis — Baytown and Houston, Texas.” Morbidity and Mortality Weekly Report (MMWR), Vol. 35, No. 44, 11-7-1986, pp. 693-695. Accessed 9-13-2016 at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00000817.htm
Centers for Disease Control and Prevention. “Epidemiologic Notes. Encephalitis — New Jersey and Pennsylvania.” Morbidity and Mortality Weekly Report (MMWR), Vol. 13, No. 43, pp. 381-382. Accessed 9-13-2016 at: https://books.google.com/books?id=VPvPAAAAMAAJ&printsec=frontcover#v=onepage&q&f=false
Centers for Disease Control and Prevention. “Epidemiologic Notes. Encephalitis,” Morbidity and Mortality Weekly Report (MMWR), Vol. 13, No. 40, 10-9-1964, p. 349. Accessed 9-14-2016 at: https://books.google.com/books?id=VPvPAAAAMAAJ&printsec=frontcover#v=onepage&q&f=true
Centers for Disease Control and Prevention. “Epidemiologic Reports, Encephalitis, Texas, Harris County.” Morbidity and Mortality Weekly Report (MMWR), Vol. 13, N35, 9-4-1964, p. 303. At: https://books.google.com/books?id=VPvPAAAAMAAJ&printsec=frontcover#v=onepage&q&f=true
Centers for Disease Control and Prevention. Saint Louis Encephalitis (webpage). Atlanta, GA: CDC, 1-29-2010 update. Accessed 9-13-2016 at: https://www.cdc.gov/sle/
Centers for Disease Control and Prevention. “State Reports — Texas — Hale County.” Morbidity and Mortality Weekly Report (MMWR), V. 13, N. 41, 10-16-1964, p. 364. Accessed 9-14-2016: https://books.google.com/books?id=VPvPAAAAMAAJ&printsec=frontcover#v=onepage&q&f=true
Kohn, George Childs (Ed.). Encyclopedia of Plague and Pestilence From Ancient Times to the Present (Revised Edition). NY: Checkmark Books, 2001.
Phalon, Richard. “Encephalitis Found Cause in Rutgers Student’s Death.” New York Times, 8-14-1975. Accessed 9-13-2016 at: http://www.nytimes.com/1975/08/14/archives/encephalitis-found-cause-in-rutgers-students-death.html?_r=0
Phillips, C. Alan and Joseph L. Melnick. “Community Infection with St. Louis Encephalitis Virus: Serologic Study of the 1964 Epidemic in Houston.” JAMA (The Journal of the American Medical Association), Vol. 193, No. 3, 7-19-1965, pp. 207-211. Partially accessed (abstract and 1st page) 9-13-2016 at: http://jama.jamanetwork.com/article.aspx?articleid=656065
Riggs, Stuart, Duane L. Smith, and C. Alan Phillips (all MD’s). “St. Louis Encephalitis in Adults During the 1964 Houston Epidemic.” JAMA (The Journal of the American Medical Association), Vol. 193, No. 4, 7-26-1965, pp. 284-288. Partially accessed (abstract and 1st page) 9-13-2016 at: http://jama.jamanetwork.com/article.aspx?articleid=656119
Sullivan, Walter. “Encephalitis.” New York Times, 10-11-1964. Accessed 9-13-2016 at: http://www.nytimes.com/1964/10/11/encephalitis.html
[1] Some non-Houston deaths, such as some of five in Hale County, TX, area may have been Western Encephalitis.
[2] CDC. “Encephalitis Surveillance Summary — State Reports,” MMWR, 13/41, 10-16-1964, p. 365.
[3] CDC. “Encephalitis — Illinois,” Morbidity and Mortality Weekly Report, V. 13, No. 36, 9-11-1964, p. 315. Notes: “Since July 29, a total of 26 cases of suspected encephalitis, including 2 deaths, have been reported from scattered areas in southern Illinois. Nine of the cases and both deaths occurred in McLeansboro….Serologic confirmation of infection with St. Louis Encephalitis virus has been obtained in 4 of the McLeansboro cases thus far. See. also. Kokernot, Hayes, Rose and Work. “St. Louis Encephalitis in McLeansboro, Illinois, 1964,” Journal of Medical Entomology, 8-10-1967.
[4] CDC. “Encephalitis Surveillance Summary — State Reports,” MMWR, 13/41, 10-16-1964, p. 366.
[5] Not using as death toll in that the CDC notes only eight.
[6] A CDC MMWR report of 10-30-1964 notes “Through October 28, 1964, a total of 120 suspected cases of St. Louis Encephalitis, including 8 deaths, has been reported from Camden and Burlington Counties, New Jersey and contiguous areas of Pennsylvania.”
[7] CDC. “Encephalitis — New Jersey and Pennsylvania.” MMWR, Vol. 13, No. 43, 10-30-1964, p. 381. Notes “The deaths all occurred in patients over 60, 7 of them in women….Sera from 85 of the suspected cases have been studied to date. Of these, 17 have confirmatory evidence of SLE virus. An additional 68 sera have been found to be presumptive for recent SLE virus…”
[8] “In an epidemic that hit Houston, Tex., last summer it was suspected that 32 deaths were caused by the virus.”
[9] “Through September 12, a total of 668 suspected cases of St. Louis Encephalitis, including 31 deaths, has been reported from Harris County (Houston), Texas….The overall attack rate is 53.7 per 100,000. The highest attack rate has occurred in the age group 70 ears and older (159.3 per 100,000). With the exception of 2 deaths in the 30-39 year age group, all of the deaths have occurred in those over 50 years of age.”
[10] Notes “A peak in incidence appears to have been reached during the week ended August 29. The overall attack rate is 50-6 per 100,000….The 27 deaths represent a case fatality ratio of 4 percent; 25 of the deaths were in persons over 50 years of age….Isolations of St. Louis Encephalitis virus have been obtained at the Texas State Health Department Laboratory and at CDC from a wild bird (blue jay) and from pools of the mosquito, Culex Quinquefasciatus, collected in Harris County.”
[11] This mortality was from a total of 215 reported cases. Notes earliest case occurred week ending June 20, and that the fatality rate was 10 percent. In the next edition the death toll was decreased to 19, reflecting a subtraction of six due to a change in death causation, and an additional three for St. Louis Encephalitis. Notes that “Early in the epidemic, the cases were chiefly from a single lower socioeconomic area of Houston; sine, cases have occurred throughout Houston and a few elsewhere in Harris County.” (CDC MMWR, “Encephalitis,” 13/35, 9-4-1964, p.303.)
[12] “Houston’s first recognized epidemic of arboencephalitis included approximately 300 valid cases of SLE with 19 confirmed deaths — a fatality rate of about 15 percent.
[13] CDC. “State Reports — Texas — Hale County.” MMWR, Vol. 13, No. 41, 10-16-1964, p. 364.
[14] CDC. “Encephalitis, Texas, South Plains Area.” MMWR, Vol. 13, No. 36, 9-11-1964, pp. 315-316. Noted: “Through September 8, 61 cases, including 4 deaths, of suspected encephalitis have been reported from the south plains area of Texas. This represents an increase of 10 cases and 1 death over the number reported last week…Hale County accounts for 58 of the 61 reported cases. Laboratory studies to date have implicated Western Encephalitis virus as the principal responsible agent.”
[15] Notes that Hemagglutination inhabitation tests against Western and St. Louis Encephalitis viruses were performed on convalescent phase serum specimens from 10 patients in the South Plains area and that both were found.
[16] Goldfield, M., R. Altman, and R. P. Kandle. “The 1964 St. Louis encephalitis outbreak.” Proceedings, 52nd Annual Meeting, New Jersey Mosquito Extermination Association, 1965, pp. 105-110.
[17] Dr. Martin Goldfield, assistant commissioner in charge of Div. of Laboratories and Epidemiology, NJ Health Dept.
[18] Anonymous. “Epidemic St. Louis encephalitis in Houston, 1964: A cooperative study.” Journal of the American Medical Association, 1965.