PREFACE

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PREFACE

This volume is a compendium of articles from the Morbidity and Mortality Weekly Report (MMWR) that were prepared on the occasion of the 50th anniversary of CDC, marked on July 1, 1996. The compendium comprises articles from the MMWR weekly selected primarily on the basis of their historical merit and interest to public health practice. For each of the 20 selections, we invited past and/or current CDC experts (and, in some cases, experts from outside CDC) to write a new editorial note about some aspect of each article and its relation to the evolution of public health practice.

The topics of these reports span the scope of public health problems addressed and reported by CDC in MMWR after responsibility for MMWR came to CDC in 1961. The new editorial notes for many of these reports were contributed to by persons who played key roles in responses to the problems at the time they occurred; we encouraged these contributors to share perspectives and details of special historical interest. We hope the reprinted reports and new commentaries are serviceable not only to local and state public health officials, who contribute to and use MMWR, but also by public health and medical practitioners in other settings, schools of public health, and other academic programs with concentrations in the history and policies of health.

MMWR's history is intertwined with the evolution of public health in the United States. In the spring of 1878, Congress passed the first National Quarantine Act requiring U.S. consuls to report sanitary conditions abroad and on vessels bound for U.S. ports. From these and other sources, the Surgeon General of the Public Health Service (PHS) was directed to publish weekly abstracts for transmission to PHS medical officers, collectors of customs, and state and local health authorities. Thus, on July 13, 1878, under the name, Bulletin No. 1, the predecessor of MMWR was born. The Bulletins lasted barely 46 issues, but they chronicled such grim and terrifying events as the great yellow fever epidemic of the Mississippi Valley.

The National Board of Health and its quarantine reports followed the Bulletin. Publication resumed, however, in 1887 when No. 47 appeared as the Weekly Abstract of Sanitary Reports. Although only a few pages, it reached 1800 readers and was, according to its editor, "greatly appreciated not only by quarantine officers, but by steamship companies, merchants, and the press." By 1897, the Abstract became Public Health Reports, a weekly journal devoted to reporting epidemics and morbidity and mortality, but scientific articles as well. Several federal agencies sponsored this publication during the first half of the century, and by 1952 MMWR acquired its present name, published then by the National Office of Vital Statistics. However, in 1960, CDC (then the Communicable Disease Center) was given the responsibility, and the first issue published by CDC appeared on January 13, 1961.

Distributing objective scientific information, albeit often preliminary, to the public at large, MMWR has filled that critical time gap between the immediacy of the news media's interpretation and the long wait for publication in the scientific journals. In fact, CDC has published extra issues when health events of national importance required immediate, scientific, and objective reporting. For example, the 1970-71 nationwide epidemic of bacteremia associated with contaminated intravenous fluids and the 1976 occurrence of Guillain-Barre syndrome associated with the swine influenza vaccination program demanded immediate reporting to the nation that MMWR provided.

The primary purpose of MMWR has been to report events of public health interest and importance to CDC's major constituents -- state and local health departments -- and as quickly as possible. In large part, they are the ones who recognize and report the data to CDC and, therefore, they should receive the greatest credit for the MMWR's role in prevention and control of morbidity and mortality.

Our experiences as Editors of the MMWR span 3 decades and most of the history of the MMWR at CDC. We are proud of the accomplishments of the MMWR on behalf of CDC and in the service of public health in the United States and worldwide, and we are pleased to present this compendium. We hope you find it helpful in the study and practice of public health.

In this compendium, we have corrected typographic inconsistencies and errors published both in the original reports and in the reprinted reports with new editorial notes. We have changed text references to page numbers and table and figure call-outs to reflect the pagination of this volume. Tables and figures appear inconsistent only because we attempted to recreate their original style and format.

Disclaimer All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the electronic PDF version and/or the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.