In May 1878, the first national Quarantine Act passed Congress. This legislation required American Counsels to file reports on sanitary conditions abroad and on vessels bound for United States ports. From this and other sources, the Surgeon General was to prepare weekly abstracts for distribution to Public Health Service medical officers, collectors of customs, and state and local health authorities. Two months later, a one-page document called Bulletins No. 1 was published. This represented the first article on the health of the United States issued by the government and reported that "Two cases of yellow fever have occurred in the harbor of Key West and on the Norwegian ship Marie Frederike and one on the Spanish bark Dona Talefora. The city is reported healthy."
The name, format, content, frequency of publication, and sponsoring government agency underwent many changes until, in 1952, Morbidity and Mortality Weekly Report (MMWR) ultimately emerged. In