A fourth fatality occurred at 11 a.m. yesterday when Mrs. Elna Bernice Worland, 55, of Leawood, Kan., was dead on arrival at a Humansville hospital from neck and head injuries suffered in a two-car wreck on Highway 13 at Dunegan. Mrs. Worland and her husband, who was injured along with two other persons in the other car, were enroute to visit a daughter, Mrs. Aileen Hoodenpyle, Route 4, Bolivar.