13 Findings INTERVAL MEDICAL HISTORY lInesses The outstanding medical event during the past 2 years on Rongelap was a poliomyelitis (type [) epidemic, which occurred early in 1963. The epi- demic apparently was carried from atoll to atoll by the crew of a ship, since it broke out on each atoll within a week or two after that ship had departed. The epidemic occurred on Rongelap Atoll in January-February 1963 with 23 children and 3 adults stricken and one of the adults (an oider exposed woman) succumbing. The children involved were all <7 years of age. Eleven were children of exposed and 12 of unexposed parents. Mild residualfacial or limb paralysis was present in 8 and moresevere paralysis in 2 children. These cases will be further described under the Pediatrics Section. This epidemic was brought undercontrol within a few months by widespread use of oral Sabine vaccine by medical personnelof the Public Health Service, Trust Territory, and Navy. Fortu- nately Utirik Atoll was spared the epidemic. Otherthan the poliomyelitis epidemic, the inter- val medicalhistory, both on Rongelap during the past 2 years and on Utirik for the past 4 years, did not reveal any epidemics or unusual diseases. Upper respiratory infections, gastroenteritis, and fungus andotherinfections of the skin predominated in the sickness inventory of the health aide. Only a few cases offish poisoning and sickness from eating improperly prepared arrowroot were reported. Deaths Four deaths had occurred in the exposed group during 1962 and early 1963: (1) No. 30, female, 60 years of age. Died, July 1962, with a stated diagnosis of cancerof the cervix. Previous exam- inations had shown progressive logs of weight and increasing hypertension. On the past survey, bleeding was noted from the cervical os anda gynecological checkup had been recommended but death occurred before this was carried out. No autopsy was obtained. (2) No. 46, male, 84 years of age. Died July 1962. Hadhistory of arterioscie- rotic heart disease, a stroke a numberofyears ago, and senility. No autopsy was obtained. (3) No. 26, male, 21 years of age. Died in December 1962, two monthsafter fail from a coconut tree. Death was preceded by disorientation and amnesia with convulsive seizures and finally coma. Autopsy showed meningeal damage grossly and histologically. Brain damage was thelikely cause of death. Other findings were few, but of interest was notation of giant and multinucleated cells in the meninges area.* (4) No. 52, female, 55 years of age. Died, February 1963, with laryngeal paralysis during the poliomyelitis epidemic. Death appeared to be from poliomyelitis with bulbar involvement. No autopsy was obtained. There was one death ofa child of an exposed par- ent: No. 107, female, 4 vears of age. Died in October 1962 of acute gastroenteritis and dehydration. Child had a history of malnutrition and weakness, skin infections, loss of pigment in hair. No autopsy was done. During 1963 one death occurred in the exposed group: the oldest Rongelap woman, estimated to be around 107 years of age; death was reported as due to ‘old age.’ Unfortunately, no autopsy was obtained. She had been knownto be quite feeble ~ and had cataracts and a considerable degree of arteriosclerosis. A 54-year-old man in the comparison popula- tion died of asthma. No autopsy was done. During the 10-year period, 10 deaths have occurred in the exposed Rongelap group, and 8 deaths have occurred in the comparison popula- tion since 1957 (when this group was first exam- ined). Table 3 lists the deaths with probable causes in the two groups. The annual mortality rate per 1000 for the exposed group is thus about 12.2 compared with about 8.4 for the comparison population and 8.3 for the Marshall Islands as a whole (19690). Poorly kept records madeit difficult to get accurate demographic data on the Utirik people. It appeared, however, that during the past + years since they were last examined, about 5 deaths had occurred in the older people and 6 infant deaths had been recorded. The deaths were dueto various causes such as pneumonia, infant diarrhea, and infections. Births. In 1962, 3 healthy babies were born to exposed parents and 5 to unexposed parents. In 1963, 3 babies were born to exposed parents and 3 to unexposed parents. *Dr. Hans Cortier of Brookhaven National Laboratory reported on the histopathology.