13 Findings preceded by disorientation and amnesia with con- INTERVAL MEDICAL HISTORY meningeal damage grossly and histologically. Brain damage wasthelikely cause of death. Other findings were few, but of interest was notation of giant and multinucleated cells in the meninges Ilinesses The outstanding medical event during the past 2 years on Rongelap was a poliomyelitis (type I) epidemic, which occurred early in 1963. Theepidemic 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 older 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 interval medical history, 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 casesof fish 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 cancer of the cervix. Previous examinations had shown progressive loss of weight and increasing hypertension. On the past survey, bleeding was noted from the cervical os and a 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 arteriosclerotic heart disease, a stroke a numberof years ago, and senility. No autopsy was obtained. (3) No. 26, male, 21 years of age. Died in December 1962, two monthsafter a fall from a coconut tree. Death was 560b 195 vulsive seizures and finally coma. Autopsy showed 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 years of age. Died in Oc- tober 1962 of acute gastroenteritis and dehydration. Child had a history of malnutrition and weakness, skin infections, loss of pigmentin 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 population 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 population since 1957 (when this group wasfirst examined). Table 3 lists the deaths with probable causes in the two groups. The annual mortality rate per 1000 for the exposed groupis thus about 12.2 compared with about 8.4 for the comparison population and 8.3 for the Marshall Islands as a whole (1960). Poorly kept records madeit difficult to get accurate demographic data on theUtirik people. It appeared, however, that during the past 4 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, 5 babies were born to exposed parents and 5 to unexposed parents. *Dr. Hans Cottier of Brookhaven National Laboratoryre- ported on the histopathology.