Medlin -} was re ee ee ee oT re ey ee ee ee ce . * ” ere = ails, sei ee ot er” em me ee in an HEALTH SURVEY IN PACIFIC direct contact or carried by flies. The spirochete causing yaws, Treponema pertenue, enters throuch open lesions such as scratches and minor cuts. The primarylesions appear most frequently on the lower extremities and maylast from 3 months to 3 years. It is not unusual for old healed-over lesions to break down. Tertiary-stage lesions often cause severe scarring and, in the form of gangosa, sometimes completely destroy the features. Many inhabitants had multiple scars as evidence of a Instory of yaws. Very few dingnoses of active vaws were established during the course of the health survey. As shown in table 10, most of these eases were found in the Marshall Islands district. Numerous cases of active yaws were suspected, but dark-field examinations of the lesions were negative, possibly due to local treatment of ulcerative lesions with merthiolate and mercuric ointments by the native health aides. Table 10. Results of surrey for active yarcs, Saipan,* Palau, and Marshall Islands distrtets we . 1 s District and island 4 Number |] or ato of cases Total [-—-+_---—_- Babeithuap [sland Elato Atoll wz or atoll 3 Marshall Istaods. a Mejit Island 2 Majuro Atoll Palau Marsball Islands -_— District and tslond 1 1 ~ 7 rare Ine Island 12 Ebda Atoll Maloelap Atoll ii i Number of cases 8 T Allux Afo!l 4 Aur Island Liklep Atoll Wotje Atoll Kwajalein Atoll Namorik Island 3 3 3 2 2 Tabal Islaud 2 Utirik Atoll Lib Istand 2 L “No active cases of yaws reported for the Saipan district. During the survey (table 11) urogenital examinations were made only of the male population, as the women were reluctant to permit examination. Little or no acute urethritis from gonococcus was noted but, although cases were not reported on the health record, medical officers at some of the hospitals stated that among the women there were manycases of “salpingitis, gonococcic™ and “cervicitis, acute, due to gonococcus.” The presenting svimptoms of the report- edly widespread gonococcal infectton among tle men were those of a nongonococcic urethritis, Syphilis was almost nonexistent, a condition foundto parallel the prevalence of yaws. Very few eases of primary chancre were found and secondary skin manifestations oc- - OCTUBER 1959 + §0132b3 1211 eee ee ee _ — wv FS