Although differences in incidence of various

Table 11
Relationship of Radiation Exposure to Infection
With Intestinal Parasites
Organism

Exposed
(69 cases)

Unexposed
(112 cases)

Totals
(181)

Entamoeba arstolytica
Entamoeba histolytica
(small race)
Entamoeba colt
Endolimax nana
lodamoeba butschtit
Giardia lamblia
Chilerastix mesnilt
Trichomonas hominis
Hookworm

14(20.3)*

19(16.9)

33 (18.2)

2 (2.9)
25 (36.2)
14 (20.3)
—
5 (7.2)
+. (5.8)
24 (34.8)
2 (2.9)

10
35
35
3
9
4
30
8

12
60
49
3
14
8
54
10

No parasites

11 (15.9)

30 (26.8)

Trichurts trichiura

21 (30.4)

(8.9)
(31.3)
(31.3)
(2.7)
(8.0)
(3.6)
(26.8)
(7.1)

41 (36.7)

(6.6)
(33.1)
(27.1)
(1.7)
(7.7)
(4,4)
(29.9)
(5.5)

62 (34.3)

41 (22.7)

*The numberin parenthesesis the percent.

highest incidence, 26.8%, was found amongadults

in the 21 to 50 age group. The other twointestinal

amebae, Entamoeba colt and Endolimas nana occurred

much more frequently in the youngest age group,
23.3 and 18.6% respectively, and both showed
increases among the older individuals. Among
flagellates, the Giardia lamblia incidence washighest in the young children and almost nonexistent
after the age of 12. T. hominis showed high, relatively unchanged incidencein all age groups.
Of the two helminths found, hookworm showed

a steady rise in incidence, from 2.3 to 12.5%, with
ages up to 50. No infections were found after 50
years of age. T. trichtura occurred in 30.2% ofthe
children 5 years old or less, and in 66.7% of the 6

to 20 year group. In the older age group, 21 to 50,
the incidence dropped to 16.1%, rising again after
50 to 31%.
Table 14 shows a breakdown ofinfectionsac-

cording to sex, with a further division into two age

groups, less or more than 13 years of age. Division
into the two age groups was madeon the basis that

both sexes probaly engaged in similar pursuits up
to puberty, but that afterwards their daily routines

probablydiffered. Older males had higherinci-

dences than older females, or similar ones, for all

parasites except J. trichiura, the incidence of which
was about half as great in males. Among younger
males, incidences tended to be lower than among
young females, except that of E. colz, which was

distinctly higher in the males.

S007Z44

parasites occurred in exposed and unexposed
groups, there is no convincing indication that
radiation had anything to do with the variations.
In most instances differences can be accountedfor
by samplingerrors in the relatively small numbers
of cases studied. In addition, the two groupsare
not precisely comparable. The unexposed or control group consisted of individuals who had lived
on different islands before joining the exposed
population of Rongelap. Environmentalsanitation had not necessarily been the samefor the two
groups.
The environment on the coral atolls and the
customsofthe inhabitants are such that it was not
expected that any trematodeorcestodeinfections
would be found. However, the complete absence
of Ascaris in the face of a 34.3% incidence of
Trichuris was unexpected. Life cycles of both these
nematodes in the external environment are such
that they are customarily found together. The
history of Marshallese association with other
peoples, Europeans, Japanese, and Americans,
makes it likely that they have been exposed to
Ascaris. Thus, oneis led to the possibility that the
external environment on Rongelap Atoll maybe
unfavorable for Ascaris even though very suitable
for Trichuris. It was not possible to obtain stools
from any of the few dogs on theisland in order to
check for dog ascarids. Several dried pig droppings were examined at one time and no Ascaris
was found in them. However,in the absence of

more epidemiological and experimental information, one can only guess the reasonsfor the lack of

Ascaris. Soil moisture, salinity, pH, porosity, etc.,

may all play some part in this unusual picture.
The fact that half the cases with eosinophilia
showed no helminthic infections at all suggests
other significant factors causing this blood picture
besides parasitic infections. On the other hand,
the greater incidence of Trichurts among Marshallese with eosinophilia than among those without
eosinophilia indicates that infection with that
helminth may have been a contributing factor in
its incidence.
The incidence of parasites in all age groupsindicates that fecal contamination is widespread and
that infections are acquired early in life. Although
individual Marshallese were generally neat and
clean in appearance,their simple sanitaryfacilities
andrural life makeit likely that fecal contamination is a continuing affair. The concentration of

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