containing 1.5 ml of newly mixed merthiolate-iodine-formalin (MIF) (70) and
thoroughly comminuted to ensure adequate fixation. The preserved samples were

transported to the Tropical Infectious Disease Research Program Laboratory,
U.S. Public Health Service Hospital, New Orleans, LA, where they were examined

both by a standardized direct smear method (2 mg) and by an ether concentration technique using the entire sample.
Treatment.

Treatment on Rongelap consisted of mebendazole,

100 mg (one

chewable tablet) twice daily for 3 days, monitored either personally by the
survey physician or under his supervision by the island Health Aide. At least
90% of the inhabitants present during the quarterly visits and eligible for
treatment (pregnant women and children aged <2 years were excluded) were so
treated at the scheduled quarterly intervals.
Treatment on Utirik with pyrantel pamoate suspension,

10 mg per pound

body weight, single dose, was given to at least 90% of the eligible inhabi-

tants present during the quarterly visits indicated in Table 1.
Body weight
was determined with a portable scale.
Coverage of the population was attained
by using survey lists and by many miles of footwork on this relatively small
island.

C.

Results and Discussion

Intestinal Protozoa - Rongelap and Utirik Atolls.

Intestinal protozoa

observed during the last survey on Rongelap Atoll (September 1979) included

amebae (not differentiated into pathogenic and non-pathogenic species) in

26.5% of specimens, and Giardia lamblia in 17.6%; no Balantidium coli were
seen despite the large number of free-roaming pigs on the island.

Intestinal protozoa found in Utirik Atoll inhabitants in September 1979,
concurrently with a minor epidemic of mild diarrheal disease, included amebae
in 7.6%, Giardia lamblia in 5.1%, and Balantidium coli in 7.6%, the Giardia
and Balantidium being present in surprisingly large numbers in some specimens.

Amebae identified included Entamoeba histolytica (cysts and trophozoites),
Entamoeba coli, and Iodamoeba butschlii.
It must be stressed that, since the
survey was concerned almost exclusively with intestinal helminths, whereas MIF

is not the field fixative of choice for direct observation of protozoa,

results cannot be considered definitive.

Nevertheless,

these

the presence of the

primary protozoal pathogens, Giardia lamblia, Entamoeba histolytica, and

Balantidium coli, on Utirik Atoll was verified under circumstances not incon-

sistent with their being involved in the etiology of the diarrhea observed.

During the November 1980 survey,
will be included.

appropriate materials

Intestinal Helminths - Rongelap Atoll.

for surveying protozoa

Intestinal helminths found in

Rongelap Atoll inhabitants before and during the period of suppressive treat-

ment with mebendazole are listed in Table 2 (A and B) (71).
As in 1958, Trichuris trichiura was the most prevalent parasite detected.

At the start of the current survey in June 1977,

73.0% of the popula-

tion tested (163) was infected, including 80.2% of children (96) and 62.4% of
adults (67); this represents a greater than twofold increase since the 1958
survey.

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