Attempts at suppression of endemic intestinal helminths on Rongelap and Utirik, with a different regimen on each, underlined the effectiveness of mebendazole (the. more costly) and raised serious questions as to the effectiveness of the recommended dosage of pyrantel pamoate under the logistic con- straints of the timing of BNL visits to the outer atolls. Of considerable sig- nificance in the context of suppressive treatment is the prolonged suppression of parasitosis obtained with mebendazole, as well as its attainable effectiveness against all three endemic helminth parasites. Even 9 months after the last of three quarterly treatments, Ascaris and Trichuris prevalence was re- duced by 84.7% and 72.3%, respectively. This suggests that, notwithstanding the arrival of parasitized persons on the quarterly Marshall Islands "field trip'' ship - as was also occurring during the survey period - treatment of the entire population every six months (after an initial three-quarterly suppression) should keep these atolls at a very low level of helminthic infection (this would be especially true if preventive treatment were given to all persons coming from infected areas at the time of their disembarking from the Marshall Islands vessels). Such a program could be instituted as early as November 1980, beginning with a complete parasitic survey, provided that mebendazole were available and that a conscientious health aide could be recruited to ensure both complete population treatment and treatment of all per- sons disembarking from Marshall Islands ships. With such conscientious suppression, virtually complete freedom from intestinal helminths could be antic- ipated in a very few years. Suitable measures against pathogenic intestinal protozoa could also be anticipated in due course. -42-