Ascaris lumbricoides, not found at all in the 1958 study, was detected

in 24.5% of those tested, in 1977, including 38.5% of children and 4.4% of

adults. Infestation by worms was related to the post~fallout period by the
Rongelapese, who appear to give less credence to the concept of introductior
being the result of increased inter-atoll contact made possible by the greater
availability »f Trust Territory shinping.
The prevalence of hookworm, detected in only 3 individuals (1.82), was
virtually unchanged since 1958, if the increased potential for absence of
study subjects from the island is taken into consideration.
Only 23.4% of the population tested appeared to be helminth-free at the
beginning of the current study, including 15.6% of children and 34.3% of
adults.

Effects of Treatment ~ Rongelap Atoll. Population-wide treatment with
mebendazole on Rongelap resulted in a dramatic reduction in population worm
burden, clearly evident at the interim stool sampling conducted in January
1978,

3 months after the second quarterly treatment (Table 2, A and B).

Per-

cent reductions of 79% and 92% of initial worm burdens of Trichuris trichiura
and Ascaris lumtricoides, respectively, had been effected, and hookworm was

not detected. Of even greater significance is that 9 months after the last
(January 1978) treatment course, these reductions were still very much in evi-

jence (September 1978).

Nevertheless, one year later (Sepcember 17379) a not-

unexpected resurgence of infection had taken place, although the gains
effected by the treatment had not been entirely eliminated.
Intestinal Helminths - Utirik Atoll. Intestinal helminths found in the
Utirik Atoll irhabitants tested (>20% of the population) are listed in Table
2 (C and D) (4). As on Rongelap, Trichuris trichiura was the most prevalent
parasite, but the level of infection on Utirik was even higher: 91% of the
sample cested (24% of the population). Ascaris lumbricoides was present in
25.8% of the initial Utirik samples, a level virtually identical with that on
Rongelap before suppressive treatment. Tze hookworm level on Utirik, only
2.2% positive specimens, was alse quite comparable with that found initially
on Rongelap. None of the children tested, and only 16.2% of the adults were
he lminth-free.
Effects of Treatment - Utirik Atoll. .Population-wide helminthsuppressive measures on Utirik were only against Ascaris lumbricoides and
hookworm, and consisted of three treatments (see Table 1) with pyrantel
pamoate, an anthelminthic not considered to have any effect against Trichuris.
(The trichuricide oxantel pamoate was to have been used in conjunction with
the ascaricide pyrantel pamoate, but it was not available because of FDA restrictions on its use in populations under U.S. jurisdiction.) Their effectiveness even against pyrantel pamoate's main target, Ascaris lumbricoides,
was disappointing: the reduction was only 21% at 6 months after the first
treatment, and only 31% at 9 months after the third treatment (compared with
96% at 9 months after the third treatment with mebendazole on Rongelap). As
expected,

the trichuriasis level was not reduced, che mean being 93.02% through-

out the study. The hookworm level was 2.52 at the conclusion of the
suppressive effort.

Eosinophilia - Roagelap and Utirik Atolls.

Beca:se intestinal nematodes

are a common cause of blood eosinophilia, particularly (but not exclusively)
during the tissue~nigration phase of the parasitic life cycle, peripheral
eosinophil counts were correlated with temporal events of the suppressive

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