HEALTH SURVEY IN PACIFIC romatous, 59 tuberculoid, and 2 mixed. As shownin table 20, 83 additional cases clinically suspicious for leprosy were found in the Saipan and Palau districts during the course of the survey. None were reported from the Marshall Islandsdistrict. Table 20. Results of survey for clinically suspicious cases of leprosy, Saipan, Palau, and Marshall Islands* Districts District and island or atoll FO TBAEARSA fea som Ten tM panne eeerhet gegen yee He paca ree ees capa yi U. 8S. ARMED FORCES MEDICAL JOURNAL No. of cases Total 83 Saipan: Saipan Island 65 Palau Lamotrek Atoll Babelthuap Island 18 4 3 District and island or ato. Palau—Continued Yap Islands Koror Island Satawal Island Woleai Atoll Elato Atoll Fais Island : No. of eases 3 2 2 r 1 I * No clinically suspicious cases of leprosy for Marshall Islands district. The fact that the true macular lesion is not readily recognized by other than specialists in the field may have reduced the discovery rate _ for leprosy in this survey. Recognition of leprosy was especially difficult because of the prevalence of tinea versicolor and traumatic contracture, both of which required differentiation from the disease. Personnel conducting the survey were reluctant to make a diagnosis of leprosy where there was anyquestionof its certainty. Diseases of ear. Inflammatorydiseases of the ear occurred at the rate of 9.8 per 1,000 inhabitants. The majority of cases were in the Saipan district where the rate was 26.4 per 1,000 persons. Therate in the Marshall Islands district was 11.4 and only 0.9 in the Palau district. The most prevalent disease of the ear was “infection, diffuse, ex- ternal auditory meatus.” It is an interesting fact that of the 161cases reported, 101 were on Saipan Island. It is not known whetherpersonnel conducting the survey were more thorough in making examinations on this island than they were elsewhere or whether an epidemic was inoccurrenceat the timeof the survey. Other conditions. Degenerative joint disease was rather prevalent, showing a rate of 70.6 per 1,000 inhabitants inthe three districts com- bined. Rates were highest in the Palau district and lowest in the Saipan district. This disease was most prevalent among the aged. A total of 825 neoplastic diseases was reported, establishing a prevalence rate of 14.7 per 1,000, Only 11 neoplasms were proved malignant, although other malignancies were suspected, The malig1220 VOLUME 10, NO. 10." pant neoplasms were distributed among theislandsoratolls as fol- ows: Saipan, 3; Babelthuap, 2; and 1 each on Tinian, Ulithi, Woleai, Yap, Kwajalein, and Wotje. Among the 312 benign neoplasms there »were 114 melanomas of skin, 63 lipomas, and 29 hemangiomas and : lymphangiomas. The bulk of these were on Majuro, Ebon, Saipan, Yap, Babelthuap, Maloelap, and Mili. The prevalence rate for vitamin deficiency was 8.8 per 1,000 inhabitants. Of the 195 cases reported, 98 were on Saipan Island where he prevalence rate was 24.2. Other islands where the rate was high were Ine, 72.8; Arno, 57.6; and Mihi, 28.2. Anemia, with a prevalence rate of 8.4 per 1,000 persons, was reported in substantial numbers from Saipan, Majuro, Ebon, and Mili. According to reports of this survey anemia was practically nonexistent in the Palau district. It was reported that a large numberof cases of leukoplakia buccalis were seen on Saipan and Babelthuap Islands. These occurred principally among betel-nut chewers. A comparatively small numberof eases were reported on the health record cards used in this study for ‘tabulation purposes. In the summary reports accompanying the -eards, however, it was estimated that on Saipan alone over 200 cases of leukoplakia buccalis were observed. Many of these were verified by biopsy. It was further pointed out in the reports that, although betel-nut chewing was also a commonpractice on the Yap Islands, leukoplakia buecalis was not prevalent there. It was suggested that this might have resulted from the oral mud packs used on Yap to hide the staining effect of the betel nut. The mud packs were not used on Babelthuap. The reports from Saipan did notstate whether mud packs were used there. SUMMARY In the summer of 1948 a survey staff aboard the U.S.S. Whidbey began a health survey of the Trust Territory of the Pacific Islands. its objective being a physical examination of every inhabitant of the area. This report covers the civil administrative districts of the Saipan, Palau, and Marshall Islands. Fifty-two percent of all stools examined were positive for intestinal parasites. The most prevalent. intestinal parasites were hookworm, Trichuris, and Ascaris. Approximately 50 percent of the Kahntests were positive. This was judged to be evidence of the yaws infection on the islands. Of those receiving chest. x-ray examinations, 4.5 percent were found to have chest defects and 1.3 percent were suspected of having active ;, pulmonarytuberculosis. The numberof chest tumors, cardiovascular CTOBER 1959 1221