me
.
.
_
and vomiting on the day of exposure,
,
(7
.,
In this group there is no further evidence
of effects of the exposure except the hematologic (blood) changes that can be de~
tected by serial studies of the blood with particular reference to lymphocytes
and pletelets,
The lymphocytes reach low levels early, within 48 hours, ang may
s!.ow little evidence of recovery for many months after exposure.
may show some depression during the second and third week.
variation ig encountered.
The granulocytes
However, considerable
The late fall in the granulocytes, during the 6th or
7th week, may occur and should be watched for.
Platelet counts reach lowest levels
on approximetely the 30th day at the time when maximum bleeding was observed in
Japanese who were exposed at Hiroshima and Nagasaki.
This time trend in the plate-
let count and the development of henorrhage is in merked contrast to that seen in
laboratory animals where platelets reach their lowest levels between the 10th and
15th days and henorrhage occurs shortly thereafter,
In this group inidviduals with neutrophil counts below 1000 per cubic ma,
may be complete by asymptomatic.
Lykevise, patients with platelet counts of 75,000
per cubic m, or less may show no external signs of bleeding.
It 4s well known that all defenses against infection are lowered, even by sublethal doses of radiation, amd thus, patients with severe hematologic depression
should be kept under close observation and administered appropriate therapy as inGicated.
There is reasonably good animal experimentation to indicate that sublethally
exposed colonies of animals are ore susceptible to endenic and epidemic infection.
The numbers of individuals in group 3 (Survival probable) will be greater than
in group 2 (Survival Possible) and the muzber in group 2 will be crester than in
group 1 (Survival improbable).
Group 1 casualties will be Lelplessly injured.
Group 2 casualties will be able to help in their own care to a limited extent.
Group 3 casualties will be useful and a roderate enount of work will not be harmful.
No therapy other than observation is needed for this group.
The rest of my comments will be focused on the fallout accident that occurred
DOEaRcuyes
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