and 4 hours later, 104. The two-year old child had an initial temperature of 101.8 degrees
which rose to 103.5 degrees in 4 hours. Both were given intramuscular procaine pemerllin
when the sharp rise in temperature occurred, and both were without symptoms and fever the
following day. A second Injection of penicillin was given at this time, and therapy was discontinued. In spite of the fact that the neulrophiles reniined depressed im both cases long after the
fever had passed, both tndividuals recovered and had no further {liness. In Figure 2.1 the blood
counts und platelets of the two-year old pattent and the thme of the occurrence of the illness
with fever ire tlustrated, A one-year old boy had symptoms of upper respiratory infection for
several days before being brought to the clinic. When he was seen, his temperature was 100.8
degrees. In addition to the head colds there was pharyngeal injection and numerous coarse
rhonchi (wheezing) throughout the chest. A diagnosis of upper respiratory infection with associated bronchitis was made and the child was given a single intramuscular tajection of procaine penicillin, On the following day no rales or rhonchi were heard, the temperature was
99°F, and he remained asymptomatic without further treatment,
Oneof the £3 individuals was a 50-year old man who reported to the clinic with weakness,
hervousness, mild abdominal pain, and shooting pain in the upper anterior chest, bilaterally.
He appeared moderately ij], bis temperature was 99.6°F, and the only positive physical finding
was muderate tenderness iu the right upper quadrant of the abdomen. Since his granulocyte
count remained low on repeated examination, be was seen at frequent intervals. Within a 10 hour
period the temperature rose to 101.6°F, following which it fell gradually to normal. The abdominal tenderness continued for 24 hours and then gradually disappeared during the subsequent
two days. A diagnosis of cholecystitis (inflamation of the gall bladder) was made. No specific
therapy was given. In Figure 2.2 his white blood count and platelet counts in relation to the
appearance of symptoms are shown.
A female, 38, developed generalized urticaria, fever, an@headache. Urticaria and fever
subsided within 8 hours without any therapy.
2.3.2
Platelet Counts
All individuals with a platelet count of 100,000 or less were examined daily for evidence of
hemorrhage into the skin, mucous membranes, and retinae. Urine was examined for red cells
and albumin, and women were questioned concerning excessive menstruation. There was no
evidence of hemorrhage into tissues even though 11 individuals reached platelet levels between
35,000 and 65,000. Two women menstruated when their platelet counts were 150,000 and 130,000
respectively. Both menstruated several extra days and thought that the bleeding was excessive
but not sufficient to cause concern.
2.3.3
Hematocrit Changes
Nineteen individuals in the Rongelap group had hematocrits of 35 per cent or below; however, none of these were below 31 per cent. Nine of the 19 were children, aged one to [ive years
who would be expected to have a lower hematocrit than normal adults; four were over 70 years
of age, in which age group a decreased hematocrit is frequently present without obvious cause.
Two of the 19 had had menorrhagia (profuse menstruation) prior to the determination, two were
three to four months pregnant and had not received supplementary iron, and two were young
women. The tow hematocrits that were observed could be explained on the basis of normal
physiological variations rather than to the effects of irradiation on hematopoiesis (blvod formation). At no time were whole blood transfusions considered since hematocrits remained
within levels consistent with well being and normal activity.
2.4 THE EFFECT OF AN EPIDEMIC OF UPPERRESPIRATORYINFECTION ONAN
IRRADIATED POPULATION
Between the 27th and 42nd post-exposure days an epidemic of upper respiratory diseases
(URI) occurred. Fifty-eight per cent of the Rongelap group and 56 per cent of the Ailinginae
group were involved. Seventy per cent of the affected individuals developed symptoms between
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