13 Findings INTERVAL MEDICAL HISTORY ilinesses The outstanding medical event during the past 2 years on Rongelap was a poliomyelitis (type I} epidemic, which occurred early in 1963. The epidemic apparently was carried from atoil to atoll by the crew ofa ship, since it broke out on each atoll within a week or two after that ship had departed. The epidemic occurred on Rongelap Atoll in January-February 1963 with 23 children and 3 adults stricken and one of the adults (an * preparations. Chromo- al blood cultures, however, + more successful. During bloods were cultured suc- ~ al chromosomespreads i completely satisfactory. ated during the 1964 surasful 2- and 3-day blood on 64 exposed people and t growth and chromosome , and the slides are now oth years on most indi- wing examinations were oratories: protein-bound d 8 unexposed peopie and inations;** serum folic acid 85 unexposed prople.°** vey 38 urine samples were 1964 survey 27 samples, yses.” Most of these were zh several pooled sampies -ere from people living on ne were obtained at Ebeye. are Dr Shicids Warren and Dr. ‘ngland Deaconess Hospitai, Mis mal Laboratory, und Mis Paunaa acal College, Philadelphia. We Jender and Carolyn Gooch of Oak # Edinburgh, Scotland, and Kurt uty for advice. Clinical Chemistry Group in the ahaven National Laboratory were nsack Hospital, Hackensack. NJ. am thers at the AEC Health and Safety ined vut these analyses. older exposed woman) succumbing. The children involved were all <7 years of age. Eleven were children of exposed and 12 of unexposed parents. Mild residualfacial or lirub paralysis was present in 8 and more severe paralysis in 2 children. These cases will be further described under the Pediatrics Section. This epidemic was brought under control within a few months by widespread use of ural Sabine vaccine by medical personnel of the Public Health Service, Trust Territory, and Navy. Fortunately Utirik Atoll was spared the epidemic. Otherthanthe poliomyelitis epidemic, the interva! medical history, both on Rongelap during the past 2 years and on Utink for the past 4 years, did not reveal any epidemics or unusual diseases. Upper respiratory infections, gastroenteritis, and fungus and otherinfections of the skin predominated in the sickness inventory of the health aide. Only a few cases of fish poisoning and sickness from eating improperly prepared arrowroot were reported. Deaths preceded bv disorientation and amnesia with convulsive seizures and finally coma. Autopsy stowed meningeal damage grossly and histologically Brain damage was thelikely cause of deatn. Other findings were few, but of interest was notation of giant and multinucleated cells in the meninges area,* (4) No. 52, female, 35 years of age. Died, February 1963, with laryngeal paralvsis during the poliomyelitis epidemic. Death appeared to be from poliomy -litis with bulbar involvement. No autopsy was obtained. There was one death ofa child of an exposed parent. No. 107, female, 4 vears of age. Died in October 1962 of acute gastroenteritis and dehvdration. Child had a history of mainutrition and weakness, skin infections, loss of pigment in hair. No autopsy was done. During 1963 one death occurred in the exposed group:the oldest Rongelap woman, estimated to be around 107 years of age: death was reported as due io “old age.” Unfortunately, no autopsy was obtained. She had been known to be quite feeble and had cataracts and a considerable degree of arteriosclerosis. A 34-year-old man in the comparison popuia- tion died of asthma. No autopsy was done. During the 10-vear period, 10 deaths have occurred in the exposed Rongelap group, and 8 deaths have occurred in the comparison population since 1957 (when this group was fint examined). Table 3 lists the deaths with probable causes in the two groups. The annual mortality rate per 1000 for the exposed groupis thus about 12.9 com- pared with about 8.4 for the comparison population and 8.3 for the Marshall Islands as a whole (1960). Four deaths had occurred in the expoced group Poorly kept records madeit difficult to get accurate demographic data on the Uurik people. It appeared, however, that during the past 4 vears diagnosis of cancer of the cervix. Previous exam- occurred in the older people and 6 infant deaths during 1962 and early 1963: (1) No. 30, female, 60 vears of age. Died, July 1962, with a stated inations had shown progressive loss of weight a: 4 increasing hypertension. On the past survey, bleeding was noted from the cervical os anda gynecological checkup had been recommended but death occurred before this was carried out. No autopsy was obtained. (2) No. 46, male, 84 vears of age. Died July 1962. Had history ofarteriosclerouc heart disease, a stroke a numberof years ago, and senility. No autopsy was obtained. (3) No. 26, male, 21 years of age. Died in December 1962, two months after a fall from a coconut tree. Death was since they were last examined, about 5 deaths had had been recorded. The deaths were due to various causes such as pneumonia, infant diarrhea. and infections. Births In 1962, 3 healthy babies were born to exposed parents and 5 to unexposed parents. In 1963, 3 babies were born to exposed parents and 5 to unexposed pa.ents. "Dr. Hans Cotter of Brookhaven National Laboratoryre- ported on che histopathology.