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Disease Patterns In Primitive Isolated Island Populations 
I, Medical Survey of the Island Populations 
To determine the spectrum of diseases found on these Islands, with emphasis 
on those of Infectious, genetic, or congenital etiologies, and to identify the 
neurological syndromes present, detailed physical examinations, supplemented as 
needed by laboratory investigations, were performed on over three thousand 
people. Examinations of entire island populations were performed on each of the 
smaller islands, and selected medical surveys were made on those with larger 
populations. Protocols included the complete neurological and opthalmological , 
as well as gener2Ll medical examinations. On several islands, as well as in 
situations where medical problems indicated the need, urinalysis, hematologic 
examination of peripheral blood, thick and thin blood smears for parasite 
identification, x-ray and electrocardiographic study, appropriate cultures for 
bacteria or viruses, and intradermal skin testing with atypical mycobacterial 
and mycotic antigens were carried out. On all children, heights and weights 
were recorded and identity photographs were taken for use in future longitudinal 
growth and development studies. 
II. Neurological Disease in the Banks, Torres and Southern Solomon Islands 
A survey of neurological disease was made in the Banks, Torres and Southern 
Solomon Islands, in order to determine the most prevalent syndromes and to 
search for any disease foci. The neurological disease encountered fell into 
several categories: congenital abnormalities, infectious or post-infectious 
disease, degenerative disease, peripheral neuropathy, and cervical and lumbar 
spondylosis. 
The congenital disease frequently resulted from definite structural damage; 
examples include: hydrocephalus, focal epilepsy (with secondary dystonia 
involving one hand), spastic paraparesis, hypotonia with hyperref lexia, club 
feet with hyperreflexia. At least five cretins with mental retardation were 
seen; two had an associated severe myopathy (one cretin on Bellona had a 
goiter). The most common sequella of infection seen was lower motor neuron 
paralysis secondary to poliomyelitis. Over six cases of old poliomyelitis were 
seen; in each case the initial febrile illness had occurred in the setting of a 
presumed epidemic, since other islanders had died or been similarly affected at 
the same time. A number of cases of leprosy were seen, one having a classical 
mononeuritis. A case of herpes zoster with radicular pain was found, possibly 
associated with the high prevalence of varicella, presently active on the 
islands . 
The degenerative diseases seen included two cases of Parkinson's disease 
and two cases of an olivopontocerebellar disease syndrome. The fact that the 
latter two cases were sporadic, and that one patient had a history of febrile 
illness preceding the onset of neurological signs , may indicate that the 
syndrome is post-encephalitis. One islander had dementia, hyperkinesis, 
cerebellar signs and hyperreflexia, possibly post-encephalitis as well. Two 
cases of severe optic atrophy of unknown etiology were seen. 
Peripheral neuropathy occurred in two individuals with a typical 
Charcot-Marle-Tooth clinical picture, although both cases were sporadic. 
