AMEBIASIS IN MILITARY OVERSEAS RETURNEES

Abstract
Endamoeba histolytica was found in stools of 168 (16.8%) of the first thousand unselected overseas returnees to this hospital in 1944. Highest incidence (17%) occurred in those who had served in tropical areas or who resided in Southern States prior to Army service. Incidence in those who served exclusively in temperate areas and who resided in Northern States prior to service was only slightly lower (15.1%). The incidence herein reported is not greater than many reliable estimates of domestic amebiasis as measured by local surveys. Apprehension that the disease will increase in the U. S. due to the return of soldiers from highly endemic areas overseas does not appear to be justified. Analysis of the positive cases reveals the overwhelming majority (76.2%) to be totally asymptomatic carriers. Those with acute dysentery constituted only 3.6%. The remainder (20.2%), be- cause of low-grade abdominal symptomatology, were classified as chronic dysentery. Undoubtedly many of the latter group are so classified only because of coexistent functional gastrointestinal disorders. It is considered possible that mucosal resistance may be lowered in the E. histolytica carrier by a variety of mechanisms (nutritional deficiencies, inter-current infections, etc.), permitting the conversion of the asymptomatic carrier state to acute or chronic dysenteric forms. If this were not true, the carrier state would command attention mainly because of the likelihood of cross-infection. High levels of sanitation and personal hygiene tend to minimize this danger.