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Retrospective and prospective studies were done on children with wheezing bronchitis on the small Pacific island of Niue. Wheezing bronchitis was found to be a common cause of morbidity, but not mortality in these children. Episodes of the disease were most common in children under the age of 4 years and tended to disappear as they became older. A case-control study indicated smoking by the mother (P less than 0.0001), positive stool examination for parasites (P less than 0.001), mother with a history of wheezing bronchitis (P less than 0.01) and father smoking (P less than 0.05) were all correlated with wheezing bronchitis. Skin testing and serologic results indicated that hypersensitivity to house dust mite (Dermatophagoides pteronyssinus) and plantain (Plantago lanceolata) antigens were also associated with having wheezing bronchitis. This study demonstrates the multifactorial etiology of wheezing bronchitis on a Pacific island.

Between June 1979 and July 1980, faecal specimens were collected from 100 children in Efate, Vanuatu, and examined for the presence of virus-like particles by direct negative staining electron microscopy. Of the children, 40 were hospital patients 22 of whom had gastroenteritis and 18 had other illnesses. The remaining 60 children were apparently healthy controls. Coronavirus-like particles were the most common agents encountered and were detected in approximately 20% of all three groups of children. Particles with the morphological features of calicivirus, astrovirus, adenovirus and parvovirus were also detected.

An extensive epidemic of dengue type 1 infection with a high incidence of hemorrhagic manifestations occurred on the island of Viti Levu, Fiji beginning early in 1975. Previous dengue outbreaks in this population were such that in 1975 two types of dengue patients were observed, one group of patients experienced primary dengue type 1 infection, whereas another experienced their dengue type 1 infection approximately 4 years after a dengue type 2 infection. Clinical and laboratory findings for the two forms of infection were assessed in patients hospitalized for their disease, usually with hemorrhage. With the exception of virologic and serologic findings, no important differences between these two groups were noted with respect to incidence and nature of hemorrhage and other clinical and laboratory findings. Both types of infection sometimes were associated with thrombocytopenia and low serum levels of the C3 component of complement. Virus was more easily isolated from the primary infection patients and the magnitude of their viremia also was higher. No significant differences were noted in a comparison of the ease of virus isolation from serum or plasma.

Dengue antigen could be demonstrated by a direct fluorescent antibody technique in simple head squashes of either male or female Aedes albopictus mosquitoes infected with any of the four dengue serotypes. Dengue viruses can be isolated rapidly and simply by combining this technique with that of parenteral inoculation of mosquitoes with test material.

The screening of different ethnic groups who live in the same natural system have enabled the authors to study interaction between genetic and environmental factors as a part of etiology of diabetes mellitus. In New Caledonian country areas, the prevalences of glucose tolerance abnormality (GTA) and diabetes mellitus (DM) have been higher with people of polynesian descent than with Melanesians. GTA 7.6 p. ct. versus 5.1 p. ct. DM 6.5 p. ct. versus 2.2 p. ct. The prevalence of these combined diseases have been 14 p. ct. with the Polynesians and 7.2 p. ct. with Melanesians. These two ethnic groups have shown mean ages and obesity rates similar enough to lead the authors to deny these two factors a major part in the difference between the ethnic prevalences of DM. Besides, the mean plasmatic glycemia two hours after a dose of glucose and the relative risk of DM and GTA according to age and obesity rate have shown that the slight differences between these groups are not involved in the different prevalences of DM. This inter-ethnic difference may be due to genetic factors. However, some environment linked factors besides obesity (such as diet and daily life activity) may share a major part in this difference.

The frequency of radiological sacroiliitis and its association with HLA-B27, Cw1, and Cw2 were determined in Navajo and Hopi Indians coming to a community hospital. In the Navajo, the phenotype frequency of HLA-B27 was 36% and the frequency of sacroiliitis, 11%. In contrast, among the Hopi, the phenotype frequency of HLA-B27 was 9% and the frequency of sacroiliitis, 4%. Of the Navajo men, who had sacroiliitis and were HLA typed, 83% were HLA-B27 positive. The increased frequency of radiological sacroiliitis and were HLA typed, 83% were HLA-B27 positive. The increased frequency of radiological sacroiliitis in the Navajo was felt to be related to the high frequency of HLA-B27 and Reiter's syndrome in this population. HLA-B27, HLA-Cw1, and HLA-Cw2 are known to be in linkage disequilibrium, and about one-half of the men with sacroiliitis from both tribes had concurrence of HLA-B27 and HLA-Cw2.

Granuloma inguinale has been endemic in Papua New Guinea for at least eighty years and recently appears to be increasing, particularly in the urban centres. Most patients were found to be recent migrants to the Port Moresby area with low socioeconomic status and poor personal hygiene. The disease was found more frequently in males. A possible association between carcinoma of the penis and granuloma inguinale was observed. Lesions were chronic, progressive and located mainly in the genital region. Attempts to culture the causative agent were unsuccessful.

The case of a patient with fulminant Clostridium perfringens septicemia and intravascular hemolysis is presented. The organisms in the blood stream were in sufficient quantity to be detected on a peripheral blood smear, and some were found to be within leukocytes. In vivo spore formation by C. perfringens is thought to be uncommon; however, in this patient probable spore formation by this organism was observed within peripheral blood leukocytes. The peripheral polymorphonuclear leukocytes from this patient were also markedly vacuolated.

Familial spastic paraplegia is described in four Cook Island children. Prior to the onset of the disease at age six or seven years, the children were apparently normal. Disease was characterised principally by progressive spastic paraplegia of the lower extremities, in addition to tremor and slow articulation. The disease in these children was probably due to the expression of an autosomal recessive gene. The disorder is of interest because the findings in these children appear to overlap the pure spastic and ataxic heredofamilial syndromes.