Preventive Medicine Unit Research Articles

Prevalence and clinical associations of steatotic liver disease in a Preventive Medicine Unit: A cross-sectional study

Steatotic Liver Disease is the most frequent chronic hepatic disease worldwide. Its prevalence is 30-38% and is associated with progression to steatohepatitis, fibrosis, cirrhosis, and Hepatocellular Carcinoma. A new terminology for this condition was recently published, classifying it into five groups. To evaluate the prevalence and the association of Steatotic Liver Disease with clinical and laboratory variables in a Preventive Medicine Unit. A cross-sectional and descriptive study. Patients over 18 years of age, with or without chronic diseases, who consulted the Preventive Medicine Unit of the Clínica Universidad de los Andes between February 2022 and March 2024 were included. Demographic, clinical, laboratory, and imaging data were collected. A hepatic steatosis diagnosis was made using abdominal ultrasound. 4535 patients were included in the analysis; the mean age was 45.1 years, and 37.4% were women. 1214 patients (26.8%) met criteria for hepatic steatosis, who were older (p<0.001) and had a higher proportion of male sex than healthy patients (p<0.001). 94.3% met the criteria for hepatic steatosis associated with metabolic dysfunction; 3.2% met the criteria for metabolic dysfunction and alcohol consumption; 0.5% met the criteria for hepatic steatosis associated with alcohol consumption; and 2.0% met the criteria for cryptogenic hepatic steatosis or due to another cause. The prevalence of hepatic steatosis in our sample was 26.8%, with a significant difference between men and women. In 94.3% of cases, it was associated with metabolic dysfunction.

Irritable Bowel Syndrome prevalence and work ability in a sample of healthcare workers exposed to occupational stress

ObjectiveOccupational stress represents a significant precipitating factor in different diseases but its role in Irritable Bowel Syndrome (IBS) needs to be clarified. The present cross-sectional study aimed at investigating the prevalence of IBS diagnosis in a sample of health workers and exploring the potential relationships between IBS, work-related stress levels and work ability. Methods653 health workers undergoing periodical occupational health surveillance at the Occupational and Preventive Medicine Unit of a major University Hospital in central Italy, were consecutively recruited and screened for IBS diagnosis, according to ROMA IV criteria. The rating scales IBS Severity Scoring System (IBS-SSS), Demand–Control–Support Questionnaire (DCSQ) and Work Ability Index (WAI) were used to assess respectively IBS severity, occupational stress and work ability levels. ResultsIBS prevalence in the sample was 16.8%. Participants suffering from IBS were characterized by a higher prevalence of psychiatric diagnosis and sleep disturbances, higher levels of job strain and isostrain as well as by lower levels of work ability compared to non affected subjects. Moreover, the severity of IBS correlated positively with occupational stress and both were negatively associated with work ability. ConclusionsThe present results suggest the need for preventive, organizational and management strategies at workplace aimed at protecting the health and well-being but also productivity of the worker with IBS.

A case study of an influenza vaccination program for health care workers in Vietnam

BackgroundIn 2017, the Vietnam Ministry of Health conducted a demonstration project to introduce seasonal influenza vaccination to health care workers. A total of 11,000 doses of influenza vaccine, single-dose prefilled syringes, were provided free to HCWs at 29 selected hospitals, clinics, and research institutes in four provinces: Hanoi, Khanh Hoa, Dak Lak and Ho Chi Minh City.MethodsBefore the campaign, a workshop was organized to discuss an implementation plan including technical requirements, cold chain, uptake reporting, and surveillance for adverse events following immunization. All sites distributed communication materials and encouraged their staff to register for vaccination. Following immunization sessions, sites sent reports on uptake and adverse events following immunization. Left-over vaccine was transferred to other sites to maximize vaccine use.ResultsThe average uptake was 57% for all health care workers, with 11 sites achieving 90% and above. These 11 sites were small with less than 500 staff, including 5 primary hospitals, 3 preventive medicine units, and 2 referral hospitals. Among the six biggest sites with over 1000 staff, four sites had the lowest uptake (14–47%). Most of the high-uptake sites were from the central to the south; only one site, a referral hospital, was from the north. After redistribution of left-over vaccine, only 130 vaccine doses (1.2%) were not used and destroyed. Based on factors that affected uptake, including registration levels, differing communication strategies, availability of vaccination, and commitment by health facility leaders, we recommended ways to increase health care worker coverage; recommendations to improve reporting adverse events following immunization were also made.ConclusionsThe project demonstrated that it was feasible to conduct influenza vaccination campaigns among health care workers in Vietnam. Improvements in promotion of registration, more intense pre-planning, especially at larger facilities, and wider, more consistent availability of communication materials will result in increased efficiency and coverage in this program’s future expansion.

Crossing Borders: One World, Global Health

Crossing Borders: One World, Global Health

Implication of pollen sensitivity among patients suffering from chronic urticaria: Current scenario

Background: Studies have implicated house dust mites and foods sensitivity in chronic urticaria based on skin prick test (SPT) and in vitro analysis. There are no studies telling the importance of pollen sensitivity in these patients. Objective: To study the implication of pollen sensitivity in chronic urticaria patients along with foods and dust mite allergens using SPT method. Materials and Methods: This study was conducted in Allergy Clinic, Preventive Medicine Unit, Kempegowda Institute of Medical Sciences Hospital, Bangalore from January 2005 to March 2010. Totally 300 patients with confirmed clinical diagnosis of chronic urticaria were recruited and were subjected for SPT with 123 allergen extracts and the results were analyzed and interpreted. Results: Out of 300 chronic urticaria patients, 171 (57%) were in the age group of 20-39 years. One hundred and forty-six (48.67%) were males and 154 (51.33%) were females. One hundred and eighty-one (60.33%) were having only chronic urticaria. One hundred and forty (46.67%) of urticaria patients were having symptoms from 6 weeks to 1 year. Forty-four (14.67%) had a family history of atopy. Majority of urticaria patients (with or without comorbid conditions) were sensitive to food allergens (164, 54.66%) followed by pollens (92, 30.66%), dust mites (60, 20%), and others. Among food allergens, majority (15, 5%) were sensitive to masoor dal followed by almonds (14, 4.66%), ginger (13, 4.33%), and yeast (13, 4.33%). Among pollens, majority (32, 10.66%) were sensitive to Prosopis juliflora followed by Parthenium hysterophorus (17, 5.66%), Peltophorum pterocarpum (17, 5.66%), and Chenopodium album (16, 5.33%). Among dust mites, 42 (14%) and 39 (13%) were sensitive to D. farinae and D. pteronyssinus, respectively. Conclusion: Pollens sensitivity is also implicated in chronic urticaria patients along with foods and dust mite allergens.

Abstract 18697: C-Reactive Protein Performance as a First-Line Biomarker for Cardiovascular Risk Assessment Among Healthy Women

Background: Over 20% of coronary events in women occur in the absence of traditional cardiovascular risk factors. Framingham Risk Score (FRS) limitations in assessing cardiovascular risk in this group are well known. C-Reactive Protein (hs-CRP) has been shown to correctly reclassify cardiovascular risk among women, more specifically among those ones initially categorized as at intermediate risk by FRS. However, evidence supporting hs-CRP use as a first-line test in clinical practice is lacking. We assessed hs-CRP performance in cardiovascular risk re-classification among healthy women routinely attended at a preventive medicine unit. Methods: We evaluated 1.455 consecutive asymptomatic non-diabetic women (mean age: 42 ± 7.9 years) submitted to a routine health evaluation. As part of the evaluation, FRS, hs-CRP levels and Reynolds Score were assessed.Two different models were set to re-classify cardiovascular risk initially estimated by FRS: the first one (Model A) established hs-CRP levels &gt;3&lt;10mg/dL as a cut-off to switch women from FRS “intermediate risk” to the “high risk” category; the second one (Model B) re-stratified cardiovascular risk using Reynolds Score. We studied the performance of both models in cardiovascular risk re-classification. Results: Cardiovascular risk estimated by FRS was low in 98.6% (N=1,435) of the study population; intermediate in 1.1% (N=16); and high in 0.3% (N=4). Hs-CRP &gt;3&lt;10 mg/dL was found in 197 women (13.5%). Among those with high hs-CRP levels, 196 (99,5%) presented low FRS and 1 (0,5%) intermediate FRS. Model A led to risk re-classification of one woman in 1,455 (0.07%). Reynolds score was highly concordant with FRS (p&lt;0.001), so that Model B did not significantly improve hs-CRP performance. Conclusion: Routine measurement of hs-CRP levels has minimal impact on cardiovascular risk re-classification of healthy women in clinical practice, due to the very low average cardiovascular risk of such population. Check-up protocols should not measure hs-CRP routinely in women and leave this determination as a second-line test for cardiovascular risk assessment in specific groups of individuals.

Serum antibodies against circulating influenza strains among vaccinated and unvaccinated general practitioners during two consecutive years (2002–2003)

Efficacy studies have not answered the question whether influenza vaccination among general practitioners (GPs) has a substantial additive effect on their immunity. To evaluate this effect the influenza antibody titres in vaccinated and unvaccinated GPs were compared in a controlled trial during two consecutive winter periods (2002–2003 and 2003–2004). The seroprotection rates against the circulating A/H3N2 influenza virus amount to 80% and 42% in the unvaccinated group in 2002 and 2003, respectively. In the vaccinated GPs the seroprotection rate increases from 91% to 96% in 2002 and from 70% to 83% in 2003 after vaccination. Besides vaccination, the (high) basic antibody titre before vaccination and working in a child and family preventive medicine unit were predicting a protective antibody level in GPs.

Detection of Norwalk-Like Virus Infection Aboard Two

Two U.S. Navy ships experienced outbreaks of gastroenteritis following port visits to Southeast Asia during August to September 1999. The USS Peleliu (LHA 5) had 162 (6% attack rate) medical visits and the USS Constellation (CV 64) had 425 medical visits (9% attack rate). Navy Environmental and Preventive Medicine Unit No. 5 personnel conducted on-board molecular diagnostic assays to presumptively detect the presence of genogroup I Norwalk-like viruses (NLV) in both outbreaks. NLV RNA were detected in 4 (80%) of 5 Peleliu stool specimens and in 9 (36%) of 25 from the Constellation. Significant antibody titer rises to NLV antigens were measured in 18 (62%) of 29 Peleliu and 69 (68%) of 102 Constellation cases, but only in 1 (4%) of 28 asymptomatic controls. All environmental swipes were negative for NLV. Stools yielded no bacterial or parasitic enteropathogens. No point source was found for either ship. The on-site laboratory investigation can provide important information for outbreak control and prevention while new cases are still presenting.

Navy Public Health Laboratory Services: The Navy Environmental Health Center (NEHC) and Navy Environmental Preventive Medicine Units (NEPMUs) (Abstract No. 9)

Navy Public Health Laboratory Services: The Navy Environmental Health Center (NEHC) and Navy Environmental Preventive Medicine Units (NEPMUs) (Abstract No. 9)

Canine Visceral Leishmaniasis in Sicily

The Sicilian province of Catania is an active foci for human visceral leishmaniasis (VL) in the Mediterranean area. Approximately 10 to 15 cases of VL are diagnosed via hospital admissions each year in this community. Recently, an increase in VL case reporting by Sicilian physicians was noted, with 38 and 37 VL cases in 1996 and 1997, respectively. Before 1995, there were no reported VL cases among U.S. military personnel or their family members living in Sicily. However, since 1996, there have been four cases referred to Walter Reed Army Medical Center for diagnosis and treatment, all involving the children of personnel assigned to Naval Air Station Sigonella. Exposure histories for all infected individuals excluded exposure to Leishmania parasites outside of Sicily. All patients lived in areas where vectoring sandflies are present. All had dogs as family pets. To evaluate the level of infection among dogs owned by Navy personnel and their families, U.S. Navy Environmental and Preventive Medicine Unit 7, in a collaborative study with the U.S. Army Veterinary Clinic, Naval Air Station Sigonella, and the Walter Reed Army Institute of Research, performed clinical evaluation and serological testing of 50 dogs residing with U.S. personnel assigned to Naval Air Station Sigonella. The data indicate a high exposure rate to Leishmania (60% of the animals tested had elevated immunoglobulin M antibody levels) in the study population, suggesting that they were infected with Leishmania infantum. Distribution of seropositive dogs by sex was equal. Most of the dogs studied appeared to be in good health. However, inapparent infection of dogs, seen by Italian veterinarians, has been observed throughout all areas of Catania. Sandflies responsible for vectoring L. infantum were trapped in the same locations as the dogs sampled in this study. The level of subclinical infection was 75% among seropositive dogs. The overall level of canine infection observed was higher than expected. This study demonstrates an increased risk to military working dogs and companion dogs of U.S. personnel for infection with L. infantum during a 2- to 3-year tour in Sicily.

Military Preventive Medicine Support: The Balkan Experience

Preventive medicine (PVNTMED) support to deployed forces is as varied as the circumstances for force deployment. The Bosnia-Herzegovina deployment of the 1st Armored Division as part of the Dayton Peace Accords Implementation Forces proved to be no exception to this premise. PVNTMED units, both in the field and at the U.S. Army-Europe support base, were challenged to provide mission support under significant mobility restrictions and in arenas of public health practice not previously thought to be of tactical significance, specifically environmental pollution. New to this operation was the deployment of a Theater Army Medical Laboratory with a mission to assist deployed PVNTMED units with the capability to rapidly diagnose infectious disease agents and provide an expanded array of environmental monitoring support. Vector-borne diseases were also a threat to health, and an innovative base camp sanitation assessment and reporting system was created to alert leaders to the risk of disease transmission to soldiers.

Malaria in Somalia: Lessons in Prevention

<h3>To the Editor.</h3> —In the article assessing malaria in US Marines returning from Somalia by Dr Newton and colleagues,¹important issues regarding prevention may be obscured by their finding that 50% of patients were administered suboptimal chemoprophylaxis. The Navy Environmental and Preventive Medicine Unit No. 5 identified 132 cases of Somalia-related malaria in 128 marines. Ninety-seven individuals were interviewed.<i>Plasmodium vivax</i>accounted for 82 (65.1%) of 126 diagnoses, 34 (27.0%) were<i>Plasmodium falciparum</i>, eight (6.3%) were mixed, and two (1.6%) were unspeciated. Malaria exposure had been anticipated²and preparations made. Appropriate prescribing is published in the widely distributed<i>Navy Medical Department Guide to Malaria Prevention and Control</i>.³For doxycycline, 89 (89.9%) of 99 prescriptions were appropriate, as were 81 (92.0%) of 88 primaquine prescriptions. For mefloquine, 59 (71.1%) of 83 were appropriate. The other 24 (28.9%) included many that failed to overlap doxycycline and mefloquine by 1

Sistema de vigilancia epidemiológica de, enfermedades de declaracion obligatoria en el hospital

The aim of this work is to present a detection system of reportable diseases among patients attending a teaching hospital. Since January 1988, based on daily data obtained from the Admissions Department of Hospital Clínic of Barcelona (HCP) (emergency department visits and hospital admissions and discharges), the Preventive Medicine Unit identifies every day those diseases considered as reportable by the Department of Health of Catalonia, Spain. Reported cases from HCP during the 1988-1991 period were compared to cases reported from HCP in 1987, as well to the corresponding cases in the remaining hospitals of Barcelona. Between 1987 and 1988 there was a 245% increase in the reporting of Individualized Reportable Diseases and of 4345% for Numeric Reportable Diseases. The increased notification has also been shown for the most frequent Individualized Reportable Diseases: 364% for hepatitis, 195% for meningococcal infection and 233% for pulmonary tuberculosis. This system is an approach to the introduction, development and perfection of the detection process, in order to improve reporting levels in the hospital, contributing to strengthen the epidemiologic surveillance system in the community.

What's preventing more prevention? Barriers to development at academic medical centers.

To determine the views of leaders in academic medicine concerning the need for programs in preventive medicine (PM) and the prevailing barriers to program development. Structured interviews. Medical schools of the United States. 90% of deans and chairpersons of departments of medicine and preventive medicine. None. 91% considered academic PM underdeveloped and 100% considered their own programs average or worse. Identified barriers to development included funding constraints, academic partiality to biomedicine, inadequate quality of preventive medicine research and faculty, public preferences for technologic care, and organization of academic medical centers (AMCs). While 80% perceived a shortage of able PM faculty and 60% considered PM research quality to be inadequate, only 12% of PM units gave research training high priority. While 95% of respondents held that AMCs should develop community programs and 75% identified social problems as a cause of chronic diseases, 65% agreed that community programs are not considered scholarly. Only 23% of PM units gave community service high priority. A policy contradiction exists: academic leadership agreed on the problems and needed changes in PM, yet the problems were often attributed to nonacademic sources, particularly finding and public preferences, and current academic practices commonly fail to address recognized developmental barriers within academic institutions. A chain of barriers is apparent. Breaking the chain may require a change in our understanding of the role of prevention.

Collection Of Adult And Larval Mosquitoes In U.S. Army Compounds In The Republic Of Korea During 1979~1983.

This paper is the result of adult female mosquito and larval collection in U.S. Army Installations in Korea from 1979 to 1983. New Jersey light traps ere operated for ault collection from May to October. The primary concern of this surveillance is to determine when to recommend insecticide spraying for mosquito control in the Army areas. The 5th Preventive Medicine Unit have developed an "index" level of female mosquitoes in a light trap similar to other U.S.Army Agencies in other parts of the world. When 10 female mosquitoes are reached on two consecutive trap-night, or 5 known vector females are collected, fogging is recommended in the trap areas. Mosquito collections were conducted in 12 U.S. Army areas by operating 39 New Jersey light traps. Mosquitoes collected from the areas were identified to be 17 species comprising 3 genera. Anopheles sinensis(40%). Culex tritaeniorhyncus(31%), Aedes vexans nipponii(19%), and Culex pipiens pallens(10%) appeared to be the most common species in the area. The species, population density and monthly appearance of adult mosquitoes were found to be almost the same in the all provinces involved. And Japanese encephalitis vector mosquitoes, Culex tritaeniorhyncus, showed their seasonal fluctuation from July to September with a peak in August each year. 3. Larval habitats confirmed in the Army areas were categorized into 16 types as shown in Table The mosquito larvae collected in those habitats were identified to be 15 species representign 4 genera. Most breeding sites in the Army areas were those which are activated during the wet season. More mosquitoes were collected from the Kyungki province than from the other provinces. The reason for more collection of mosquitoes from military installations in the Kyungki provinces appears to be the geographic characteritics surrounded by rice fields, marshes and other stagnant water areas.

Eimeria korros and E. modesta spp. n. (Protozoa: Eimeriidae) from a Snake and a Tree Shrew in South Vietnam

Two new coccidia are described from vertebrates of Vietnam: Eimeria korros sp. n. from a snake, Ptayas korros, and Eimeria modesta sp. n. from the tree shrew, Tupaia glis modesta. Endogenous reproduction of the snake Eimeria occurred in the gall bladder epithelium; in the tree shrew, endogenous stages were found in the terminal ileum. During the course of faunal surveys in the northern provinces of the Republic of South Vietnam in 1966, a number of snakes, lizards, and mammals were examined. Although vertebrates were collected for purposes other than the study of protozoal parasites, it was nevertheless possible to examine many stool and blood specimens to this end. Intestinal coccidia were found in the stools of a single specimen of a snake, Ptyas korros (Schlegel, 1837) and of several tree shrews, Tupaia glis modesta (J. Allen, 1906). The coccidia, both considered new species of Eimeria, are described in the present report. MATERIALS AND METHODS Animals were brought to the laboratory alive and were examined for intestinal parasites within 1 hr after killing. Screening for intestinal coccidia was by microscopic examination of an unconcentrated suspension of fresh feces from the rectum of mammals, or by examination of bile and intestinal contents in snakes and lizards. When the presence of coccidia was thus detected, unconcentrated suspensions of stool or bile in 3% potassium dichromate were kept in covered petri dishes and examined periodically for development. Surrounding temperatures varied between 70 F at night and 108 F in the daytime. Portions of the liver and gall bladder, and of the large and small intestine, were taken from the infected snake and from three infected tree shrews. Received for publication 31 May 1967. * The opinions or assertions contained herein are the private ones of the authors and are not to be construed as official or reflecting the views of the Navy Department or the naval service at large. From the Bureau of Medicine and Surgery, Navy Department, Research Task No. M4305.12-3004. Field work for this project was accomplished while the authors were assigned to the U. S. Navy Preventive Medicine Unit, Naval Support Activity, Danang, Vietnam. This material was fixed and preserved in formalin and later sectioned and stained with hematoxylin and eosin. All observations were made with a compound brightfield microscope. Measurements were taken on fresh material using a calibrated ocular micrometer, and drawings were prepared from sketches made with the aid of a camera lucida. Measurements are in microns, with means in parentheses following the range. DESCRIPTIONS OF PARASITES Eimeria korros sp. n.

Susceptibility of Certain Japanese Mosquitoes to Plasmodium gallinaceum and Plasmodium berghei

Nine species of mosquitoes in Japan, five under laboratory colonization, Armigeres subalbatus (Coq.), Aedes albopictus (Skuse), Aedes togoi (Theo.), Culex pipiens var. pallens Coq., and Culex tritaeniorhynchus Giles, and four species reared from wild collected larvae and pupae, Anopheles sinensis Wied., Aedes japonicus (Theo.), Culex hayashi Yamada, and Culex bitaeniorhynchus Giles, were exposed to animals infected with Plasmodium gallinaceum Brumpt and Plasmodium berghei (Vincke and Lips). The exposed mosquitoes were dissected at prescribed intervals and examined for oocysts and sporozoites. Cage mates of these mosquitoes were allowed to feed on susceptible animals to determine abilities to transmit the infections. Four species, A. subalbatus, A. albopictus, A. togoi, and A. japonicus were capable of developing oocysts and sporozoites of P. gallinaceum and transmitting the infection to susceptible chicks. There was no evidence that A. sinensis, C. pipiens pallens, C. hayashi, and C. bitaeniorhynchus were susceptible to this parasite. None of these mosquitoes developed oocysts or sporozoites of P. berghei, nor were they capable of transmitting the infection to young white mice. Several species of mosquitoes in Japan were established in laboratory colonies at the U. S. Navy Preventive Medicine Unit No. 8 at Yokosuka, Japan, in 1955-56 (Weathersby, 1962). These mosquitoes, together with other species reared in the laboratory, from larvae and pupae collected in nature, were studied with regard to their susceptibilities to Plasmodium gallinaceum Brumpt and Plasmodium berghei (Vincke and Lips). The susceptibility of some of the species has been reported previously and is included here for additional information and comparison. A review of the literature regarding susceptibility of mosquitoes to avian malarias was written by Huff (1954) in which detailed tables were included. Ninety-seven species of mosquitoes were listed as being susceptible to one or more (eleven) species of Plasmodium. Nineteen Plasmodium are listed for which no susceptible mosquitoes are known. Thirty-two species of mosquitoes have been shown to be susceptible to P. gallinaceum since Brumpt described the parasite in 1935. Five mosquitoes are known to become infected with Received for publication 16 February 1962. * The opinions or assertions contained herein are the private ones of the writer and are not to be construed as official or reflecting the views of the Navy Department or the naval service at large. P. berghei (Vincke and Lips, 1950; Yoeli and Wall, 1951; Yoeli and Most, 1960).

Shunsennia biplumulosa, a New Species of Chigger from Japan (Acarina: Trombiculidae)

Body: Body size derived from measurements in microns of four partially engorged specimens. Length, 400 to 562, average 497; width, 237 to 326, average 300. Color, pale orange. Double eyes present, though small, inconspicuous and well removed from the lateral margin of the scutum. Spiracles and tracheae absent. Anal opening slightly anterior to midpoint from coxa III to posterior margin, probably varying with the degree of engorgement. Gnathosoma: Cheliceral base and palpal femur punctate. Cheliceral blade with five minute ventral teeth and a tricuspid cap. Palpal femoral and genual setae with rather long side branches. Lateral palpal tibial seta simple. Dorsal and ventral palpal tibial setae with short barbs. Palpal claw apparently two pronged. Palpal tarsus with six feathered setae and a short spine. Galeal seta simple. Legs: All legs with six segments ending with two claws and a claw-like empodium. Coxal setae 2-2-2 (one specimen had three setae on one coxa I). With the following specialized setae: Leg I, 2 genualae, 1 microgenuala, 2 tibialae, 1 microtibiala, 1 spur, 1 subterminala, 1 pretarsala; leg II, 2 genualae, 1 microgenuala, 2 tibialae, 1 microtibiala, 1 spur, 1 pretarsala; leg III, 1 genuala, 1 tibiala. The description of S. tarsalis, J. and T., the genotype species, mentioned the considerable variation in degree of feathering on the leg The same condition was noted on the leg setae of S. biplumulosa. Scutum: Broadly rectangular, about three times as wide as long; anterior margin slightly convex mesally and posterior margin with a definite concavity. Scutal setae similar in diameter and quality. Sensillae simple. Scutal measurements (mean of four specimens): AW-99, PW-127, SB-41, ASB-47, PSB-22, AP-42, AM-86, AL-71, PL-93, SD-69, S-95. Setae: Approximately 60 to 63 dorsal setae and 68 to 77 ventral setae, irregular in arrangement and variable in form from plumose to barbate. The dorsal setae varied in length from 80 to 105, while the ventral setae varied from 32 to 88, the shorter, anterior setae being more plumose than the longer, posterior setae. There seemed to be no definite humeral setae. A single pair of sternal setae was located between coxae II and III. Type data: Holotype, taken from a shrew-mole, Urotrichus talpoides, Mt. Fuji, Yamanashi Prefecture, Japan, August 17, 1954; deposited in the United States National Museum, No. 2222. One paratype, same data as the holotype, deposited at the Medical Zoological Laboratory, Institute for Infectious Diseases, University of Tokyo. One paratype, same data as the holotype, deposited at the Rocky Mountain Laboratory, Hamilton, Montana. One paratype, same data as the holotype, retained by the author. All collections were made by personnel of the Preventive Medicine Unit, Third Marine Division.

Preventive Medicine Unit: Army Medical Service

Preventive Medicine Unit: Army Medical Service