Inquiry indicates that there are many variable factors in the reporting of amebiasis/amebic dysentery in the United States. In some States, cases of amebic dysentery only are reported while in other States reports include cases of amebiasis. In one State, reports are based on clinical evidence alone, while in 16 States diagnosis is confirmed by laboratory examination before the case is reported. In other States, some of the reported cases are confirmed by laboratory examination. Replies indicate that in 13 States, cases of infection disclosed by routine laboratory examination of stools are included in reports without clinical examination or reference of the report to the physician. Information on these various points is not available for certain States either because replies were equivocal or because of failure to answer the specific questions.
Over the past 15 years, there has been a gradual increase in the number of reported cases of amebiasis/amebic dysentery, with a more marked increase since 1945. Admissions to Veterans Administration Facilities have also increased since that year but it is not believed that such admissions account entirely for the increase in reported cases.
During the above-mentioned period, a gradual decrease has taken place in reported deaths from amebiasis/amebic dysentery. This decrease has not been as spectacular as has the decrease in deaths from bacillary dysentery. Deaths from unspecified dysentery have been out of proportion to reported cases and some of these deaths may have been due to amebic dysentery.
On the basis of cases reported, morbidity rates, and deaths reported, it would appear that amebiasis is more prevalent in the West South Central States, comprising Arkansas, Louisiana. Oklahoma, and Texas, than in any other part of the United States. There is evidence that the disease is more widespread in the Southern States as a whole than in any other section, with the possible exception of the Pacific Coast States, where the morbidity rate is comparatively high. On the other hand, New England ranks lowest in all of the above-mentioned categories.
It would appear that up to the present time the return of infected military personnel to the United States has influenced very little the amount of reported amebiasis in this country.
Chief, Laboratory of Tropical Diseases, National Institutes of Health, U. S. Public Health Service, Bethesda, Md.