Medicine: Mumu, Bye-Bye

Moving from the jungle was a native with elephantiasis . . . pushing a rude wheelbarrow before him. In the barrow rested his scrotum, a monstrous growth that . . . weighed more than 70 pounds and tied him a prisoner to his barrow.

Few descriptions of a tropical disease have revolted more readers than this passage in James A. Michener's Tales of the South Pacific. In World War II, mumu,* or filariasis, which produces elephantiasis in its late stages, terrified U.S. fighting men in the Pacific as much as did the enemy. Some 15,000 U.S. servicemen were infected, but thanks largely to their being moved quickly out of the area, none got elephantiasis and few had any severe aftereffects.

Last week Dr. John F. Kessel of the U.C.L.A. School of Medicine reported that a postwar drug, combined with vigorous mosquito control, has all but eradicated mumu from Tahiti and nearby islands. Next to be attacked is American Samoa. Dr. Kessel and his U.C.L.A. team, encouraged by Samoa's Governor H. Rex Lee, will start work there this month.

Coconuts & Canoes. Filariasis infects some 190 million people in the tropics. In the Pacific it is contracted from the bite of a mosquito, which deposits microscopic juvenile forms of a nematode, Wuchereria bancrofti, in the skin. In the human victim, the roundworms mature to a length of 1½ in. to 3 in. They live and multiply almost exclusively in lymph nodes, especially the big nodes in the arm pits, groin and scrotum. Their tiny offspring are picked up from a victim's bloodstream by a feeding mosquito—soon to infect another victim.

An expatriate U.S. yachtsman named William Albert Robinson, who lives in Papeete and had a touch of filariasis himself, interested Dr. Kessel in a campaign to rid Tahiti of the wormlets. Kessel trained a staff of Tahitian technicians, showed a film that taught natives where the mosquitoes bred—in holes in trees and rocks, in abandoned canoes, in tin cans, rain barrels, gasoline drums and worn-out tires, in coconuts half eaten by rats—and how to destroy the breeding places.

Broken Cycle. Dr. Kessel's most potent weapon was the drug diethylcarbamazine (Lederle Laboratories' Hetrazan). It does not kill all the adult worms or directly cure a full-blown case of filariasis, but it prevents reinfection by killing the wormlets in their early, vulnerable phase.

Of 40,000 Tahitians, all but a handful have taken Hetrazan. In five years, the incidence of filariasis has dropped from 40% to less than 5%, and elephantiasis has all but disappeared. Dr. Kessel expects the same results in Samoa, where filariasis in some areas is up nearly 100% since 1948.