An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic.

From June 1978 through December 1980, at least 36 cases of amebiasis occurred in persons who had had colonic-irrigation therapy at a chiropractic clinic in western Colorado. Of 10 persons who required colectomy, six did. Of 176 persons who had been to the clinic in the last four months of 1980, 80 had received other forms of treatment. Twenty-one per cent of the colonic-irrigation group had bloody diarrhea, as compared with 1 per cent of the non-irrigation group (P = 0.00013). Thirty-seven per cent of the colonic-irrigation group who submitted specimens had evidence of amebic infection on either stool examination or serum titer, as compared with 2.4 per cent in the non-irrigation group (P = 0.00012). Persons who were given colonic irrigation immediately after a person with bloody diarrhea received it were at the highest risk for the development of amebiasis. Tests of the colonic-irrigation machine after routine cleaning showed heavy contamination with fecal coliform bacteria. The severity of disease in this outbreak may have been related to the route of inoculation.

Blood banking in the small hospital.

This represents an attempt to briefly outline the type of blood bank and transfusion service we at Montrose Memorial Hospital have developed and utilized to supply our blood needs. Basically it is a system based on a fairly large list of known, pretested, and available donors who can be contacted quickly to supply blood upon demand. Only bare minimum stock supplies are maintained. The major problem is waste of blood, but Montrose experience continues to fall below the average for rural areas. Although the starting and maintaining of this walking blood bank was and is a complicated involved, and somewhat tedious process, we have been happy with the results and have been able to supply in an adequate fashion the blood requirements of an isolated yet extremely active population with a sophisticated medical community.