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Jake Walk in Vietnam

Ann Intern Med. 1977;86(5):665-666. doi:10.7326/0003-4819-86-5-665_2
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To the editor: The recent paper by Morgan and Tuloss, "The Jake Walk Blues" (Ann Intern Med 85:804-808, 1976) on paralytic disease caused by poisoning with triortho-cresyl phosphate, reminded me of tragic outbreaks of this affliction that occurred in the Quang Tri Province of Viet Nam during 1970-71.

While serving with a medical assistance team, (Navy MILPHAP N-4), assigned to work within the local health care system in the northernmost province of South Vietnam, I observed small clusters of Vietnamese patients with newly developing spastic quadriplegia. This epidemic paralysis peculiarly attacked family groups. As noted by Morgan and Tuloss, muscle


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