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1932]
44
three deaths were reported from Tetanus after the Independence Day rejoicing's.
Besides our Islington case, other cases from toy pistol injuries with infection of the
wound by Tetanus have been reported in May, 1928, a youth, 18 years old, in
York, who recovered; a butcher's assistant, aged 17 years, in London, in April,
1932, who died; and a man, aged 50 years, in London, in March, 1932, who died.
How the Infection is caused.—The bacilli appear to enter the wound
in the part of the charge which penetrates to the deeper tissues or to be carried
in from the skin, or to be introduced at a later date, although the last seems least
likely. The wad which keeps the powder in the end of the cartridge is said to be
made of hair felt, which might convey spores. Several samples of the same brand
of blank cartridge marked with "E" were purchased for investigation. Some of
the boxes containing them were marked "Made in France," the others appeared to
be British made, but each was impressed with the mark of the same maker.
These cartridges were submitted for bacteriological examination. At first, although
a number were examined, Tetanus was not found, but later it was obtained in
several cartridges, these being the ones with the hair felt, not necessarily the
foreign make. The important point is that the rough finish of the toy pistol is
very apt to cause an abrasion of the skin of the hand or finger, or in the firing when
pulling the trigger. The number of cases is small, and fatalities can be avoided
if proper surgical treatment is obtained and prophylactic treatment with antitetanus
serum is given at an early stage.
The cartridges which had apparently paper material as a wad did not show
Tetanus. The strain of Tetanus obtained from the cartridges was a very virulent
one. The question, quite apart from taking precautions after an accident which
occurs to one, is that it would be better if hair felt is used in making these wads
that it should be first thoroughly sterilized.
REPORT ON THE STERILITY OF MATERNITY OUTFITS EXAMINED
IN ISLINGTON DURING THE YEAR 1932.
An enquiry was made as regards the sterility of maternity outfits commercially
sold. It was ascertained as regards practising midwives that it was usual not to
buy the outfits as sold, but to prepare their own if occasion required. A sample
maternity outfit was obtained from two places. As it happened, the maker was
the same, a wholesale firm not in this Borough. These outfits were sent for
bacteriological examination to separate bacteriologists, one on the 10th December
and the other on the 16th December. The Medical Officer of Health received a
telephone message regarding the non-sterility shortly after the first was sent, and
later from the same source intimation was given that the Bacillus Welchii had
been found, and that therefore the outfit could not be considered safe. Meanwhile,
upon receipt of the first message on the non-sterility, the whole stock of the outfits
had been handed over to me by request and were properly sterilized at our disinfecting
station, and returned. Upon intimating to the manufacturer who had
supplied the outfits that these alleged sterilized outfits were not sterile (that when
cultures were made growths of the following bacteria were obtained from the
cotton wool, Bacillus Welchii; from the lint, Bacillus Subtilis; from sanitary towels
examined, Bacillus Welchii), and asking for an explanation, the reply was that
the question of efficient sterilization had had their close attention for several
months, and that as a result of tests made, the firm had decided towards the end