Tuberculous Infection of Nurses the Health of The

1212 DEC. 12, 1936 TUBERCULOUS INFECTION OF NURSES MTEBRITDS1AJRN -93 to 16. Despite a marked increase in the number of TUBERCULOUS INFECTION OF NURSES cases of malaria in Iraq, the total figures for this disease show a satisfactory diminution. There was a small outbreak MEMORANDUM BY JOINT TUBERCULOSIS of intestinal schistosomiasis, apparently the result of bathing COUNCIL in a stream-the Wadi Tiban-in the Aden hinterland. This At a meeting of the Joint Tuberculosis Council on is the first recorded instance of infection of Europeans with November 21st a report of a subcommittee on tuberculosis Schistosoma mansoni in Southern Arabia. Of a party of infection among nurses was considered. Before submitting twelve R.A.F. personnel who bathed in this stream all subse- its report the subcommittee had communicated with a quently showed a marked eosinophilia, and four were admitted large number of hospitals and sanatoria, and replies had to hospital with intermittent gastro-enteritis and mild fever; bean received from thirty-eight of these. It was perhaps in only one case were the ova of Schistosomna mansonti actually unfortunate that most of the replies had come from discovered. A course of intravenous tartar emetic reduced special institutions for tuberculous patients, for in these the eosinophil count to normal within three or four months. special precautions are usually taken to which less Transfer of Casualties Air attention would possibly be given than in general by hospitals. Whether this is so or not, the replies did not During the year under review a total of 282 patients were modify the impression previously formed by the sub- evacuated by air in 164 flights over 46,995 miles, as compared committee that the risk of -infection is likely to be higher with 173 patients in 122 flights over 28,516 miles in the in general hospitals which occasionally receive tuberculosis previous year. These figures do not include those for India. cases than in the special institutions. On one occasion a naval rating requiring hospital treatment was transferred from a warship, operating in the Persian Gulf Age of Entry of Probationers near the Elphinstone Inlet, to a flying boat, !which transported him to the R.A.F. General Hospital at Hinaidi, a distance Particular consideration was given to the age at which of 900 miles. In December the wireless operator of a survey probationers are employed. The age at entry is usually party working at Masirah, Southern Arabia, was reported 18 years, but a shortage of candidates has reduced this dangerously ill. A medical officer flew from Basra, a flight age to 17 in some areas. In view of the special suscepti- of approximately 1,050 miles, and the patient was success- bility of adolescent females to develop pulmonary tuber- fully evacuated by air to the civil hospital at Muscat. Again, culosis it was considered undesirable that young girls in the same month an outbreak of small-pox occurred at should be employed, and the recommendation was made Sharjah, an Imperial Airways resthouse on the Persian Gulf. that no probationer under the age of 18 years should be A medical officer was immediately despatched by air to accepted for work in wards occupied by phthisical vaccinate the employees of the company and to investigate patients. It was, however, pointed out that the actual the outbreak. age limit was probably of much less importance than the degree of care given to the conditions under which young The Quetta Earthquake nurses work. Following the earthquake at Quetta aircraft were extensively The hours of work at the institutions replying to the employed to bring medical aid to the stricken area. During questionary varied from forty-eight to seventy-seven per three weeks in June thirteen machines, operating from week, the average for probationcrs being about sixty Risalpur, Peshawar, Kohat, Lahore, Ambala, and Karachi, hours. This is somewhat longer than the period recom- conveyed to Quetta one complete medical unit, fifteen medical mended by the College of Nursing. officers, eleven nurses, more than 12,000 lb. of medical stores and tinned food, 4,300 lb. of clothing, and large quantities Importance of X-Ray Examination of antitetanic serum. Eighty-eight adults and forty-eight children were evacuated by air from Quetta to Karachi, The importance of medical examination of nurses who Lahore, and Risalpur. This number included three stretcher are exposed to the risks of infection, both at the time of cases; the remainder were sitting cases, most of whom were commencing work and subsequently, is obvious, but in suffering from minor injuries or shock. The report also only about half of the institutions does this include alludes to a flight of unusual interest, when two aircraft an x-ray examination. As radiography is the most impor- conveyed a consignment of plague vaccine to Gilgit for tant method of detecting incipient tuberculosis a skiagram to in Chinese at the time of a nurse's entry is insufficient. The Joint delivery Kashgar Turkestan. Tuberculosis Council recommends that x-ray examination should be repeated at least annually where nurses are serving tuberculous patients with open pulmonary lesions. STUDENTSHIPS AND RESEARCH FELLOWSHIPS In some sanatoria x-ray examination of the chest is a routine whenever malaise, lassitude, or cough indicates the The Medical Research Council arnounces that it has made the possibility of early disease. following awards of post-graduate studentships and research fellowships in clinical science and experimental pathology for the year 1936-7. Post-Graduate Studentships: John Vivian Dacie, M.B., THE HEALTH OF THE ROYAL AIR M.R.C.P., resident pathologist, King's College Hospital, London; James Hardman, M.B.Birm., F.R.C.S., clinical FORCE assistant in surgery, Royal Infirmary, Sheffield; Alan Robert Kelsall, B.Chir., late house-physician, St. Bartholomew's REPORT FOR 1935 Hospital, London; Mrs. Freda Bury Pratt, M.D.Liverp., late assistant clinical pathologist, Elizabeth Garrett Anderson The Report on the Health of the Royal Air Force for Hospital, London. 19351 records a decrease, in the incidence of sickness of Research Fellowships: Leslie Ivan Mark Castleden, M.D., 6 per 1,000, resulting in the lowest figure since the honorary medical tutor, British Post-Graduate Medical School, inception of these reports. The mortality rate shows an London; Denys Arthur Jennings, B.M., B.Ch., late house- increase to 4.8 per 1,000, but this is chiefly attributable physician, St. Thomas's Hospital, London; Miss Joyce to the earthquake at Quetta, which was the cause of Wright, B.M., B.Ch., late assistant bacteriologist, Nev fifty-two deaths. As in previous years injuries constituted Somerset Hospital, Capetown. the principal cause of medical non-effectiveness, followed These studentships and fellowships are awarded for work by gonorrhoea and infections of the upper air passages. in Great Britain on a whole-time basis ; their objects are to The last-named group showed a marked increase, especially encourage young British medical graduates of special ability among the apprentices. and original mind towards becoming investigators in those branches of medical science which are concerned directly with Diseases Abroad disease as it occurs in human beings. The studentships are The incidence of dysentery decreased from 17 per 1,000 awarded for personal maintenance during a year's training in in 1934 to 7 per 1,000 in 1935; this was chiefly accounted research methods under a suitable director, and the fellow- for by a decline in the number of cases at Hinaidi from ships as probationary appointments for research on specific 'London: H.MI. Stationery Office. 1936. (2s.) problems of disease..

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