INVESTIGATIONS IN TETANUS IN NARCOTICS ADDICTS IN NEW YORK CITY

Cherubin, Charles E (Harlem Hosp., N.Y., N.Y. 10037), S. J. Millian, E. Palusci and M. Fortunato. Investigations in tetanus in narcotics addicts in New York City. Amer. J. Epid., 1968, 88: 215–223.—A serologic investigation of addicts indicated that differences in protective levels of tetanus antibody between male and female addicts were insufficient to explain the increased risk of the disease among women addicts. Neither were there ethnic differences in antibody protection that would explain the focus of the disease that exists among Negro addicts in the Harlem area. An interview survey of addicts on a detoxification ward revealed an unexpected pattern of “skin popping” (subcutaneous injection) in “Upper Manhattan”, the Harlem area. Only 6 per cent of women addicts from other areas usually used this method, whereas this was true of 25 per cent of women in this area. Of men addicts from Harlem, 9 per cent were usually “skin poppers” as compared to 2 per cent of men addicts from other areas. Similar differences were also found in the temporary use of this method among addicts who were usually “main-liners”. These findings seem to explain the observed increased risk of tetanus among addict women and particularly in the Harlem area. A substantial fraction of addicts were unprotected against tetanus by humoral antibodies. Since tetanus is an “occupational” disease of addicts, the need for the development of tetanus immunization programs for the addicted population is indicated.