The courier-index., 1917-11-23
Little Rock, Nov. IT, 1917.

Little Rock. Nov. IT, 1917 To the Public.
 A good deal of uneasiness has been occasioned by the appearance of several cases of tetanus in tho state and especially by the report of tetanus sent out by the city health department of Memphis The State Board of Health has made a very thorough canvass and herewith sub mits the following report of the cases notified.
 Since May Of this year fifteen cases of tetanus have occurred within the state. with nine deaths. Twelve cases occurred outside of the city of Little Rock, with six deaths. Of these twelve cases. four who had not been vaccinated developed the dis ease, one from gun shot wound; one following punctlre wound of the foot with rusty nail; another follow ing introduction of needle in the foot; and the other from crushing injury to the foot. Of the other eight all of them had sores or abra- sions of the skin somewhere on the body. One of them had received an injury to the foot by rusty iron; another had stuck a splinter through his toe; another had sores on his legs and puncture wound on his heel stimulating nail puncture, and had been riding bareback a great deal; another had had the scab from vaccination knocked off with whip and the wound was dressed with a dirty cloth; another had sores on the legs and feet which were supposed to be the entrance of infection.
 Another point about most of the cases is that tetanus developed four or five weeks after vaccination. in some instances after the vaccination had practically healed. The incuba- tion period of tetanus is from ten to fourteen days. Thus it would seem that in practically all the cases at least vaccination was not respon- sible for the tetanus.
 Of the five deaths in Memphis, two cases had not been vaccinated and no tetanus bacilli were found in the virus. The three cases in Little Rock are problematical.
 A recent communication from Sur geon General Blue and Surgeon Gen eral Gorgas states that no evidence has been found to indicate that teta- nus was present in any of the vac cine virus, and further urges that no backward steps be taken and in- sists that any modification of the vaccination order at this time would be disastrous.
 There are now in Arkansas a num- Der of severe epidemics of smallpox in different sections of the state. and adjoining states are complaining that. smallpox contacts are coming out of Arkansas and spreading the disease
 In view of the above findings and the message from the Surgeons General, and further that no cases of tetanus have occurred within the past three weeks, the Board feels that the compulsory vaccination or der should not be modified. Many of the counties have already complied and many others are complying as rapidly as possible. Therefore. the order will remain in full force and effect.
 It is further becoming necessary to issue compulsory vaccination or ders to require all persons of all ages to be vaccinated in certain re- stricted districts where smallpox has gotten out from under control of the local health authorities and many contacts have resulted.
 The following precautions are urged by the federal, state and local health authorities, namely, that the field of vaccination be thoroughly sterilized;