138

EDITORIALS AND COMMENTS

tissues. It may act either by inhibition of establishment of cellular infection when administered before the virus, or by interference with infection of
cells beyond the affected area when applied after
infection has already occurred. The absence of
interferon from lungs of fatal human cases of influenza A2 infection,'2 and its presence in lungs of
mice which recovered from experimentally induced
influenza infectionsj suggest that interferon may
promote recovery by limiting spread of viruses
within tissues. The feasibility of parenteral administration of sufficient concentrations of interferon to
inhibit spread of viruses which have already infected human parenchymatous organs must await
D.M.M.
further investigation.
REFERENCES

1. IsAACS, A. AND LINDENMANN, B.: Proc. Roy. Soc. [Biol.].

147B: 258, 1957.
2. PORTERFIELD, J. S.: Lancet, 2: 326, 1959.
3. Su.roN, R. N. P. AND TYRRELL, D. A. J.: Brit. J. Exy.

Path., 42: 99, 1961.

4. ANDREWS, R. D.: Brit. Med. J., 1: 1728, 1961.
5. 1sAAcS, A. AND WESTwooD, M. A.: Laacet, 2: 324, 1959.

6. ISAACS, A. AND HiTcHcocK, (1.: Ibid., 2: 69, 1960.

7. Hinciicoci., G. AND ISAACS, A.: Brit. Med. J., 2: 1268, 1960.
8. ISAACS, A.: In: Perspectives in virology, Vol. 2, edited

by M. Pollard, Burgess Publishing Co., Minneapolis.

Minn., 1960, p. 117.
9. IsAAcs, A.: Virology, 10: 144, 1960.

10. Medical Research Council, Scientific Committee on Inter-

feron: Lancet, 1: 873, 1962.

11. JoNes, B. R., GALBRAITH, J. E. K. AND AL-HUssAINI, M.

K.: Ibid., 1: 875, 1962.

12. BARON, S. AND IsAAcs, A.: Brit. Med. J., 1: 18, 1962.

STERILIZATION OF SYRINGES
A BOOKLET has recently been issued by the
-.United Kingdom Medical Research Council
that should prove invaluable to all those responsible
for the preparation and use of syringes, either in
small or in large numbers. As Memorandum No. 41
on "The Sterilization, Use and Care of Syringes,"' it
is a completely rewritten edition of the well-known
war-time Memorandum No. 15, published in 1945.
The emphasis and some of the practices advocated in this document apply less to Canada than
to the United Kingdom, but many of the points
which are stressed are universally applicable. For
example, we are reminded that sterilization may
fail if the syringe and needle are not scrupulously
cleaned before sterilization. Sterility can only be
guaranteed if the syringe and needle, thoroughly
cleaned, are held at a suitable high temperature for
a sufficient time in hot air or in steam under pre.sure. Exposure to boiling water, chemical disinfectants and hot oil is unsatisfactory.
Because of the difficulty of ensuring adequate
circulation of steam around and through the syringe
and needle in a container, and the necessity for
subsequent drying, hot air is to be favoured over
steam under pressure. The recommended exposure
for syringes and needles sterilized in hot air is
given as 16O. C. for a minimum of one hour. Longer
periods are advised for large loads, and the temperature inside ovens should be checked in several

Canad. Med. Ass.

July 21, 1962, vol. J.87

positions to ensure that heat is uniformly distributed. Lubrication of syringes is not strictly
necessary, and it may interfere with sterilization
when moist heat is used. When lubrication is used
to improve compression, fluid silicones are favoured
rather than liquid paraffin which is regarded as unsatisfactory.
For those who doubt the importance of syringetransmitted infections, an appendix is provided to
this pamphlet that lists 50 references to instances
of infection following injection.
Although this memorandum makes mention ef
disposable syringes and needles, the impression
is given that they are unlikely to merit serious
consideration for some time to come and that even
then they will be unsuitable for some procedures.
On this continent, sterile disposable syringes and
needles are already widely used, and there are very
few procedures for which a sterile disposable kit
cannot be obtained. The cost of some disposable
items is already below the normal cost of breakagereplacement of their glass counterparts. Some fear
has been expressed that a complete changeover to
disposables would create a difficult situation in an
emergency or disaster if factories or communications were destroyed and, as well, there are people
who are not convinced that disposables are a
reasonable economic proposition. However, the advantages of convenient packaging and of guaranteed sterility of syringes with new sharp needles
seem to outweigh any economic or other benefits
associated with questionably sharp, doubtfully
sterile and awkwardly packaged traditional syringes
and needles.
The procedures laid down in the new M.R.C.
Memorandum are a valuable guide, and if followed
to the letter should lead to confidence in the sterility
of the traditional syringes and needles supplied by
the average hospital. However, knowing that less
than perfect procedures are likely to obtain in
practice-in particular, failure to clean needles
properly-leaves one with the uneasy feeling that
sterility cannot be guaranteed. Nor should it be
forgotten that few bacteriologists will have available the time and facilities to carry out dependable
tests on the sterility of re-used needles. Furthermore, the cost of the high-voltage sterilizing apparatus which enables manufacturers to give guarantees of sterility is .vell beyond the budget of the
most wealthy hospital. Perhaps, then, it is not unfair
to suggest that glass syringes and re-usable needles,
if not already obsolete, cannot be justifiably recommended for the majority of injection procedures.
E.P.
REFERENCE

1. Medical Research Council, Working Party on Sterilization

of Syringes: The sterilization, use and care of syringes,
Medical Council Memorandum No. 41 (revision of War
1\lemorandum No. 15), Her Majesty's Stationery Office,
London, 1962.