Military Jet Injectors: Hypospray Multidose

Jet Infectors - Hypospray Multidose

Background Info
The Hypospray Multidose, was a multi-use nozzle jet injector manufactured and marketed by the Robert P. Scherer Corporation of Detroit, Michigan (www.rpscherer.com).

The Hypospray Multidose model was used in both civilian and military populations between 1952 and the early 1970s.

Jet Infectors - Hypospray Multidose Jet Injector

Military Usage
Within the U.S. Armed Forces, the Hypospray Multidose emerged during the late 1950s. The photograph below, shows Lawrence E. Blackman of Darlington, South Carolina receiving the first typhus shot with a Hypospray Jet Injector at Fort Gordon in Georgia on August 26th of 1959. Mr. John R. Gordon, a representative of R.P. Scherer Corp., administers the shot. Major Sergeant Edward Sammons from the Post Surgeon’s Office observes.

Jet Infectors - Hypospray Multidose 1959 Fort Gordon
(Photo by Roy C. McManus. Post Sig Photo Lab, Fort Gordon, GA).

The Windward Marine, the newspaper for U.S. Marine Corp Air Station at Kaneohe Bay, Hawaii, documented the introduction of the Hypospray. The 1960 article, showcased below, demonstrates the Hypospray Multidose being used upon a fellow soldier.

Jet Infectors - 1960 USMC Hawaii - Hypospray Multidose

(Windward Marine, US MCAS Kaneohe Bay, April 29, 1960)

Here is a recruit receiving an immunization with the Hypospray Multidose at Fort Leonard Wood in 1967.

Jet Infectors - Hypospray Multidose Fort Leonard Wood 1967

Presently, one of the few existing Hypospray Multidose jet injectors is on display at the Public Health Museum in Tewksbury, Massachusetts.

Public Health Museum - Hypospray Multidose
(Public Health Museum, July 24, 2017)

 

Research Documented Presence of Blood & Risk of Hepatitis
Numerous studies have documented the presence of blood when using the Hypospray Multidose. One of these studies, even warned of the risk of transmitting hepatitis via jet injection.

  • The mass Salk Polio vaccination campaign was the first major field-trial of jet injectors. Dr. Robert Hingson, who had been a major contributor to the development of jet injection technology, reported during the mass Salk Polio vaccination campaigns that jet injectors produced bleeding and ecchymosis at the injection site. This campaign used several jet injectors including the Hypospray Multidose Jet Injector (Hingson et al., 1957).

 

  • Kutscher and colleagues (1962) noted bleeding at the injection site when using the Hypospray Multidose. The researchers also noted that the skin could become lacerated if the vaccinator failed to abide by the correct injection technique stated by the manufacturer. The researchers also noted, “If the patient’s arm is held on the hip with arm muscles tensed, the Hypospray may not penetrate the muscle and some portion of the injected material may rebound and not attain its target” (emphasis added). In other words the injected material would splash back onto the jet injector.

Most shockingly, in spite of the presence of blood, Kutscher cited as one of the advantages of jet injection technology was the “diminution of the problem of instrument sterilization.” Diminution is defined as a reduction in the size, extent, or importance of something. Therefore, Kutscher is stating not having to sterilize the jet injector as often as the sterilizing of needles and syringes is an advantage. The lack of sterilization leaves the possibility for cross-contamination of blood and diseases. Kutscher does state, “The Hypospray unit itself is not sterilized although the head can and should be disinfected” (Kutscher et al., 1962) but this does not guarantee the device is actually sterile. If he is reporting splash back, lacerations from improper injection technique, and bleeding at the injection site then more than just the head of the jet injector needs to be sterilized.

  • In 1967, Dr. Sol Rosenthal studied the transference of blood by various inoculation devices amongst school children. “The ever expanding, mass skin-testing and vaccination programs, the newer methods of inoculation, and the mounting incidence of viral hepatitis prompted this study,” said Rosenthal. “It was reasoned that if the detection of the transference of erythrocytes (hemoglobin) or serum could be assayed, one might infer that the parenteral hepatitis agent would likewise be transferred” (Rosenthal, 1967).

Rosenthal compared the use of syringes to the Hypospray Multi-dose K-3 jet injector. He found the presence of enough blood capable of contaminating the next child in 1.2 percent of cases with syringes and in 17 percent of cases on the injector nozzle. This is worth reiterating, in 1967 Rosenthal raised concern when he found there was enough blood detected on the jet injector nozzle to transmit blood-borne pathogens (Rosenthal, 1967; Weniger & Papania, 2008).

  • Gross and colleagues studied a mass vaccination campaign of children within the County of Los Angeles which used Hypospray Multidose jet injectors. These researchers found, “A drop of blood or vaccine following an injection was encountered less than 12 percent of the time” (Gross et al., 1970).

 

  • German researchers, Horn, Opiz and Schau (1975), found through their investigations of the Hypospray Multidose that the risk of cross-contamination to subsequent patients was not only possibly but a concern which needed to be addressed. Horn warned of the risk of spreading hepatitis via jet injection:

We were able to demonstrate by direct staining of material obtained from the nozzle, that this part of the injector becomes contaminated with material originating in human white blood corpuscles. These findings are very similar to those of Hughes with syringes and have an obvious implication in relation to the transfer of hepatitis virus by jet injectors (emphasis added) (Horn, Opiz & Schau, 1975).

 

References:

  • (Gross et al., 1970) Gross PA, Grigsby SF, Kogan BA, Heidbreder GA. Jet injector: appraisal of its use in a local setting. Am J Public Health Nations Health. Sep 1970;60(9) 1839-1844.
  • (Hingson et al., 1957) Hingson RA, Davis HS, Bloomfield RA, Brailey RF. Mass inoculation of the Salk polio vaccine with the multiple dose jet injector. GP [General Practice] 15:94–96, 1957.
  • (Horn, Opiz & Schau, 1975) Horn H, Opiz B, Schau G. Investigations into the risk of infection by the use of jet injectors. Health and Social Serv J 85:2396–2397, 1975.
  • (Kutscher et al., 1962) Kutscher AH, Hyman GA, Zegarelli EV, et al. A comparative evaluation of the jet injection technique (Hypospray) and the hypodermic needle for the parenteral administration of drugs: a controlled study. Am J Med Sci 54:418–420, 1962.
  • (Rosenthal, 1967) Rosenthal SR. Transference of blood by various inoculation devices. Am Rev Respir Dis. October 1967; 96(4):815-819.
  • (Weniger & Papania, 2008) Weniger BG, Papania MJ. Alternative Vaccine Delivery Methods [Chapter 61]. In: Plotkin SA, Orenstein WA, Offit PA, eds. Vaccines, 5th ed. Philadelphia, PA: Saunders (Elsevier); 2008;1357-1392.

© Shaun Brown and Jet Infectors, 2016 – 2017
Fair Use Notice (17 U.S.C. § 107)


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