Tetanus, 2000

Two cases of tetanus were reported during 2000. The first case occurred in a 34-year-old, white, non-Hispanic male with no history of tetanus immunization as an adult. He presented at a regional hospital emergency room in greater Minnesota following a seizure which occurred 13 days after a puncture wound caused by stepping on a nail. Sixteen days after the injury, he developed arm pain, arm and jaw stiffness, and numbness. He received Td, TIG, and intravenous penicillin. The case was hospitalized for 9 days, including 3 days in intensive care.

The second case occurred in a 65-year-old, white, non-Hispanic female with no history of tetanus immunization. She sustained a knee laceration after falling on railroad ties and subsequently received tetanus toxoid within 6 hours of the injury. One week later, she was hospitalized for general tetanus symptoms and received TIG. She was hospitalized for 41 days, during which time she was on mechanical ventilation for 30 days.

Tetanus is preventable through adequate vaccination. Due to the extreme potency of tetanus toxin, tetanus disease does not confer immunity. Therefore, completing the vaccination series is recommended for previously unvaccinated persons who develop tetanus. Tetanus cases occur almost exclusively among persons who are unvaccinated or inadequately vaccinated. A recent serologic survey of immunity to tetanus found that although 80% of persons 6 to 39 years of age had tetanus immunity, the prevalence of immunity dropped sharply with increasing age; only 28% of persons 70 years of age or older were immune.

• For up to date information see>> Tetanus
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2000