Abstract
Tetanus as a complication of vaccination against smallpox, while rare, has occasionally developed in the United States. During the past fourteen years cases have occurred in thirty-two states and in the District of Columbia. The complication, however, is almost unknown in Europe and the same condition appears to be true for other portions of the world, although so far as our information goes traumatic tetanus occurs everywhere. CHARACTER OF THE ATTACK The symptoms of postvaccination tetanus do not differ from those of severe traumatic tetanus. The onset is usually from eighteen to twenty-four days subsequent to the vaccination. The first symptoms noted may be difficulty in swallowing or in opening the jaws, or stiffness of the muscles of the back or limbs. Trismus, general spasticity, opisthotonos and generalized convulsions usually develop rapidly. From 75 to 80 per cent of the cases prove fatal, many of them within twenty-four hours from
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