Incidence Of Tetanus Research Articles

Analisis Perilaku Ibu Berstatus Mahasiswi Pasca Sarjana Kesehatan Masyarakat Universitas Indonesia (Fkmui) Terhadap Pemberian Imunisasi Anak

Imunisasi merupakan salah satu pencapaian terbesar dalam program kesehatan masyarakat yang terbukti signifikan menurunkan insiden penyakit. Tujuan penelitian untuk mengetahui analisis perilaku ibu berstatus Mahasiswi Pasca Sarjana Kesehatan Masyarakat Universitas Indonesia (FKMUI) terhadap pemberian imunisasi anak. Metode kualitatif pendekatan Rapid Assessment Procedure (RAP) berlokasi di FKMUI. Pemilihan informan menggunakan purposive sampling dengan prinsip kesesuaian (appropriateness) dan kecukupan (adequacy). Pengumpulan data dengan Focus Group Discussion (FGD) 2 kelompok masing-masing terdiri dari 6 mahasiswi pascasarjana FKM UI yang memiliki balita yang diimunisasi lengkap. Wawancara mendalam oleh mahasiswi pascasarjana yang memberikan imunisasi tidak lengkap, dan yang tidak memberikan imunisasi serta Pegawai Kementerian Kesehatan Subdit Imunisasi Ditjen P2P sebagai triangulasi sumber. Hasil penelitian menyebutkan sebagian besar informan mempunyai pengetahuan yang baik, sikap yang positif. Seluruh informan sepakat media informasi penting untuk keberhasilan program imunisasi terutama untuk menangkis isu ataupun hoax seputar imunisasi. Sebagian besar informan mendapatkan dukungan dari keluarga untuk memberikan imunisasi anaknya sehingga status imunisasi anak lengkap, namun ada informan yang tidak mendapatkan dukungan keluarga terdekat yaitu suami, hal ini membuat status imunisasi anaknya tidak lengkap. Dukungan keluarga dan media elektronik memiliki pengaruh besar dalam memotivasi ibu untuk memberi imunnisasi kepada anaknya. Disarankan untuk lebih berhati hati dalam memilah informasi yang masuk agar kesehatan anak dan lingkungan tetap terjaga dengan baik

Incidence of Tetanus and Diphtheria in Relation to Adult Vaccination Schedules.

The World Health Organization (WHO) does not recommend routine adult booster vaccination for tetanus and diphtheria after completion of the childhood vaccination series. However, many countries continue to implement adult booster vaccinations, leading to the question of whether this is necessary to reduce the incidence of these 2 rare diseases. We conducted an observational cohort study based on WHO case reports from 2001 through 2016. We compared the incidence of tetanus and diphtheria in 31 North American and European countries that either do or do not recommend adult booster vaccination. Countries that vaccinate adults every 5-20 years (group 1) were compared with countries that do not routinely vaccinate adults for tetanus or diphtheria (group 2). Comparison of group 1 vs group 2 revealed no significant decline in tetanus incidence rates among countries that vaccinate adults (P = .52; risk ratio [RR] = 0.78; 95% confidence interval [CI], .36 to 1.70). The risk of contracting diphtheria was increased among countries that vaccinate adults due to inclusion of Latvia, a country that had poor vaccination coverage (P < .001). However, if Latvia is excluded, there is no difference in diphtheria incidence between countries that do or do not routinely vaccinate adults (P = .26; RR = 2.46; 95% CI, .54 to 11.23). Review of >11 billion person-years of incidence data revealed no benefit associated with performing adult booster vaccinations against tetanus or diphtheria. Similar to other vaccines, this analysis supports the WHO position on adult booster vaccination and, if approved by governing health authorities, this may allow more countries to focus healthcare resources on vulnerable and undervaccinated populations.

Five years study of mortality and morbidity patterns of Tetanus cases in a Tertiary Care PICU (Pediatric Intensive Care Unit), Multan Pakistan.

Objectives: Tetanus is an avoidable disease. Significant reduction in the incidence of tetanus is observed around the globe but in Pakistan, its incidence is still high. The objective of current study was to determine the demographic, clinical features, outcome and complications of tetanus patients admitted in Pediatric Intensive Care Unit (PICU). Study Design: This Descriptive-observational study. Setting: At PICU of The Children Hospital &amp; ICH Multan Pakistan. Periods: 1st January 2013 to 31st December 2017. Material and Methods: A total of 77 tetanus cases admit through the study period in PICU. Clinical features, complications, duration of stay and outcome of 77 tetanus cases during study period were noted. Results: Amongst a total of 77 cases, 62 were male (80.6%) and 15(19.4%) female. Most (57.1%) were between 2 to 7 years. Twenty five (32.4%) were unvaccinated, 52 (67.6%) partially vaccinated. According to the grade of severity (Ablett classification), majority (40) were of grade-III. Regarding the outcome, 15 (19.5%) expired. Conclusion: Tetanus is a fatal disease with high mortality rate. Vaccination and right management of the disease are the best options to minimize the load of tetanus in our country.

Guidelines for the use of post-traumatic tetanus vaccines and passive immune preparation

Post-traumatic tetanus is the main type of non-neonatal tetanus. To reduce the incidence and mortality rate of tetanus and guide the primary medical institutions to prevent and control tetanus after trauma, National Immunization Planning Technical Working Group of the Chinese Center for Disease Control and Prevention has compiled this document in the reference with Position Paper by World Health Organization, the latest research progress from home and abroad. The guidelines focus on the basic procedures for the prevention and disposition of post-traumatic tetanus, the application of tetanus vaccines and immune preparation, and the pre-exposure immunization in high-risk populations of trauma.

Improving immunization strategy and promoting the development of tetanus prevention and control in China

Neonatal tetanus has been basically eliminated in China, but the incidence of non-neonatal tetanus is still high. Tetanus after trauma is the main type of non-neonatal tetanus. The correct application of tetanus toxoid containing vaccine (TTCV) has been neglected in the prevention of tetanus after trauma in China. On May 9, 2019, National Advisory Committee of Experts on Immunization Planning (NIAC) reviewed and approved the first guidelines for the use of TTCV and passive immune preparation after trauma, which clarified the basic process of treatment of tetanus after trauma, as well as the pointer to the use of TTCV and passive immune preparation after trauma. The main measure to prevent tetanus after trauma is to use TTCV for active immunization, and to use passive immune preparation for those without TTCV immune history. Through the construction of the top-down control and prevention system of tetanus, the change of the concept of tetanus immunoprophylaxis of medical staff is promoted. Active immunization is the main measure, but passive immunization is an added measure for the prevention of tetanus after trauma, which is of great significance to reverse the mistake of prevention of tetanus in China.

Tetanus is a difficult diagnosis in children

The sporadic incidence of tetanus, the identity of symptoms with the clinical picture of a number of common neuroinfections, the high frequency of various background pathologies create difficulties in disease diagnosing in children. On the case history example of a 3 years 9 months old child with two diseases (tetanus, enterovirus infection) that developed against the background of the active form of herpesvirus infection, an algorithm of diagnostic and therapeutic measures is presented.A differential diagnosis was made between the generalized form of tetanus and meningoencephalitis of enteroviral etiology. Lack of vaccination, living in rural areas, violation of the integrity of the skin and soil contamination testified in favor of tetanus. The clinical symptoms of tetanus were revealed: a triad of symptoms (trismus, «sardonic smile», dysphagia), tetanic cramps against a background of clear consciousness, muscle hypertonicity in the interictal period. The patient received complex treatment; 100 thousand IU of anti-tetanus serum and tetanus anatoxin were introduced. Discharged on the 23rd day of illness with recovery.

Tetanus treatment — modern aspects

In recent years, the incidence of tetanus in Ukraine has increased, due to violations in both routine active and active passive immunization, the lack of proper computer educational work and the presence of high-risk regions. The study highlights the main aspects of the epidemiology and pathogenesis of tetanus. The modern aspects of etiotropic, specific and non-specific pathogenetic, symptomatic therapy, taking into account the advantages and disadvantages of certain techniques have been analyzed. Objective. The purpose of the work is to analyze domestic and foreign literary sources in order to study and summarize the evidence base currently used, and experimental pharmacological therapy for providing medical care to patients with tetanus. Conclusions. The treatment of tetanus requires the joint efforts and coordinated interaction of doctors of many specialties: infectious disease specialists, surgeons, anaesthesiologists, and their application in practice of modern techniques taking into account world experience. An important factor in determining the outcome of the treatment of tetanus is undoubtedly the timing of the start of treatment after diagnosis.

Maternal Antibody Susceptible Vaccinated Infected Recovered (MSVIR) Model for Tetanus Disease and Its Applications in Indonesia

Tetanus is caused by Clostridium tetani bacteria that infect open wounds. Tetanus infection can cause death if not treated promply. SIR models are constructed to explain the spread of infectious diseases. Tetanus is not an infectious disease, but SIR models still can be used. Infected persons can not transmit the disease through contact. Tetanus infection is affected by the environment and first aid when injured. Lack of environment and awareness in first aid will increase the case of tetanus. Prevention efforts are done by vaccination in children, women of childbearing age, and pregnant women as protection for mother and baby (maternal antibody). The purposes of this research are to formulate SIR model with vaccination and maternal antibody (MSVIR) for tetanus disease and to apply the model in Indonesia. The MSVIR model is a first order linear differential equation system with five dependent variables, there are M, S, V, I, and R, and an independent variable t (time). The parameter’s values were estimated based on data in 2009-2014. The accuracy of this model was measured based on data in 2015-2016 years. The relative error rates on 2015-2016 were -0.0567 and 0.0825. The model is considered good enough. Based on the predictions during 2011-2030, the incidence of tetanus will increase 6.62% by 1.2% average increase per year.

Neonatal Mortality in Yogyakarta Rural Areas

The outcome of neonatal care was studied in three subdistricts rural areas in Yogyakarta Province with a total population of 112075 people. For data collection all pregnancies and deliveries between May 1983 -April 1984 were registered and visited twice during pregnancy, on delivery, 5 days and one month afterwards by trained health cadres.&#x0D; There were 1819 singleton liveborn infants with a neonatal mortality rate of 25.3 o/oo, in which 82.6% of the deaths occurred in the early neonatal period. An amount of 91.5% of the women delivered in their own house and 83.9% were assisted by a traditional birth attendant either trained or untrained. There was still 27.1% of pregnancies which never got any antenatal care. The coverage of tetanus immunization was 75.2% with 1.1 o/oo incidence of tetanus. The incidence of low birth weight infants was 8.1%, of which 19. 7% died before one month of age, I representing 63% of neonatal mortality.&#x0D; The causes of neonatal deaths were as follows: birth asphyxia and hypoxia 56.5%, prematurity/low birth weight 13%, infection/sepsis 13%, diarrhea 8. 7%, tetanus neonatorum 4.4% and others/unknown 4.4%.&#x0D; In rural areas, traditional birth attendants play a key role on assisting labour and taking care of the mothers as well as their newborns up to one month of age. Improvement of health service delivery at all levels of the health care system which includes the traditional birth attendants is needed especially concerning resuscitation of the newborns and the problems of low birthweights.

ANALISIS PERILAKU IBU BERSTATUS MAHASISWI PASCA SARJANA KESEHATAN MASYARAKAT UNIVERSITAS INDONESIA (FKMUI) TERHADAP PEMBERIAN IMUNISASI ANAK

ABSTRACTImmunization has been considered one of the greatest achievements in public health programs and with immunization a number of diseases can be reduced such as eradicating smallpox, eradicating polio, and significant progress in reducing the incidence of diphtheria, tetanus, whooping cough and measles (1). Right now immunization at the global level is stagnant at 86%. It is estimated that around 19.5 million children worldwide do not receive basic immunization (2). In Indonesia, an estimated 1.9 million children under 1 year were not fully immunized in 2015 (3) and as many as 242135 children were not immunized in 2016. To find out the Mother’s Behavior As A Public Health Postgraduate Student Of University Of Indonesia On Giving Children’s Immunization. This study used a qualitative method using the Rapid Assessment Procedure (RAP) approach located in the University of Indonesia's Public Health Faculty . The informant selection technique uses purposive sampling with the principle of appropriateness and adequacy. Data collection method is with Focus Group Discussion (FGD) 2 groups with each consisting of 6 postgraduate students from University of Indonesia's Public Health Faculty who have fully immunized. As triangulation source, interview conducted with postgraduate students who provide incomplete immunizations, postgraduate students who do not provide immunizations, and staff of the Ministry of Health, Immunization Directorate General of P2P. Nearly all informants had good knowledge, positive attitudes towards immunization is that only a small percentage of informants refused immunization. All informants agreed that media information is important for the success of immunization programs, especially to prevent issues or hoaxes about immunization. Most of the informants received support from their families to give their children immunizations so that the status of immunization for children was complete, but there were informants who did not get the support of their closest family wich is the husband, which made their child's immunization status incomplete. But family support and electronic media have a big influence in motivating mothers to immunize their children. It is recommended to be more careful in sorting the information so that children's and the environment health are maintained properly.Keywords : Immunization behavior, child immunization, mother's education

Otogenic tetanus though immunisable but still existing

Otogenic tetanus is an uncommon entity which may follow ear suppuration or ear injury. Straightforward diagnosis may not be possible if the otolaryngologist is not familiar with the entity. Delay in diagnosis may lead to serious consequences. The global incidence of tetanus is still estimated at about one million cases annually with a high case fatality ratio. These patients initially present with discharging ears; therefore, this case report is intended to increase awareness among otolaryngologists who would be the first to diagnose and initiate appropriate management. In spite of simple preventive measures available through immunization, tetanus remains a major cause of mortality in some developing countries such as India.

Study of clinico-epidemiological factors and outcome of tetanus in a tertiary care hospital

Background: Tetanus is an acute neurological fatal disorder caused by anaerobic spore forming bacillus Clostridium tetani, which produced an exotoxin (Tetanospasmin) in a wound. Purpose of this study was to find out the clinico-epidemiological factors of tetanus and how we can modify or minimize the outcome of this disease.Methods: This prospective, observational study was conducted in isolation ward in department of general surgery, SMS hospital Jaipur (Rajasthan) from 1 March 2016 to October 2017. Two hundred patients with clinical diagnosis of tetanus, who were admitted in single unit of SMS hospital, recruited in this study. Patients with age less than 1 yr were excluded. After admission, patient’s detailed history and thorough clinical examination done. The day to day progress of the cases was followed till the time of their discharge from the hospital. Outcome variables were age, gender, geographical area, causes of tetanus and site of injury, precipitating factors, role of baclofen, morbidity, cured and mortality.Results: In this study, mean age of patients were 17 years and male to female ratio was 2.44:1. Most of patients were from rural backgrounds with rural to urban ratio of 6.14:1. Overall mortality in present study was 16.5%. The severity of disease directly related with mortality. The mortality for mild, moderate and severe tetanus was 0%, 1.9% and 68.1% respectively.Conclusions: Though tetanus is a vaccine preventable illness, its prevalence is high in our country. The incidence of tetanus can be reduced by: strengthening of primary immunization programme; proper wound management and giving prophylactic tetanus immune globulins along with tetanus vaccine.

Effect of Chronic Social Stress on Prenatal Transfer of Antitetanus Immunity in Captive Breeding Rhesus Macaques (Macaca mulatta).

Because tetanus can cause significant morbidity and mortality in NHP, colonywide vaccination with tetanus toxoid is recommended for outdoor breeding colonies of rhesus macaques, with primary immunizations commonly given to infants at 6 mo of age followed by booster vaccines every 10 y. Maternal antibodies are thought to offer protective immunity to infants younger than 6 mo. However, historical colony data from the Yerkes National Primate Research Center show a higher incidence of tetanus among infants (≤ 6 mo old) born to subordinate dams. Whether this higher incidence of infantile tetanus is due to a higher incidence of trauma among subordinate animals or is a stress-induced impairment of maternal antibody protection is unknown. Studies in other NHP species suggest that chronic exposure to social stressors interferes with the receptor-mediated transplacental transfer of IgG. Therefore, the primary aim of this study was to determine whether chronic stress associated with social subordination impairs prenatal transfer of antitetanus immunity in breeding female rhesus macaques. Subjects included 26 high- and 26 low-ranking adult female rhesus macaques that were nearly 5 or 10 y after their initial immunization and their nonimmunized infants. We hypothesized that infants born to subordinate dams that were nearly 10 y after immunization would have the lowest infant-to-dam antibody ratios and thus would be at greatest risk for infection. Results revealed no significant intergroup differences in infant antitetanus IgG levels. However, infant-to-dam IgG ratios against tetanus were significantly lower among subordinate animals compared with dominant macaques, after accounting for the number of years since the dam's initial vaccination. In addition, higher maternal hair cortisol levels predicted lower infantto-dam tetanus toxoid IgG ratios. Together, these findings suggest that chronic social stress in female rhesus macaques may hamper the prenatal transfer of antitetanus immunity to offspring.

A study of clinical profile of childhood tetanus in south Gujarat area

Introduction: Despite the availability of cheap, safe and effective vaccine, tetanus is still a serious health problem worldwide and rural India, and a common cause of death in the new born. Community surveys have shown that only a small proportion of neonatal tetanus (NT) cases are routinely reported and under – reporting is often highest in areas at highest risk of NT. So, the objective of the study was to find out the epidemiological factors, clinical profile and outcome of childhood tetanus. Also to find out the preventable factors and prognostic factors in childhood tetanus. Methods: It was a prospective observational study. Legal guardians of all children less than 12 years old including neonates with diagnosis of tetanus admitted in pediatric department were inquired for detailed history regarding the present complaint, history of sources of infection, history of antenatal care, immunization status and detailed labor history. Grading of tetanus was done after detailed general and systemic examination. Result: Total 35 cases were included in the study with Male: Female ratio of 1.7:1. Among them 28.57% were neonatal tetanus and 28.57% were traumatic case. Among 10 neonatal tetanus cases 9 mothers were not immunized and among 25 non-neonatal cases 19 were unimmunized. Mortality was 90% in NT cases and 36% in Non-Neonatal Tetanus (NNT) cases. Common complication were septicemia [9 (25.71%)], Disseminated Intravascular Coagulation (DIC) [8 (22.85%)], Hyperpyrexia [7 (17.14%)], Pneumonia [5 (14.28%)], Bed sore [3 (8.5%)], and thrombo phlebitis [1(2.8%)] of cases. Conclusion: Although incidence of childhood tetanus has been reduced over the years, but still tetanus is more common in rural population due to illiteracy, poor socioeconomic status, poor vaccination and superstitions. The mortality by tetanus can be reduced by improving routine immunization specifically in rural and low socioeconomic population, by recognition of disease severity and providing proper management with intensive care as early as possible.

Pattern and outcome of tetanus in a tertiary health facility in Northwest Nigeria

Background: Tetanus, a disease that is largely preventable, is still a major public health problem in the developing world and is associated with high morbidity and mortality rates. There is a paucity of published literature on tetanus in adults (non-neonatal) in this study area. Materials and Methods: This was a 14-year retrospective study of patients who presented with a clinical diagnosis of tetanus in Ahmadu Bello University Teaching Hospital, Zaria, Northwest Nigeria between January 2001 and December 2014. Data were analyzed using the Statistical Package for the Social Sciences computer software package. Results: A total of 91 cases were reviewed. The median age of patients was 14 years with a male-to-female ratio of 3:1. Majority of the patients (88%) were Conclusion: Tetanus is still a major public health problem in our centre and affects people belonging to the younger age group with a high case of fatality rate. The incidence of tetanus can be reduced drastically by an effective and sustained immunization programme.

Tetanus in Southern Vietnam: Current Situation.

In Vietnam, there are no accurate data on tetanus incidence to allow assessment of disease burden or vaccination program efficacy. We analyzed age structure of 786 tetanus cases admitted to a tertiary referral center in Vietnam for three separate years during an 18-year period to examine the impact of tetanus prevention programs, namely the Expanded Program on Immunization (EPI) and the Maternal and Neonatal Tetanus (MNT) initiative. Most cases were born before the initiation of EPI. Median age increased from 33 (interquartile range: 20–52) in 1994, to 46 (32–63) in 2012 (P < 0.001). Birth-year distribution was unchanged, indicating the same birth cohorts presented with tetanus in 1994, 2003, and 2012. Enzyme-linked immunosorbent assay measurements in 90 men and 90 women covered by MNT but not EPI showed 73.3% (95% confidence interval [CI]: 62.9–82.1%) of women had anti-tetanus antibody compared with 24.4% (95% CI: 15.9–34.7%) of men, indicating continued tetanus vulnerability in older men in Vietnam.

Tetanus disease and deaths in men reveal need for vaccination.

With efforts focused on the elimination of maternal and neonatal tetanus, less attention has been given to tetanus incidence and mortality among men. Since 2007 voluntary medical male circumcision has been scaled-up in 14 sub-Saharan African countries as an effective intervention to reduce the risk of human immunodeficiency virus (HIV) acquisition among men. As part of a review of adverse events from these programmes, we identified 13 cases of tetanus from five countries reported to the World Health Organization (WHO) up to March 2016. Eight patients died and only one patient had a known history of tetanus vaccination. Tetanus after voluntary medical male circumcision was rare among more than 11 million procedures conducted. Nevertheless, the cases prompted a review of the evidence on tetanus vaccination coverage and case notifications in sub-Saharan Africa, supplemented by a literature review of non-neonatal tetanus in Africa over the years 2003–2014. The WHO African Region reported the highest number of non-neonatal tetanus cases per million population and lowest historic coverage of tetanus-toxoid-containing vaccine. Coverage of the third dose of diphtheria–tetanus–polio vaccine ranged from 65% to 98% across the 14 countries in 2013. In hospital-based studies, non-neonatal tetanus comprised 0.3–10.7% of admissions, and a median of 71% of patients were men. The identification of tetanus cases following voluntary medical male circumcision highlights a gender gap in tetanus morbidity disproportionately affecting men. Incorporating tetanus vaccination for boys and men into national programmes should be a priority to align with the goal of universal health coverage.

Neonatal tetanus: Case series

Neonatal tetanus occurs in developing countries, particularly those with the least developed health infrastructure. It usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with a nonsterile instrument. World Health Organization defines it as an illness in a child who has the normal ability to suck in the first 2 days of life, but who loses the ability between 3 and 28 days of life and becomes rigid and has spasms. The overall incidence of tetanus is reducing globally and is rare in developed nations. We describe four cases of neonatal tetanus with regard to demography, clinical profile, and outcome. From them, 3 newborns were delivered at home by untrained birth attendants. All the mothers were from lower socio-economic class, illiterate and were below 25 years of age. Common symptoms were unable to feed, difficulty in respiration, episodes of spasms, and convulsions. Mortality was 50%.

Profile and outcome of patients with post-neonatal tetanus in a tertiary centre in south west Nigeria: any remarkable reduction in the scourge?

IntroductionThe incidence of tetanus has remained unacceptably high in developing countries. We aimed to describe the profile and outcome of children with tetanus admitted at the Lagos State University Teaching Hospital (LASUTH), Ikeja.MethodsA prospective and cross-sectional study of children aged 1 month to 12 years of age admitted with clinical diagnosis of tetanus, between January 2011 and December 2013, at the Paediatric department of LASUTH. The age, sex, presenting complaint, immunization status, portal of entry, socio-economic class, complications, duration of admission and outcome of the subjects were analyzed using Microsoft Excel supplemented with Statistical Package for Social Sciences (SPSS) version 17.0. Level of significance set at p< 0.05.ResultsA total of 49 subject participated in the study. Male: Female ratio was 1.7: 1.0. mean age ± SD of 6.5± 3.2 years. Only 24.5% of the subjects were fully immunized, lower limb injury was the most common portal of entry (34.7%). Majority (79.6) were of the middle and lower social classes. Most of the subjects (67.3%) presented with generalised spasm. Only 1 patient (2.0%) did not have trismus. Case fatality rate was 4.1%.ConclusionTetanus is still prevalent among children in our environment. It is commoner among those with no immunization or incomplete immunization, commoner in those in the middle and lower social class. Lower limb injury was the most common portal of entry. Trismus was a common presenting feature. There is a need to develop programmes with will help improve compliance to immunization.

A systematic review of tetanus in individuals with previous tetanus toxoid immunization.

To assess the characteristics of tetanus in previously immunized individuals. A systematic literature search was undertaken using Ovid MEDLINE(R) and EMBASE databases for articles published between 1946 and September 3, 2013. The search strategy was developed using MESH terms for "tetanus", "immunization" and "vaccination". Inclusion criteria were articles in English or French that described at least one case of tetanus, immunization history and/or the results of anti-tetanus antibodies. Articles were reviewed for relevant references. 51 unique articles published from1946-2013 were included in the review. The articles described 359 cases of clinical tetanus in individuals with prior receipt of one or more doses of tetanus toxoid vaccine and/or levels of tetanus antibody titres generally considered protective. Of the 210 cases that reported patient status at discharge, 180 (85.7%) survived with only three cases reporting residual deficits. Tetanus spores are ubiquitous and this report clearly documents that tetanus cases can occur in individuals previously immunized with tetanus toxoid vaccine. Clinicians should not rule out tetanus when clinical symptoms suggest it, regardless of the vaccination history. When treated, the prognosis for tetanus is good. Further research is needed to assess the incidence of tetanus in partially- and fully-immunized populations and determine whether this is due to waning immunity of vaccine failure.