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Cause:
Toxin produced by the bacterium Clostridium tetani.
Illness and treatment:
Most cases are generalized tetanus, with descending rigidity
and painful spasms of skeletal muscles starting with the jaw
and neck (referred to as “lockjaw”). Treatment is with human
tetanus immune globulin (TIG), wound care, antibiotics, and
supportive care. Active immunization should begin or
continue as soon as the person is stable.
Sources:
Spores are widely
distributed in soil and in the intestinal tracts (and feces)
of animals and humans. The spores can also be found on skin
as well as in contaminated heroin. C. tetani usually
enters the body through a wound (apparent or inapparent) and
grows in damaged tissue.
Additional risks:
Almost all reported cases of tetanus are persons with no
vaccination or without a booster in the preceding decade.
During 1980 – 2000, most cases were persons 40 years and
older. Cases under 40 years are now increasing, in part due
to injection-drug use.
Prevention:
Universal childhood immunization with regular booster doses
for adolescents and adults prevents toxin production in
contaminated wounds.
Recent Washington trends:
There was one
case reported in 2000 and one in 2005.
2008:
No cases were reported.
Purpose of Reporting and
Surveillance
-
To assist in the diagnosis of
potential cases and facilitate prompt administration of
tetanus immune globulin (TIG)
-
To identify groups at risk for tetanus (due to
under-immunization, occupation, drug use, etc.) and focus
prevention efforts
Legal Reporting Requirements
- Health care providers: notifiable to Local Health
Jurisdiction within 3 work days
- Hospitals: notifiable to Local Health Jurisdiction
within 3 work days
- Laboratories: no requirements for reporting
- Local health jurisdictions: notifiable to the Washington
State Department of Health (DOH) Communicable Disease
Epidemiology Section (CDES) within 7 days of case
investigation completion or summary information required
within 21 days.
Last
update
November 2009 |
