There is a direct relationship between the distance from the inoculation wound to the central nervous system and the onset of symptoms. Tetanus is a clinical diagnosis and there are no definitive laboratory tests. The diagnosis is supported by an incomplete or out-of-date vaccination status, culture of C. Complications of tetanus arise either as a direct result of the disease or due to the intensive care management.
Direct complications include the following: respiratory compromise because of chest wall muscle rigidity, spasm and diaphragmatic dysfunction; airway obstruction due to laryngeal spasm and respiratory apnoea; aspiration pneumonia; fractures associated with severe muscle spasm.
Autonomic dysfunctions, often exacerbated by intensive care interventions, can cause labile hypertension, hypotension, tachycardia, bradycardia and arrhythmias which can result in hemodynamic instability and cardiac arrest. Short incubation and early manifestations of autonomic dysfunction, young age, and old age are associated with more severe disease and higher case fatality.
Sequelae of neonatal tetanus: Studies have linked neonatal tetanus to neurological disabilities ranging from cerebral palsy and severe psychomotor retardation to subtle intellectual and behavioural abnormalities but it has not been established how much is caused by the neurotoxin and how much is the result of compromised respiration and hypoxia.
Epidemiology Soil is the main reservoir of C. Tetanus spores have a worldwide distribution and the incidence of tetanus in a population primarily reflects the effectiveness of the immunisation program.
Tetanus remains common in countries with inadequate immunisation coverage, low antenatal care attendance, unsafe traditional cord care practices and where women deliver without the assistance of trained health professionals.
Neonatal tetanus has been eliminated from Europe and the overall number of tetanus cases has declined sharply since the s. Tetanus is today a rare disease in Europe and in a total of cases of tetanus cases, of which were confirmed, were reported by 25 EU countriesi. The highest tetanus risk in Europe is found in the elderly unvaccinated or partially vaccinated population and among injecting drug users. Induced tetanus immunity wanes with increasing age and this partly explains the higher incidence in higher age groups.
The EU case definition of tetanus for the purpose of reporting communicable diseases to the community network can be reviewed here. Transmission Tetanus is spread by the direct transfer of C. It is not transmitted from person to person. Contaminated puncture wounds, compound fractures, burns, frostbites, ulcers, gangrene, unclean deliveries and unhygienic cord care practices are risk factors for tetanus in unvaccinated or partly vaccinated populations.
The time from inoculation with tetanus spores to the first symptoms can be from one day to one month with a median of 7 days. Plotkin The incubation period for neonatal tetanus age at first symptom is between the first 3—14 days of life, and is most common between days 6—8. Prevention Immunisation is the only effective prevention of tetanus. Tetanus toxoid is an effective, safe, stable and inexpensive vaccine that can be given to all ages, to pregnant women and to immunocompromised individuals.
Most countries recommend a minimum of five doses of tetanus toxoid vaccine over 12—15 years, starting in infancy. Further booster doses can be given in early adulthood, to ensure long-lasting protection.
Opportunistic immunisation of people who are treated for wounds and cuts is important for maintaining high protection levels, as is targeted vaccination of population groups born before general immunisations programmes started.
Tetanus antibody levels decline with increasing age which helps explain why the highest tetanus incidence in Europe is among the elderly.
Booster vaccination of elderly people can improve protection against tetanus. Maternal tetanus antibodies passively protect newborns, and immunising pregnant women remain an important intervention for the prevention of neonatal tetanus in countries with low protection levels in the adult population. Vaccination schedules for the European countries can be reviewed in the Vaccine Scheduler.
Management and treatment Although tetanus has become an uncommon disease in Europe, it remains an important differential diagnosis, particularly in elderly patients and intra-venous drug users.
Tetanus immunoglobulin should be given to individuals with high-risk conditions, such as: wounds requiring surgical intervention which is delayed for more than six hours; burns and injuries with significant devitalised tissue, especially where there has been contact with soil or manure; wounds containing foreign bodies; compound fractures; wounds or burns in septic patients, injecting drug users with multiple skin abscesses. Human anti-tetanus immunoglobulin can neutralise circulating toxin but will not pass the blood-brain-barrier and has no effect on already bound toxin.
The benefit of intrathecal administration of antitoxin has not been proven. Toxin production at infection site is reduced by proper wound care and the administration of appropriate antibiotics. Treatment should be started on clinical suspicion. Yes, let me download! Exclusive Corporate feature. Corporate Account. Statista Accounts: Access All Statistics.
Basic Account. You only have access to basic statistics. Single Account. The ideal entry-level account for individual users. Corporate solution including all features. Statistics on " Vaccine-preventable diseases in the U. The most important statistics. Further related statistics. Deaths from tetanus confirmed in Europe , by country Deaths from tetanus in Spain Cases of tetanus South Korea DTP vaccine: booster dose among children aged 6 in Spain , by region Td vaccination coverage: booster dose among individuals aged in Spain Td vaccine: booster dose among children aged 14 years old in Spain , by region Coverage of tetanus vaccine in Italy , by region Share of infants with DPT vaccinations Spain Number of tetanus cases in Indonesia U.
Further Content: You might find this interesting as well. Statistics Deaths from tetanus confirmed in Europe , by country Deaths from tetanus in Spain Cases of tetanus South Korea DTP vaccine: booster dose among children aged 6 in Spain , by region Td vaccination coverage: booster dose among individuals aged in Spain Td vaccine: booster dose among children aged 14 years old in Spain , by region Coverage of tetanus vaccine in Italy , by region Share of infants with DPT vaccinations Spain Number of tetanus cases in Indonesia U.
Topics Vaccine-preventable diseases in the U. Vaccinations in Europe Influenza in the U. Hepatitis in the U. Vaccinations in Canada. Learn more about how Statista can support your business. Sporadic cases of tetanus continue to occur in adults who did not get all the recommended tetanus vaccinations. Public health officials conduct tetanus surveillance to monitor trends in incidence and identify populations at increased risk.
Caption: The figure above shows reported tetanus cases in the United States during —, according to the National Notifiable Disease Surveillance System. From —, the number of tetanus cases reported each year, which already had decreased greatly since , continued to decline, and remained low through Skip directly to site content Skip directly to page options Skip directly to A-Z link. Section Navigation.
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