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Tetanus in England and Wales, 1984-2000
A A Rushdy1, J M White, M E Ramsay
1Immunisation Division, Public Health Laboratory Service Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW1 5EQ.
Epidemiology and Infection
|March 5, 2003
Summary
Tetanus incidence in England and Wales reached record lows between 1984-2000. Enhanced surveillance is crucial for evaluating vaccination policies, especially for older adults and those with outdoor injuries.
Area of Science:
- Public Health
- Epidemiology
- Immunization Policy
Background:
- Tetanus surveillance data from England and Wales (1984-2000) were reviewed.
- Hospital Episode Statistics were analyzed to assess tetanus under-reporting.
Purpose of the Study:
- To evaluate the national tetanus surveillance system.
- To assess the effectiveness of national vaccination policies.
- To estimate the extent of under-reporting of tetanus cases.
Main Methods:
- Retrospective review of national tetanus surveillance data.
- Analysis of Hospital Episode Statistics for tetanus cases.
- Calculation of annual incidence rates and under-reporting estimates.
Main Results:
- 175 tetanus cases reported, with an annual incidence of 0.20 per million (lowest recorded).
- Highest incidence observed in individuals over 64 years old.
- Estimated under-reporting of tetanus cases ranged from 54-64%.
Conclusions:
- General Practitioners (GPs) should ensure complete patient vaccination, prioritizing those born before 1961.
- Maintaining high childhood tetanus vaccination coverage is essential.
- Enhanced surveillance is vital for evaluating immunization policies as tetanus becomes rarer.