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Tetanus surveillance--United States, 1995-1997
B Bardenheier1, D R Prevots, N Khetsuriani
1Epidemiology and Surveillance Division, National Immunization Program, CDC, Atlanta, GA, USA.
Summary
Tetanus remains a significant public health concern, primarily affecting unvaccinated individuals. Older adults are at the highest risk for severe tetanus disease, emphasizing the need for updated vaccination status.
Area of Science:
- Epidemiology
- Immunization
- Public Health
Background:
- Tetanus, a serious bacterial disease, persists despite vaccine availability.
- A significant proportion of tetanus cases occur in unvaccinated or inadequately vaccinated individuals.
Purpose of the Study:
- To analyze the epidemiology of tetanus cases reported in the United States between 1995 and 1997.
- To identify risk factors and assess outcomes in patients with tetanus.
Main Methods:
- Data on physician-diagnosed tetanus cases were collected through the National Notifiable Diseases Surveillance System.
- Supplemental clinical and epidemiological information was provided by state and local health departments to the National Immunization Program.
Main Results:
- 124 tetanus cases were reported from 33 states during 1995-1997, with an average annual incidence of 0.15 per 1,000,000 population.
- Adults aged 60 years and older faced a significantly higher risk of tetanus and severe disease, with a case-fatality ratio of 18%.
- Only 13% of patients had received a primary tetanus toxoid (TT) series, and vaccination status correlated with disease severity; no deaths occurred in fully vaccinated individuals.
Conclusions:
- Tetanus is preventable and primarily affects unvaccinated or inadequately vaccinated populations.
- Older adults remain at the highest risk for tetanus and severe outcomes.
- Routine vaccination and prompt wound management, including tetanus toxoid administration, are crucial for prevention.