Your SlideShare is downloading. ×
Tetanus8p
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×

Introducing the official SlideShare app

Stunning, full-screen experience for iPhone and Android

Text the download link to your phone

Standard text messaging rates apply

Tetanus8p

1,236
views

Published on

Published in: Health & Medicine

1 Comment
1 Like
Statistics
Notes
No Downloads
Views
Total Views
1,236
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
55
Comments
1
Likes
1
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide
  • The age distribution of reported tetanus cases shifted to a younger age group in 1995-1997, due primarily to the contribution cases in California. Many of these cases were young Hispanic men who developed tetanus as a result of injection drug use, particularly heroin.
  • 1995-1997 is the most recent summary of tetanus cases reported in the U.S.
  • Recommendation from the 1991 DTP ACIP statement
  • Transcript

    • 1.
      • Tetanus and Tetanus Toxoid
      Epidemiology and Prevention of Vaccine-Preventable Diseases National Immunization Program Centers for Disease Control and Prevention Revised December 2004
    • 2. Note to presenters: Images of vaccine-preventable diseases are available from the Immunization Action Coalition website at http://www.vaccineinformation.org/photos/index.asp
    • 3. Tetanus
      • First described by Hippocrates
      • Etiology discovered in 1884 by Carle and Rattone
      • Passive immunity used for treatment and prophylaxis during World War I
      • Tetanus toxoid first widely used during World War II
    • 4. Clostridium tetani
      • Anaerobic gram-positive, spore-forming bacteria
      • Spores found in soil, dust, animal feces; may persist for months to years
      • Multiple toxins produced with growth of bacteria
      • Tetanospasmin estimated human lethal dose = 2.5 ng/kg
    • 5. Tetanus Pathogenesis
      • Anaerobic conditions allow germination of spores and production of toxins
      • Toxin binds in central nervous system
      • Interferes with neurotransmitter release to block inhibitor impulses
      • Leads to unopposed muscle contraction and spasm
    • 6. Tetanus Clinical Features
      • Incubation period; 8 days (range, 3-21 days)
      • Three clinical forms: Local (not common), cephalic (rare), generalized (most common)
      • Generalized tetanus: descending symptoms of trismus (lockjaw), difficulty swallowing, muscle rigidity, spasms
      • Spasms continue for 3-4 weeks; complete recovery may take months
    • 7. Neonatal Tetanus
      • Generalized tetanus in newborn infant
      • Infant born without protective passive immunity
      • High fatality rate without therapy
      • Estimated >215,000 deaths worldwide in 1998
    • 8. Tetanus Complications
      • Laryngospasm
      • Fractures
      • Hypertension
      • Nosocomial infections
      • Pulmonary embolism
      • Aspiration
      • Death
    • 9. Tetanus Wound Management * Yes, if >10 years since last dose ** Yes, if >5 years since last dose Vaccination History Unknown or <3 doses 3+ doses Td TIG Yes No No* No Td TIG Yes Yes No** No Clean, minor wounds All other wounds
    • 10. Tetanus Epidemiology
      • Reservoir Soil and intestine of animals and humans
      • Transmission Contaminated wounds Tissue injury
      • Temporal pattern Peak in summer or wet season
      • Communicability Not contagious
    • 11. Tetanus—United States, 1947-2002
    • 12. Tetanus—United States, 1980-2002
    • 13. Tetanus—United States, 1980-2002 Age Distribution
    • 14. Age Distribution of Reported Tetanus Cases, 1991-1995 and 1996-2000
    • 15. Tetanus—1998-2000 Injuries and Conditions Data available for 129 of 130 reported cases. Source: MMWR 2003;52(SS-3):1-12
    • 16. DTaP, DT, and Td DTaP, DT Td (adult) Diphtheria 7-8 Lf units 2 Lf units Tetanus 5-12.5 Lf units 5 Lf units Pertussis vaccine and pediatric DT used through age 6 years. Adult Td for children 7 years of age and older.
    • 17. Tetanus Toxoid
      • Formalin-inactivated tetanus toxin
      • Schedule Three or four doses + booster Booster every 10 years
      • Efficacy Approximately 100%
      • Duration Approximately 10 years
      • Should be administered with diphtheria toxoid as DTaP, DT, or Td
    • 18. Routine DTaP Primary Vaccination Schedule Dose Primary 1 Primary 2 Primary 3 Primary 4 Age 2 months 4 months 6 months 15-18 months Interval --- 4 wks 4 wks 6 mos
    • 19. Children Who Receive DT
      • The number of doses of DT needed to complete the series depends on the child’s age at the first dose:
        • if first dose given at <12 months of age, 4 doses are recommended
        • if first dose given at >12 months, 3 doses complete the primary series
    • 20. Routine DTaP Schedule Children <7 years of age
      • 4-6 years, before entering school
      • 11-12 years of age if 5 years since last dose (Td)
      • Every 10 years thereafter (Td)
      Booster Doses
    • 21. Routine Td Schedule Unvaccinated Persons > 7 Years of Age Booster dose every 10 years Dose Primary 1 Primary 2 Primary 3 Interval --- 4 wks 6-12 mos
    • 22. Diphtheria and Tetanus Toxoids Adverse Reactions
      • Local reactions (erythema, induration)
      • Exaggerated local reactions (Arthus-type)
      • Fever and systemic symptoms not common
      • Severe systemic reactions rare
    • 23. Diphtheria and Tetanus Toxoids Contraindications and Precautions
      • Severe allergic reaction to vaccine component or following prior dose
      • Moderate or severe acute illness
    • 24. National Immunization Program
      • Hotline 800.232.2522
      • Email [email_address]
      • Website www.cdc.gov/nip