Materiały źródłowe

• #1 Tetanus: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/229594-overview

  Tetanus is characterized by an acute onset of hypertonia, painful muscular contractions (usually of the muscles of the jaw and neck), and generalized muscle spasms without other apparent medical causes. Despite widespread immunization of infants and children since the 1940s, tetanus still occurs in the United States. […] Tetanus primarily affects older adults because of their higher rate of being unvaccinated or inadequately vaccinated. […] Because of the widespread use of tetanus immunizations, the reported incidence of tetanus in the United States has declined substantially since the mid 1940s. […] From 2001-2008, 233 cases of tetanus were reported in the United States, a 95% reduction since 1947. Deaths from the disease had decreased by 99% since that year. […] The case mortality rate was 13.2%. Tetanus cases among Hispanic individuals were approximately twice that among non-Hispanic persons, attributed to an increased rate of injection drug use among Hispanic patients.

• #1 Tetanus (lockjaw) – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/tetanus-lockjaw/

  Tetanus occurs more often in persons who have never been vaccinated against tetanus or who have not had a booster dose in the past 10 years. […] Tetanus occurs worldwide but is more common in agricultural regions of warmer climates, especially where contact with animal manure is more likely. […] Neonatal tetanus frequently occurs in developing countries when access to vaccine and maternity care is limited. […] Maintaining up-to-date tetanus vaccination is the single most important measure to prevent tetanus.

• #1

  https://www.who.int/news-room/fact-sheets/detail/tetanus

  Tetanus can be prevented through immunization with tetanus-toxoid-containing vaccines (TTCV). However, people who recover from tetanus do not have natural immunity and can be infected again. […] The majority of reported tetanus cases are birth-associated among newborn babies and mothers who have not been sufficiently vaccinated with TTCV. […] The disease remains an important public health problem in many parts of the world, but especially in low-income countries or districts, where immunization coverage is low, and unclean birth practices are common. […] In countries where national programmes have maintained high immunization coverage for several decades, tetanus incidence rates are very low. […] The global neonatal tetanus elimination goal was launched at the World Health Assembly in 1989 to reduce neonatal tetanus as a public health problem (defined as less than one case of neonatal tetanus per 1000 live births in every district) in all countries.

• #1 Tetanus – UpToDate

  https://www.uptodate.com/contents/tetanus

  Case-fatality rates in many resource-limited settings remain high and have not changed significantly in the past several decades. […] According to data from the global burden of disease survey, an estimated 48,000 to 80,000 deaths occurred from tetanus worldwide in 2016. […] Neonatal tetanus, which the World Health Organization targeted for elimination by 1995, accounted for approximately 34,000 deaths in 2015. […] Following disruption of national programmes during the COVID-19 pandemic, the WHO reported that the number of neonatal tetanus cases increased in 18 (31 percent) of priority countries between 2020 and 2022, underlining the need for sustainable prevention programs.

• #1 Tetanus – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/tetanus

  Worldwide in 2019, tetanus was estimated to have caused 34,700 deaths, mostly in South Asia and Sub-Saharan Africa, but the disease is so rarely reported that this figure is only a rough estimate. […] In the United States since 1947, reported tetanus cases have declined more than 95%, and deaths resulting from tetanus have declined more than 99%. […] Disease incidence is directly related to the immunization level in a population, attesting to the effectiveness of preventive efforts. […] Patients with burns, surgical wounds, or a history of injection drug use are especially prone to developing tetanus. […] Tetanus vaccination is required for all infants, children, adolescents, and adults. […] Because tetanus infection does not confer immunity, patients who have recovered from clinical tetanus should be vaccinated unless they have completed a full primary series. […] Patients who have a wound that poses an increased risk of tetanus should be given prophylaxis depending on wound type and vaccination history; tetanus immune globulin also may be indicated.

• #1 Tetanus – Wikipedia

  https://en.wikipedia.org/wiki/Tetanus

  In 2013, it caused about 59,000 deaths down from 356,000 in 1990. Tetanus, notably the neonatal form, remains a significant public health problem in non-industrialized countries, with 59,000 newborns dying worldwide in 2008 as a result of neonatal tetanus. […] In the United States, from 2000 through 2007, an average of 31 cases were reported per year. Nearly all of the cases in the United States occur in unimmunized individuals, or individuals who have allowed their inoculations to lapse.

• #1 Tetanus– a case report highlighting the challenges in diagnosis and treatment | Tropical Diseases, Travel Medicine and Vaccines | Full Text

  https://tdtmvjournal.biomedcentral.com/articles/10.1186/s40794-024-00220-5

  Tetanus has become an increasingly rare infectious disease due to the development of successful vaccination programs in the mid-20th century. […] The decreasing incidence in developed countries has hindered clinical trials evaluating the best treatment modalities for tetanus infections. […] Its high mortality rate and the abundant presence of tetanus spores worldwide contribute to the fact that in many countries, tetanus is still a major public health issue. […] The World Health Organization (WHO) has therefore launched the Maternal and Neonatal Tetanus Elimination (MNTE) Initiative. […] The incidence of tetanus cases is still steadily declining since the first development of TTCV in 1926. […] It has been shown that the global incidence of tetanus cases has decreased by 88% between 1990 and 2019, nevertheless, a total number of 73,662 cases were reported in 2019 worldwide.

• #1 Tetanus (Clostridium tetani Infection) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482484/

  Most instances of tetanus occur in developing countries where immunity is deficient, particularly in areas affected by natural disasters.[12] […] In resource-rich countries, the unvaccinated and those with waning vaccine immunity are at risk. Among this group, surveillance data highlights individuals who inject drugs and those with insulin-dependent diabetes as particularly vulnerable.[7] […] The spores of C tetani are present in the environment irrespective of geographical location, residing in the soil and entering through openings in the skin. Wounds containing devitalized tissue pose the highest risk, making all age groups susceptible to infection. Without high-quality medical care, the case-fatality rate can approach 100%, while with optimal care, the case-fatality ratio ranges from 10% to 20%.[3] Neonates face an increased risk in resource-poor regions when nonhygienic deliveries are performed, nonsterilized materials are used to cut the umbilical cord, or contaminated dressings are applied to the umbilical stump.[11] In 2015, the World Health Organization (WHO) estimated that approximately 34,000 neonates died from neonatal tetanus.[13]

• #1 Tetanus – UpToDate

  https://www.uptodate.com/contents/tetanus

  Tetanus is a nervous system disorder characterized by muscle spasms that is caused by the toxin-producing anaerobe Clostridium tetani, which is found in the soil. […] Although tetanus is now rare in resource-rich settings, the disease remains a threat to all unvaccinated people, particularly in resource-limited countries. […] The epidemiology, pathogenesis, clinical features, diagnosis, and management of tetanus will be reviewed here. […] Because of almost universal vaccination of children with tetanus toxoid in resource-rich countries, the incidence of tetanus in these regions has dropped dramatically and steadily since 1940. […] During the period between 2009 and 2017, the United States Centers for Disease Control and Prevention (CDC) reported that there were 264 cases of tetanus in the United States.

• #1 Tetanus Surveillance and Trends | Tetanus | CDC

  https://www.cdc.gov/tetanus/php/surveillance/index.html

  CDC tracks tetanus cases using a national surveillance system. […] Tetanus cases are rare in the United States and have decreased significantly since the late 1940s. […] Tetanus is a nationally notifiable disease. […] Health departments report cases of tetanus to the National Notifiable Diseases Surveillance System (NNDSS). CDC collects national information about tetanus through NNDSS. […] In the United States, sporadic cases of tetanus continue to occur. Since 2000, there have been less than 50 reported cases each year. […] Since 1947 reported tetanus cases have declined more than 95%. Reported deaths from tetanus have declined more than 99%. […] Vaccination and continued use of TIG for wound management played a role in the decline of cases and deaths. […] Tetanus cases declined with use of TIG and vaccines.

• #1 Tetanus surveillance — United States, 2001-2008 – PubMed

  https://pubmed.ncbi.nlm.nih.gov/21451446/

  Tetanus is a life-threatening but preventable disease caused by the toxin of Clostridium tetani, a ubiquitous, spore-forming, gram-positive bacillus found in high concentrations in soil and animal excrement. […] Reported tetanus cases have declined 95%, and deaths from tetanus have declined 99% in the United States since 1947, when the disease became reportable nationally. […] To update a previous report and to determine the populations at greatest risk for the disease, CDC analyzed cases reported to the National Notifiable Diseases Surveillance System (NNDSS) during 2001–2008. […] This report summarizes the results of that analysis, which found that 233 tetanus cases were reported during 2001–2008; among the 197 cases with known outcomes, the case-fatality rate was 13.2%. […] Average annual incidence during that period was 0.10 per 1 million population overall and 0.23 among persons aged 65 years.

• #1 Tetanus disease info and PEP treatment | HyperTET® S/D

  https://www.hypertet.com/en/hcp/tetanus

  According to CDC surveillance data from 2001 to 2008, an analysis of sufficiently complete case reports of patients with acute wounds who sought medical care revealed that 96% did not receive recommended PEP. […] From 2009 through 2017 in the United States, a total of 264 cases were reported with a fatality rate of 7.2%. […] Almost all reported cases of tetanus are in persons who have never been vaccinated, are inadequately vaccinated, or whose vaccination history is unknown or uncertain.

• #1 Tetanus – UpToDate

  https://www.uptodate.com/contents/tetanus

  In 2019, 26 cases of tetanus and 2 deaths were reported in the United States through the national tetanus surveillance system. […] Most patients with tetanus lack a history of receipt of a full series of tetanus toxoid immunization and receive inadequate prophylaxis following a wound. […] Despite the low rate of clinical disease in the United States, many adults are inadequately vaccinated against tetanus. […] The annual incidence of tetanus in other resource-rich countries is also low and declining due to vaccination programs. […] In contrast with resource-rich nations where tetanus is rare, tetanus remains endemic in resource-limited settings, and the incidence often increases following natural disasters such as earthquakes and tsunamis. […] True disease incidence is unknown, since tetanus is not a notifiable disease in most countries.

• #1 Tetanus – Annual Epidemiological Report for 2022

  https://www.ecdc.europa.eu/en/publications-data/tetanus-annual-epidemiological-report-2022

  In 2022, 53 tetanus cases were reported in the European Union/European Economic Area (EU/EEA), of which 16 (30%) were confirmed cases. […] The current epidemiology in the EU/EEA may be explained by lower vaccination coverage or waning immunity among older populations. […] Due to the severity of tetanus, there is a need to maintain high vaccination rates in all eligible age groups and to continue developing and implementing strategies to protect specific groups particularly the elderly in countries with higher rates of disease.

• #1 Tetanus – Canada.ca

  https://www.canada.ca/en/public-health/services/immunization/vaccine-preventable-diseases/tetanus/health-professionals.html

  Tetanus occurrence is worldwide. Cases are sporadic and relatively uncommon in industrialized countries, due to: […] Tetanus is rare in Canada. During the 1920s and 1930s, between 26 and 55 deaths due to tetanus were reported annually. With the introduction of tetanus toxoid in Canada in 1940, morbidity and mortality rapidly declined. Between 2000 and 2013 a total of 42 cases were reported, with an average of 3 cases reported per year (range 1 to 8 cases). […] Health professionals play a critical role in identifying and reporting cases of tetanus.

• #1 Tetanus: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/229594-overview

  The CDC has not published a tetanus surveillance summary for the United States since 2008, but continues to publish the number of reported cases by state through the National Notifiable Diseases Surveillance System. […] C tetani is found worldwide in soil, on inanimate objects, in animal feces, and, occasionally, in human feces. Tetanus is predominantly a disease of underdeveloped countries. […] From 1990 to 2019, the incidence and death rate of tetanus fell significantly globally. […] Developed nations have incidences of tetanus similar to those observed in the United States. […] The risk for development of tetanus and for the most severe form of the disease in developed countries is highest in the elderly population. […] From 2001-2008, the incidence rate among patients aged 65 years or older was approximately 0.23 cases per 1 million population vs 0.08 cases per 1 million population for those younger than 65 years. […] Tetanus affects both sexes. […] From 2001-2008, the incidence of tetanus in the United States was almost twice as high among Hispanic individuals compared with non-Hispanic persons (0.13 vs 0.07 cases per million population).

• #1 Trends in Tetanus Epidemiology in the United States, 1972-2001

  https://cdc.confex.com/cdc/nic2005/techprogram/paper_7813.htm

  Tetanus is severe and often fatal. The introduction and widespread use of tetanus toxoid (TT) vaccine in the late 1940s accelerated reductions in both tetanus morbidity and mortality. To describe the epidemiology of tetanus from 1972 to 2001 in the United States. We analyzed all reports of tetanus cases submitted to the National Notifiable Diseases Surveillance System, CDC, from January 1972 through December 2001. Between 1972 and 2001, 1842 cases of tetanus were reported. The average annual incidence per million decreased from 0.39 in 1972-1976 to 0.16 in 1997-2001; the case fatality rate (CFR) decreased from 45% to 16%. Among the 932 cases (51%) for whom TT vaccination history was reported: 644 (69%) were unvaccinated and had a CFR of 28%; 172 (18%) had received 1 or 2 TT doses (CFR of 17%), and 114 (12%) had received 3 or more doses (CFR of 4%). Only 4 of 520 persons dying from tetanus (0.7%) had a history of at least 3 TT doses. Tetanus incidence and mortality were highest throughout the study period among persons 60 and older, with an overall incidence of 0.78/million and CFR of 40%. Diabetics were at increased risk for fatal tetanus [age-adjusted relative risk 1.9 (95%CI 1.4-2.6)], compared to non-diabetics. Injection drug users (IDUs) accounted for 12% of tetanus cases in 1992-2001, an almost 3-fold increase compared with the previous decade. Between 1972 and 2001, reported tetanus incidence decreased by 59% and CFR decreased by 64%. Receipt of 3 TT doses protects against both disease and mortality. Older adults, diabetics, and IDUs are at particular risk for tetanus disease and death. To understand the epidemiology of tetanus in the United States today so that immunization programs can target persons at increased risk.

• #1 Tetanus – Health Protection Surveillance Centre

  https://www.hpsc.ie/a-z/vaccinepreventable/tetanus/

  Tetanus is a notifiable disease. […] Tetanus is not contagious, person to person spread does not occur. […] Anyone who is not fully protected against tetanus by immunisation is at risk from the disease. […] Individuals with impaired immunity may be at risk, regardless of their immunisation status.

• #1 Tetanus reported cases and incidence

  https://immunizationdata.who.int/global/wiise-detail-page/tetanus-reported-cases-and-incidence?CODE=Global&DISEASE=TTETANUS

  Reported cases and incidence of Tetanus are collected annually through the WHO/UNICEF Joint Reporting Form on Immunization (JRF). […] These data are used to provide global trends over time, and to inform the Strategic Advisory Group of Experts on Immunization (SAGE) and other advisory bodies to make evidence-based decisions as they deliberate different policies (for example, the need for booster doses, and targeted ages).

• #1

  https://www.epicentro.iss.it/ben/2002/marzo02/2_en

  Epidemiology of Tetanus in Italy […] Tetanus is an actute infectious disease, the symptoms of which are caused by an exotoxin produced during the multiplication of Clostridium tetani, an organism that is widely distributed in the soil, in dust, and in the feces of herbivorous animals. […] A vaccine that produces a three-dose efficacy in excess of 90% has been available since the 1930s, and as a result of its widespread use, tetanus has become a rare disease in the industrialized world. […] Tetanus reporting has been mandatory in Italy since 1995. It is considered a Class I condition, that requires notification within 12 hours of a suspected case. The surveillance case definition is strictly clinical. As for all vaccine-preventable diseases, surveillance for tetanus is considered essential for the evaluation of the success of vaccination program efforts. […] The decline in tetanus cases has been paralleled by a decline in case-fatality, from 64% in the 1970s to 40% in the 1990s. […] Despite the increase in vaccine coverage and decreases in case rates attained in the 1990s, the incidence of tetanus remains approximately 10 times higher than rates in other European countries and the United States.

• #1

  https://www.gov.uk/government/publications/tetanus-in-england-annual-reports/tetanus-in-england-2022

  This report updates Tetanus in England: 2021 (which presented surveillance data for England for that year) and reiterates current recommendations on diagnosis and clinical management of tetanus. […] Data sources in England for the enhanced surveillance of tetanus include notifications, reference and NHS laboratory reports, death registrations, and individual case details such as vaccination history, source of infection and severity of disease obtained from hospital records and GPs. […] Cases of tetanus are known to be under-reported. A comparison of surveillance data against hospital episode statistics between 2001 and 2014 suggested that tetanus was under-reported by 88% during that period, with 67 additional cases identified in the hospital statistics that were not captured through enhanced surveillance.

• #1 Tetanus | Article | GLOWM

  https://www.glowm.com/article/heading/vol-17–maternal-immunization–tetanus/id/419403

  The initial elimination target focused on eliminating NT from 59 priority countries by 1995, however, this target was revised in 1991 at the 44th World Health Assembly, just 2 years after it was set, due to slow implementation of elimination strategies. […] The revised target date for elimination of NT in all countries was 2000. […] The global elimination target date was set at 2005, then moved to 2015 and again to 2020. It has still not been met in several countries distributed in three of the six WHO regions. […] The recommended strategies for achieving MNTE include the following: Strengthening routine immunization of pregnant women, achieving 80% coverage with 2 doses of TTCV (TTCV2+); Targeting 80% of women of reproductive age 15-49 years in selected high-risk areas, with appropriately spaced doses of TTCV through supplementary immunization activities (SIAs); Promoting clean birth deliveries and cord care practices through the provision of care by a skilled birth attendant (SBA) present at 70% of deliveries; Enhancing reliable NT surveillance, including case investigation and response.

• #1

  https://www.who.int/news-room/fact-sheets/detail/tetanus

  As of July 2023, there are 11 countries that have not achieved MNTE. […] Maintaining elimination will require continued strengthening of routine immunization activities for both pregnant women and children, maintaining and increasing access to clean deliveries, reliable neonatal tetanus surveillance, and introduction and/or strengthening of school-based immunization, where feasible.

• #1 Maternal and Neonatal Tetanus Elimination | RRTM

  https://www.dovepress.com/maternal-and-neonatal-tetanus-elimination-where-are-we-now-peer-reviewed-fulltext-article-RRTM

  Despite missing the deadline of 2015 as elimination target, MNTE has been a huge success, and there has been a significant fall in the MNT cases and tetanus deaths. […] The remaining 12 countries have shown improving trends as shown by the surveillance indicators, there is still a long way to go to achieve global elimination.

• #1 Region of the Americas eliminates maternal and neonatal tetanus

  https://www.unicef.org/press-releases/region-americas-eliminates-maternal-and-neonatal-tetanus

  WASHINGTON / NEW YORK, 21 September, 2017 – The Region of the Americas has eliminated maternal and neonatal tetanus (MNT), a disease that used to be responsible for the deaths of more than 10,000 newborns every year in the Americas. […] The elimination of the disease was declared this year in Haiti, which made it possible to reach the regional goal. […] MNT is the sixth vaccine-preventable disease to be eliminated from the Americas, following the regional eradication of smallpox in 1971, poliomyelitis in 1994, rubella and congenital rubella syndrome in 2015, and measles in 2016. […] Unlike other vaccine-preventable diseases, MNT is considered eliminated when there is an annual rate of less than one case of neonatal tetanus per 1,000 live births at the district level. […] Recent progress in global elimination has led to 43 countries, including Haiti, eliminating MNT between 2000 and June 2017.

• #1 Tetanus Clinical Information – MN Dept. of Health

  https://www.health.state.mn.us/diseases/tetanus/hcp/clinical.html

  Tetanus is rare in the United States, where 50 or fewer cases of tetanus occur each year, deaths are more likely to occur in persons 60 years of age and older. However, continued success depends upon maintaining high vaccination rates. Tetanus disease can occur anytime of the year, but is most frequently seen in warmer climates or during the warmer months. […] Tetanus is not contagious from person to person. It is the only vaccine-preventable disease that is infectious, but not contagious. […] Vaccination is the primary means to prevent disease. […] Tetanus is a reportable disease. Report suspect cases of tetanus within one working day to the Minnesota Department of Health.

• #1 Tetanus (Clostridium tetani Infection) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482484/

  Tetanus is a vaccine-preventable disease, and tetanus toxoid-containing vaccines (TTCV) are included in the routine childhood immunization schedule. The average annual incidence of tetanus in the US from 2001 to 2008 was 0.01 per 100,000 population.[7] From 2009 to 2015, there were 197 reported tetanus cases and 16 associated deaths reported in the US.[14] The age groups at the highest risk are newborns and older individuals. The tetanus toxoid vaccine was first produced in 1924 and used extensively among soldiers during World War II. The pentavalent vaccine, which protects against diphtheria, tetanus, pertussis, Hib, and hepatitis B (DTP-Hib-HepB), is the most commonly used childhood vaccine worldwide.[3] Infection from C tetani does not confer immunity and is not transmitted from person to person.

• #1 Tetanus | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/tetanus

  In the U.S., 49% tetanus cases occurred in persons 50 years of age or older. Neonatal tetanus is rare in the U.S., with only two cases reported since 1989. […] Today, tetanus in the U.S. affects primarily older adults. […] From 1994 through 2008, Iowa had 6 cases of tetanus reported, 2 of which were known to be fatal.

• #1 Chapter 16: Tetanus | Manual for the Surveillance of Vaccine-Preventable Diseases | CDC

  https://www.cdc.gov/surv-manual/php/table-of-contents/chapter-16-tetanus.html

  This chapter provides general guidance for vaccine-preventable disease surveillance, describing the disease background/epidemiology, case investigation and reporting/notification, disease case definitions, and activities for enhancing surveillance, case investigation, and outbreak control for tetanus. […] In the United States, reported mortality due to tetanus has declined 99% since the early 1900s and has remained relatively constant since 2000, averaging about two deaths per year. Documented tetanus incidence has declined by approximately 99% since 1947, when national reporting of tetanus cases began. […] From 2013 through 2022, a total of 267 cases and 13 deaths from tetanus were reported in the United States through the National Notifiable Diseases Surveillance System (NNDSS). […] Because tetanus is preventable, the possibility of failure to vaccinate or maintain up-to-date status with tetanus vaccination should be investigated in every case. Each case should be used as a case study to understand which measures, including prophylactic TIG, tetanus vaccination, and wound care, could have been taken to prevent such cases in the future.

• #1 Current epidemiology of tetanus in England, 2001–2014 | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/current-epidemiology-of-tetanus-in-england-20012014/5F1F4B170CBE0C8BD8FEDCD99DC87659

  Public Health England conducts enhanced national surveillance of tetanus, a potentially life-threatening vaccine-preventable disease. […] The average annual incidence was 013/million (95% confidence interval 010016) of which 500% were male. […] Overall, 403% (31/77) cases were in people who inject drugs (PWID), including a cluster of 22 cases during 20032004. […] Due to the success of the childhood immunization programme, tetanus remains a rare disease in England with the majority of cases occurring in older unimmunized or partially immunized adults. […] It is essential that high routine vaccine coverage is maintained and that susceptible individuals, particularly older adults, are protected through vaccination and are offered timely post-exposure management following a tetanus-prone wound.

• #1 Eurosurveillance | Epidemiology of tetanus in Italy in years 1971-2000

  https://www.eurosurveillance.org/content/10.2807/esm.07.07.00357-en

  The incidence of reported tetanus in Italy decreased from 0.5/100 000 in the 1970s to 0.2/100 000 in the 1990s. […] During this period of time, the case-fatality ratio decreased from 68% to 39%. […] Italy has the highest reported number of tetanus cases in European countries. […] Vaccination campaigns need to be conducted to target this group, and the surveillance of tetanus has to be improved to identify additional groups of population at risk.

• #1 Tetanus– a case report highlighting the challenges in diagnosis and treatment | Tropical Diseases, Travel Medicine and Vaccines | Full Text

  https://tdtmvjournal.biomedcentral.com/articles/10.1186/s40794-024-00220-5

  Recent epidemiological data show a total of 50 reported cases in 2021 in 26 countries belonging to the European Union (EU) or European Economic Area (EEA). […] This decline in incidence has mostly depended on increasing TTCV vaccination rates, such as in Western Europe. […] The Dutch Governmental institute of Healthcare and Environment (Rijksinstituut Volksgezondheid en Milieu, RIVM) have reported a total number of 478 tetanus cases since 1952, with 308 reported deaths. […] Despite the successful vaccination program against tetanus infections, 0 to 5 annual cases are reported in the Netherlands, mostly concerning unvaccinated or partly vaccinated risk groups. […] In order to reduce the incidence of maternal and neonatal tetanus, adequate preventative measures are advised by the WHO.

• #1

  https://link.springer.com/article/10.17269/s41997-022-00732-7

  This report aims to use tetanus hospitalization data to describe the epidemiology in Canada from 1995 to 2019 and to assess progress on national reduction targets, including validating that Canada has eliminated maternal and neonatal tetanus (MNT). […] From 1995 to 2019, 155 non-MNT, 6 neonatal, and 0 maternal tetanus cases were retrieved from CIHI. […] In the same time period, there were 91 national notifications of tetanus. […] Tetanus incidence remains low and hospitalization data reveal that Canada has met its reduction target of maintaining 5 cases or fewer annually in recent years. […] For MNT, Canada has successfully met the elimination target of zero cases. […] This report affirms that tetanus has been eliminated in Canada, finding zero cases of MNT in the study period. […] Non-MNT case counts and incidence rates in Canada remain low, attributable to effective vaccination programs in Canada.

• #1 Tetanus/ Neonatal Tetanus (NT) – Taiwan Centers for Disease Control

  https://www.cdc.gov.tw/En/Category/ListContent/bg0g_VU_Ysrgkes_KRUDgQ?uaid=_q5n4hHxd17JmerH8BJkfg

  Tetanus occurs worldwide and is more common in warmer climates where the soil contains a lot of organic matter. […] since the national vaccination program was implemented, there are now around 10 to 24 Tetanus reported cases annually in Taiwan and no confirmed NT case has been reported since 1996 apart from a child born to a foreign mother in 2001. […] Taiwan National Infectious Disease Statistics System Tetanus and Neonatal Tetanus. […] Surveillance system.

• #1 Clinical profile and outcomes of tetanus patients in a tertiary hospital in the Philippines: a ten-year retrospective study | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09037-1

  Tetanus is a life-threatening but preventable neurologic disorder characterized by trismus and muscle spasms. Despite its decreasing global incidence, it remains to be endemic in resource-limited settings such as the Philippines. This study aimed to determine the incidence, demographic characteristics, risk factors, clinical presentation, management, complications, and outcomes of non-neonatal tetanus cases in a tertiary hospital in the Philippines. […] The Philippines reports an incidence rate of 6.9 tetanus cases per 1 million total population as of 2022; it remains to be a public health concern which poses a significant risk of morbidity and mortality. […] Although the total number of cases has decreased over the past decade, tetanus remains to have a high incidence and mortality rate in the Philippines.

• #1 Chapter 16: Tetanus | Manual for the Surveillance of Vaccine-Preventable Diseases | CDC

  https://www.cdc.gov/surv-manual/php/table-of-contents/chapter-16-tetanus.html

  Information obtained through surveillance is used to assess temporal, geographic, and demographic occurrence of tetanus. The data are also used to raise awareness of the importance of tetanus immunization and to characterize populations where additional efforts are needed to improve vaccination levels and prevention measures to reduce disease incidence. […] Tetanus is a reportable disease in all states and territories of the United States. […] Notifications for probable cases of tetanus should be sent to the Centers for Disease Control and Prevention (CDC) using event code 10210 in the NNDSS. […] The case investigation should include collecting the epidemiologic information on the CDC Tetanus Surveillance Worksheet.

• #1 Surveillance and updates

  https://www.ecdc.europa.eu/en/tetanus/surveillance-and-disease-data

  Surveillance report […] Tetanus – Annual Epidemiological Report for 2022 […] […] […] Surveillance report […] Tetanus – Annual Epidemiological Report for 2021 […] […] […] Surveillance report […] Tetanus – Annual Epidemiological Report for 2018 […] […] […] Surveillance report […] Tetanus – Annual Epidemiological Report for 2017 […] […] […] Surveillance report […] Tetanus – Annual Epidemiological Report for 2016 […] […] […] Disease data for tetanus from ECDC Surveillance Atlas […] The Surveillance Atlas of Infectious Diseases is a tool that interacts with the latest available data about a number of infectious diseases.

• #1 Tetanus – Canada.ca

  https://www.canada.ca/en/public-health/services/immunization/vaccine-preventable-diseases/tetanus/surveillance.html

  Tetanus is a notifiable disease in all provinces and territories, with cases reported to provincial/territorial departments of health. […] Tetanus is a nationally notifiable disease. All tetanus cases that meet the national case definition are reported to the Public Health Agency of Canada through a national surveillance system: […] Deaths due to tetanus are also monitored nationally. Mortality data is obtained from the Statistics Canada Canadian Vital Statistics Death Database, which collects demographic and cause of death information annually from all provincial and territorial vital statistics registries on all deaths in Canada. Data on deaths with tetanus listed as a cause of death can be found on CANSIM.

• #1 JMIR Public Health and Surveillance – Performance of the Neonatal Tetanus Surveillance System (NTSS) in Sana’a, Yemen: Evaluation Study

  https://publichealth.jmir.org/2021/5/e27606/

  Background: The Neonatal Tetanus Surveillance System (NTSS) in Yemen was established in 2009 to identify high-risk areas, determine trends, and evaluate elimination activities. Since its launch, the NTSS had never been evaluated. […] The overall usefulness score percentage was 38%, which indicates a poor performance. […] The performance of the NTSS was rated as average on flexibility (score percent: 68%) and acceptability (score percent: 64%) attributes and poor on stability (score percentage: 33%), simplicity (score percentage: 57%), and representativeness (score percentage: 39%) attributes. […] The overall performance of the NTSS was poor. Most of the system attributes require improvement, including stability, simplicity, quality of data, and completeness of investigation. […] High-quality NT surveillance is a key component of the NT elimination strategy, and its data are used to identify areas or subpopulations at high-risk for NT and guide effective public health response for NT elimination.

• #1

  https://link.springer.com/article/10.17269/s41997-022-00732-7

  The results provide some evidence that statistically more cases occurred in males than in females among hospitalizations and national notifications, particularly for those under 70 years of age. […] This report affirms that tetanus deaths are rare in Canada. […] The last notable finding was the discrepancy between national notifications for tetanus and the number of cases in Canadian hospitals. […] The Canadian vaccine-preventable disease reduction targets by 2025 for tetanus are outlined in Table 3. […] Canada has successfully achieved the targets for MNT during the entire period of study. […] Understanding tetanus epidemiology through sustained surveillance efforts will aid public health management and allow ongoing assessments for the reduction targets to mitigate disease burden in Canada.

• #1 Tetanus surveillance — United States, 2001-2008 – PubMed

  https://pubmed.ncbi.nlm.nih.gov/21451446/

  Incidence among Hispanics was nearly twice that among non-Hispanics, a difference accounted for by 16 cases among Hispanic injection drug users (IDUs). […] Among the 92 patients for whom tetanus toxoid-containing (TT) vaccination status was available, 37 (40.2%) had received no doses of TT vaccine. […] Tetanus remains a rare but life-threatening disease in the United States. […] Health-care providers should ensure up-to-date TT vaccination of all their patients, especially persons aged 65 years, persons with diabetes, and injection drug users.

• #1 Tetanus | Article | GLOWM

  https://www.glowm.com/article/heading/vol-17–maternal-immunization–tetanus/id/419403

  Tetanus is the only vaccine-preventable disease that is infectious but not contagious and cannot be spread from person to person. […] Complete eradication, however, is not possible due to the ubiquitous nature of the spores in the environment and intestine of many animals. […] Case-fatality rates vary from 10% to 70% depending on the age, general health of the patient, and treatment available. […] Therefore, early treatment, proper wound management, and effective vaccination strategies are the cornerstones to tetanus control and elimination. […] Clusters of tetanus cases have been identified as a complication of disasters, including earthquakes and tsunamis, and tetanus should be included as a differential diagnosis for people falling ill after disasters. […] The neonatal tetanus elimination (NTE) goal was formally launched during the 42nd World Health Assembly in 1989.

• #1 Tetanus epidemiology in Santa Catarina, Brazil from 1998 to 2008

  http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0123-93922010000200005

  Despite considerable investment in tetanus prophylaxis, it is still present throughout the national territory. […] The age group with the largest number of cases was the one ranging from 35 to 49 with a total of 94 cases (32.30%). […] The data in Table 02, related to the clinical characteristics of the tetanus cases in Santa Catarina, shows that out of 291 cases, 103 patients were unvaccinated, which corresponds to 35.39%. […] In developed countries, tetanus has become rare thanks to the prophylactic measures and socioeconomic and cultural development, which allows proper immunization of the population and appropriate care to traumatized patients. […] The more vulnerable lesion site, as expected, was the lower limbs, since most of the time victims are in contact with ground. […] If it were possible to characterize a tetanus case as the most common one in Santa Catarina from 1998 to 2008, it would be a 35 – 49 years old man, a countryman unvaccinated against tetanus who suffered a perforating injury in the inferior limbs and lives in Vale do Itaja.

• #2 Tetanus surveillance — United States, 2001-2008 – PubMed

  https://pubmed.ncbi.nlm.nih.gov/21451446/

  Tetanus is a life-threatening but preventable disease caused by the toxin of Clostridium tetani, a ubiquitous, spore-forming, gram-positive bacillus found in high concentrations in soil and animal excrement. […] Reported tetanus cases have declined 95%, and deaths from tetanus have declined 99% in the United States since 1947, when the disease became reportable nationally. […] To update a previous report and to determine the populations at greatest risk for the disease, CDC analyzed cases reported to the National Notifiable Diseases Surveillance System (NNDSS) during 2001–2008. […] This report summarizes the results of that analysis, which found that 233 tetanus cases were reported during 2001–2008; among the 197 cases with known outcomes, the case-fatality rate was 13.2%. […] Average annual incidence during that period was 0.10 per 1 million population overall and 0.23 among persons aged 65 years.

• #2 Tetanus Clinical Information – MN Dept. of Health

  https://www.health.state.mn.us/diseases/tetanus/hcp/clinical.html

  Tetanus is rare in the United States, where 50 or fewer cases of tetanus occur each year, deaths are more likely to occur in persons 60 years of age and older. However, continued success depends upon maintaining high vaccination rates. Tetanus disease can occur anytime of the year, but is most frequently seen in warmer climates or during the warmer months. […] Tetanus is not contagious from person to person. It is the only vaccine-preventable disease that is infectious, but not contagious. […] Vaccination is the primary means to prevent disease. […] Tetanus is a reportable disease. Report suspect cases of tetanus within one working day to the Minnesota Department of Health.

• #2 Tetanus (Clostridium tetani Infection) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482484/

  Most instances of tetanus occur in developing countries where immunity is deficient, particularly in areas affected by natural disasters.[12] […] In resource-rich countries, the unvaccinated and those with waning vaccine immunity are at risk. Among this group, surveillance data highlights individuals who inject drugs and those with insulin-dependent diabetes as particularly vulnerable.[7] […] The spores of C tetani are present in the environment irrespective of geographical location, residing in the soil and entering through openings in the skin. Wounds containing devitalized tissue pose the highest risk, making all age groups susceptible to infection. Without high-quality medical care, the case-fatality rate can approach 100%, while with optimal care, the case-fatality ratio ranges from 10% to 20%.[3] Neonates face an increased risk in resource-poor regions when nonhygienic deliveries are performed, nonsterilized materials are used to cut the umbilical cord, or contaminated dressings are applied to the umbilical stump.[11] In 2015, the World Health Organization (WHO) estimated that approximately 34,000 neonates died from neonatal tetanus.[13]

• #2 Tetanus – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/tetanus

  Worldwide in 2019, tetanus was estimated to have caused 34,700 deaths, mostly in South Asia and Sub-Saharan Africa, but the disease is so rarely reported that this figure is only a rough estimate. […] In the United States since 1947, reported tetanus cases have declined more than 95%, and deaths resulting from tetanus have declined more than 99%. […] Disease incidence is directly related to the immunization level in a population, attesting to the effectiveness of preventive efforts. […] Patients with burns, surgical wounds, or a history of injection drug use are especially prone to developing tetanus. […] Tetanus vaccination is required for all infants, children, adolescents, and adults. […] Because tetanus infection does not confer immunity, patients who have recovered from clinical tetanus should be vaccinated unless they have completed a full primary series. […] Patients who have a wound that poses an increased risk of tetanus should be given prophylaxis depending on wound type and vaccination history; tetanus immune globulin also may be indicated.

• #2 Tetanus surveillance — United States, 2001-2008 – PubMed

  https://pubmed.ncbi.nlm.nih.gov/21451446/

  Incidence among Hispanics was nearly twice that among non-Hispanics, a difference accounted for by 16 cases among Hispanic injection drug users (IDUs). […] Among the 92 patients for whom tetanus toxoid-containing (TT) vaccination status was available, 37 (40.2%) had received no doses of TT vaccine. […] Tetanus remains a rare but life-threatening disease in the United States. […] Health-care providers should ensure up-to-date TT vaccination of all their patients, especially persons aged 65 years, persons with diabetes, and injection drug users.

• #2 Tetanus | Washington State Department of Health

  https://doh.wa.gov/public-health-provider-resources/notifiable-conditions/tetanus

  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 […] Health care providers and health care facilities: notifiable to local health jurisdiction within 3 business days […] Local health jurisdictions: notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE) within 7 days of case investigation completion or summary information required within 21 days.

• #2 Maternal and Neonatal Tetanus Elimination | RRTM

  https://www.dovepress.com/maternal-and-neonatal-tetanus-elimination-where-are-we-now-peer-reviewed-fulltext-article-RRTM

  The three-pronged elimination strategies which are used for achieving MNTE are rigorous immunization of women of reproductive age (1549 years) with tetanus toxoid, strengthening of clean delivery services for pregnant women, and effective surveillance for the MNT. […] It is of paramount importance to sustain MNTE status once it is achieved and validated. […] The validation process is carried out using uniform methods across the globe as specified by WHO. […] The elimination of MNT is a dynamic process, and the countries which have achieved MNTE should continuously put in all efforts to sustain the status of MNTE. […] Sustained MNTE can be monitored by conducting the standalone post-validation assessment, or by checking of the MNTE status as an integral part of the review process of any health program like the annual vaccine-preventable disease (VPD) data desk review, and national immunization program review.

• #2 Clinical profile and outcomes of tetanus patients in a tertiary hospital in the Philippines: a ten-year retrospective study | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09037-1

  The cumulative incidence rate of non-neonatal tetanus in UP-PGH from January 2012 to June 2023 is 0.027% or 26.9 per 100,000 total inpatient admissions. […] The overall mortality rate was at 29%; 27% and 36% for the adult and pediatric subgroups respectively. […] Tetanus remains to have a high incidence and case fatality rate in the Philippines. Although the total number of cases and deaths from tetanus have been steadily decreasing over the past decade, its high morbidity and mortality rate demands greater efforts to address this vaccine-preventable disease.

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