A Report of Five Child Tetanus Cases

Abstract

We present five cases of generalized tetanus in children 5 to 13 years old, who were admitted to the intensive care unit of Ternopil Regional Children's Hospital (Western Ukraine) during the past 6 years (2012–2017). In our study, four children were unvaccinated and one received the full series of vaccinations. Proper vaccination in cases of infected wound may not prevent the development of the disease but improves the prognosis for recovery. Treatment of tetanus in Ukraine requires standardization of treatment protocols according to the World Health Organization recommendations, including making human tetanus immune globulin available, as specified by evidence-based medicine. Vaccines availability and education of physicians and parents about the benefits of immunization should be priority national health measures to prevent tetanus.

Keywords

tetanus - vaccines and immunization - Clostridium tetani

• References

• 1 Thwaites CL, Beeching NJ, Newton CR. Maternal and neonatal tetanus. Lancet 2015; 385 (9965): 362-370
• 2 Bleck TP. Tetanus: pathophysiology, management, and prophylaxis. Dis Mon 1991; 37 (09) 545-603
• 3 Centers for Disease Control and Prevention (CDC). Tetanus surveillance --- United States, 2001-2008. MMWR Morb Mortal Wkly Rep 2011; 60 (12) 365-369
• 4 Rushdy AA, White JM, Ramsay ME, Crowcroft NS. Tetanus in England and Wales, 1984-2000. Epidemiol Infect 2003; 130 (01) 71-77
• 5 National report about the state of technogenic and natural safety in Ukraine in 2014; 2014:244–263. Available at: http://undicz.dsns.gov.ua/ua/Nacionalna-dopovid-pro-stan-tehnogennoyi-ta-prirodnoyi-bezpeki-v-Ukrayini.html . Accessed July 9, 2018
• 6 World Health Organization. WHO Technical Note: current recommendations for treatment of tetanus during humanitarian emergencies. Geneva, Switzerland: WHO; January 2010
• 7 Fetuga BM, Ogunlesi TA, Adekanmbi FA. Risk factors for mortality in neonatal tetanus: a 15-year experience in Sagamu, Nigeria. World J Pediatr 2010; 6 (01) 71-75
• 8 Basu S, Paul DK, Ganguly S, Chandra PK. Risk factors for mortality from neonatal tetanus: 7 years experience in North Bengal, India. Ann Trop Paediatr 2006; 26 (03) 233-239
• 9 Giovanetti F, Pellegrino A. A case of tetanus in a child whose parents refused immunisation--Piedmont Region, Italy, 2006. Euro Surveill 2007; 12 (06) E070621.2
• 10 Johnson MG, Bradley KK, Mendus S, Burnsed L, Clinton R, Tiwari T. Vaccine-preventable disease among homeschooled children: two cases of tetanus in Oklahoma. Pediatrics 2013; 132 (06) e1686-e1689
• 11 Padmakumar B, Date AR. Tetanus in an unvaccinated child in the United Kingdom: case report. J Public Health (Oxf) 2005; 27 (01) 118-119
• 12 Aydin-Teke T, Bayhan GI, Afşarlar CE, Oz FN, Akansel AR, Tanir G. A report of two pediatric tetanus cases. Turk J Pediatr 2011; 53 (04) 437-440
• 13 WHO. European Health Information Gateway. Data. % of infants vaccinated against tetanus. Available at: https://gateway.euro.who.int/ru/indicators/hfa_607-7170-of-infants-vaccinated-against-tetanus/visualizations/?country . Accessed July 9, 2018
• 14 Boyarchuk OR, Sagal IR, Hariyan TV. Influence factors on formation of population adherence to immunization. Curr Issues Pediatr Obstet Gynecol 2015; 2: 11-14
• 15 Wright DK, Lalloo UG, Nayiager S, Govender P. Autonomic nervous system dysfunction in severe tetanus: current perspectives. Crit Care Med 1989; 17 (04) 371-375
• 16 Abdelmoneim T, DeNicola LK, Hasan MY. Tetanus: complications and management in a pediatric intensive care unit. In The Rare Case Registry of PedsCCM: The Pediatric Critical Care Web Site; September 16, 1997. Available at: http://pedsccm.org/RARE/Tetanus.html . Accessed July 9, 2018
• 17 Lin TS, Chen LK, Lin TY, Wen SH, Chen MC, Jan RH. Autonomic dysfunction because of severe tetanus in an unvaccinated child. Pediatr Neonatol 2011; 52 (03) 169-171
• 18 Alagbe-Briggs OT, Tinubu SA. Tetanus--a case report with severe autonomic instability and: a review of the literature. Niger J Med 2012; 21 (03) 353-356
• 19 Regulation of the Ministry of Health N° 198 dated 05.08.99 “Improvement of prevention, diagnosis and treatment of tetanus.” Available at: http://mozdocs.kiev.ua/view.php?id=776 . Accessed July 9, 2018