Tetanus, 2014

Two cases of tetanus were reported in 2014. One occurred in a vaccinated, white non-Hispanic 29 year-old male. He sustained a linear laceration, less than 1 cm deep, to his hand while cutting sheet metal. He presented with back and neck stiffness 5 days after the injury and was hospitalized. He did not require mechanical ventilation. He received tetanus immune globulin (TIG) within 1-4 days of symptom onset. He was discharged after 2 days and fully recovered.

The second case was fatal, and occurred in a vaccinated white non-Hispanic previously healthy 76 year-old female. She fell while gardening and lacerated both shins. She presented to a clinic twice. On the first visit she presented with cellulitis and received antibiotic therapy. On the second visit, 6 days after her injury, she received Td. Eight days after injury, she had severe muscle spasms and was in respiratory distress. She was then intubated upon admission to the hospital for symptoms related to generalized tetanus. She received TIG shortly after admission (within 1-4 days of symptom onset); however, she remained ventilated in the ICU until her death 30 days after admission.

Although both case-patients had received Td within the previous 10 years, it is unclear whether each had completed a primary series. If not, TIG would have been indicated at the time of the case-fatality’s injury.

• For up to date information see>> Tetanus
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2014