VacciNation

Tetanus is a potentially fatal infectious disease characterized by rigidity and muscular spasms.  The symptoms include lock-jaw, muscular stiffness, and eventually convulsive muscular spasm throughout the body (3).  It is one of several infectious diseases that is preventable by vaccination.  Tetanus is caused by infection of the spore-forming bacterium Clostridium tetani.  These spores can enter the body through open wounds or breaks in the skin and germinate in low-oxygen conditions (3).  The disease is considered to be noncommunicable, meaning that it is not transmitted from one person to another but rather through exposure to the bacteria.  Even if everybody in the world were to be vaccinated for Tetanus, the disease would never be fully eradicated because the bacteria is present in soil all around the world and in animal feces (3).  

 

Tetanus can affect people of all ages, but it is found to be most serious in babies and their mothers if both are not previously vaccinated.   It occurs commonly in lower-income areas and areas that lack access to adequate medical care.  In those areas, mothers that contract an infection from C. tetani bacterium during pregnancy, can infect the fetus, resulting in neonatal tetanus, a largely fatal form of tetanus (3).  This happened in areas such as Indonesia in 2004 following the tsunami in the area.  As a result of the unclean conditions and lack of medical supplies, there was an outbreak of tetanus that resulted in a 18.9% fatality rate among those diagnosed (1).  Around the world, Indonesia still has the largest outbreak of tetanus in its population.  Other countries that are severely affected by tetanus include Uganda, Nepal, and the Philippines (4).

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Since the beginning of the 1900s, the documented rate of individuals with tetanus has decreased at a constant rate due to the increased incidence of vaccines for it and improved wound care strategies.  The tetanus vaccine is called tetanus-toxoid-containing vaccines (TTCV) and can be given at any stage of life including during pregnancy (3).  Another vaccination alternative is known as the DTaP vaccine. The vaccine is a three-fold immunization for Diphtheria, Tetanus, and Pertussis, three of the most common vaccine-preventable diseases (3).  This is an excellent alternative vaccine, but it is also more expensive and not as widely available around the world.

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Worldwide, leaders have responded to the issue of Tetanus in their respective countries mainly by having it handled by nonprofit organizations such as the World Health Organization, UNICEF and UNFPA (2).  These three organizations have been instrumental in their efforts to reduce the vaccination inequity in these countries.  Their primary target for these vaccines include women of reproductive age who have not yet been vaccinated.  They have also been educating these women on having more sterile birthing environments, especially if they are unable to reach a hospital in those areas (2).  Such nonprofits efforts have been fairly successful thus far, the rate of neonatal and maternal tetanus is at an all-time low.  

 

References

1. Barboza, P. (2006). Outbreak of tetanus cases following the tsunami in Aceh Province, Indonesia. Retrieved February 27, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/19153905

2. Ministry of Health of the Republic Indonesia with WHO, UNICEF and UNFPA. (2016, May 19). Indonesia has eliminated maternal and neonatal tetanus [Press release]. Retrieved February 27, 2017, from http://indonesia.unfpa.org/news/2016/07/indonesia-has-eliminated-maternal-and-neonatal-tetanus

3. Tiwari, T. S., MD. (2014, April 01). Chapter 16: Tetanus. Retrieved February 27, 2017, from https://www.cdc.gov/vaccines/pubs/surv-manual/chpt16-tetanus.html

4. World Health Organization. (2016, December 1). [Tetanus (total) reported cases]. Unpublished raw data.