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Tetanus
Find most of the information you need in these resources
Always refer to your local signed PGD's in practice, and remember the Green Book takes priority over the SPmC - and sometimes WHO takes priority over the Green Book! They don't always say the same!
Other useful links and further reading:
Tetanus chapter of the Yellow Book (CDC)
Posters for the management of tetanus prone wounds
Tetanus: guidance, data and analysis: The diagnosis, surveillance and epidemiology of tetanus.
Tetanus: advice for people who inject drugs: A resource for clinicians to give to their patients.
Tetanus: advice for health professionals: Guidance on the management of suspected tetanus cases and on the assessment and management of tetanus-prone wounds. Don't forget to also consider rabies risk if an exposure was from an animal, especially if it is liked with travel abroad!
Recent Updates & News
23rd Jan 2025: The School leaver booster (Td/IPV): vaccine coverage estimates are out. It made me quite sad looking at the uptake data, I have to admit. Td/IPV coverage for year 10 students during the 2023/24 was 72.7%, which is 6.8 percentage points lower than the year 10 cohort in 2022/23.
22nd Jan 2025: The routine imms schedule has been updated to reflect a change to the use of REPEVAX rather than Boostrix-IPV at 3 years and 4 months.
JULY 2024 (10th) PGD updated for Td/IPV
JUNE 2024 a sad reminder of why Tetanus vaccination is super important! 7-year-old girl whose parents refused her tetanus vaccine hospitalised in intensive care
MARCH 2024 Updated guidance for management of tetanus prone wounds
MAY 2023 updated annual surveillance reports added to datasets
Bits and bobs to casually drop into conversation
Did you know....
According to the CDC:
Wounds without visible contamination can become infected with tetanus spores; tetanus transmission has been associated with abortion, dental infection, injection drug use, otitis media, pregnancy, and surgery.
Neonatal tetanus can be acquired when spores contaminate the umbilical cord due to unhygienic delivery practices.
Direct person-to-person transmission does not occur.
In 2020, over 11,750 tetanus cases were reported worldwide to the WHO, of which 2,230 occurred in neonates. Most tetanus cases were reported from countries in Africa and Southeast Asia.
The duration of the incubation period is inversely related to the severity of symptoms, and shorter incubation periods are associated with injuries closer to the central nervous system.
Case-fatality ratios for generalized tetanus vary between 25% and 100% and can only be reduced to 10%–20% where modern intensive care is available. Important bit of information for travellers!
Because the spores exist in the environment, tetanus cannot be eradicated. Tetanus disease does not result in immunity. Other than avoiding ALL possible environmental exposures (not likely feasible), vaccination is the only prevention against tetanus.
