Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Tetanus”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 523 records · Page 29Linked to original sources
PubMed2000

Immunity to diphtheria and tetanus in England and Wales.

The immunity profile of the English and Welsh population to diphtheria and tetanus has been determined by measuring diphtheria and tetanus antitoxin levels for 3088 and 3142 sera, respectively. Time-resolved fluorimetric immunoassay - DELFIA was used to measure diphtheria antitoxin levels and an in-house, indirect ELISA to measure tetanus antitoxin levels. More than 80% of those aged between 2 and 20-24 years had protective diphtheria antitoxin levels of 0.01 IU/ml, or greater, and more than 80% of those aged between 4 and 35-39 years had protective tetanus antitoxin levels of 0.1 IU/ml, or greater. Only 29% and 53% of those aged 60 and over were protected against diphtheria and tetanus. Two increases of diphtheria antitoxin levels greater than 0.1 IU/ml and tetanus antitoxin levels greater than 1.0 IU/ml were apparent, starting at 4 and 14 years of age, which correspond with the policy of giving a diphtheria and tetanus toxoid booster on school entry and a tetanus plus low-dose diphtheria toxoid (recently introduced) booster to school leavers. This is the first comprehensive study of diphtheria and tetanus immunity in the English and Welsh population and shows that the accelerated schedule of immunisation, introduced in 1990, has effectively primed immunological memory against both these antigens and that boosting at school entry and at school leaving is effective in increasing levels of immunity.

Adolescent↗
PubMed2004

Prognostic factors affecting deaths from adult tetanus.

The objective of this study was to determine prognostic factors related to death from adult tetanus. Fifty-three cases of tetanus, 25 females and 28 males, were treated in Cukurova University Hospital during 1994-2000. The mean age was 46.6 years. Forty-one (77.7%) patients came from rural areas. Most (64.1%) cases had minor trauma, but 19 (35.8%) had deep injuries. The mean incubation period was 11.5 days. Mortality was high (52.8%), caused by cardiac or respiratory failure or complications, and was related to the length of the incubation period. In cases with an incubation period < or = 7 days, the mortality rate was 75% (p 0.07). Mortality was significantly associated with generalised tetanus (p < 0.05), fever of > or = 40 degrees C, tachycardia of > 120 beats/min (p < 0.05), post-operative tetanus (p 0.03), and the absence of post-traumatic tetanus vaccination (p 0.068). Patients who were given tetanus human immunoglobulin or tetanus antiserum (p > 0.05) had similar outcomes. Patients who were given penicillin had a mortality rate similar to patients who were given metronidazole (p 0.15). The mortality rate was higher (92%) in patients with severe tetanus than in patients with moderate disease (53%). By multivariate analysis, the time to mortality caused by tetanus, and also the mortality rate, were both related significantly to age and tachycardia.

Adult↗
PubMed1982

Use of tetanus toxoid for testing cell-mediated immunity.

Tetanus toxoid was assessed as a skin test antigen for the measurement of cutaneous delayed-type hypersensitivity (DTH) by comparing the responses to intradermal injections of aqueous tetanus toxoid and an extract of Candida albicans in 50 randomly selected healthy adults and 10 adults with immunodeficiency. Of 42 healthy subjects previously immunised with tetanus toxoid, 33 (79%) reacted to tetanus toxoid and 33 (79%) reacted to Candida albicans. Of eight non-immunised subjects, none reacted to tetanus toxoid although five reacted to Candida albicans. Ten immunodeficient adults previously shown to be anergic to a standard panel of five skin test antigens including Candida albicans, and who had received primary immunisation and booster doses of tetanus toxoid, were anergic on current testing with tetanus toxoid and Candida albicans. Tetanus toxoid in previously immunised subjects has certain advantages as a "recall" DTH test antigen over the standard skin test antigens candidin, mumps, trichophyton, tuberculin and streptokinase-streptodornase used to diagnose cell-mediated immuno-deficiency. It is a sensitive measurement of DTH, it recalls a defined immunological event, it has a low incidence of side effects, and it produces a slight but beneficial boosting of serum antibody to tetanus toxoid.

Adenocarcinoma↗
PubMed1990

Effect of tetanus toxin on oxytocin and vasopressin release from nerve endings of the neurohypophysis.

The effect of tetanus toxin on neuropeptide hormone release from isolated nerve endings of the neural lobe of rat pituitaries (neurosecretosomes) was measured in a perfusion system. Tetanus toxin inhibited depolarization-evoked release of oxytocin and vasopressin in a time- and dose-dependent manner. At 1 microgram/ml, tetanus toxin blocked stimulated release by 85%. Tetanus toxin that was preincubated with a neutralizing monoclonal antibody or heated to 100 degrees C had no effect on hormone release. The ionophores A23187 and ionomycin were potent stimulators of hormone release in control nerve endings, but were not able to overcome the effect of tetanus toxin in intoxicated nerve endings. 8-Bromo-cyclic GMP, which has been reported to reverse the action of tetanus toxin in PC12 cells, had no effect on the action of tetanus toxin in neurosecretosomes. Neurosecretosomes are the first system in which tetanus toxin has been shown to block release from peptidergic nerve terminals. They appear to be a valuable in vitro system for studying the biochemical mechanism of tetanus toxin action.

Animals↗
PubMed1990

Beliefs and policies of Maryland nursing home medical directors regarding tetanus immunization.

Tetanus is more common in the elderly, who have a higher case-fatality rate than younger age groups. Immunization against tetanus is recommended for all elderly, including nursing home residents, but the tetanus immunization policies of nursing homes are unknown. Nursing home medical directors in Maryland were surveyed about their beliefs concerning tetanus and the tetanus immunization policies of their nursing homes. One hundred twenty-five directors of 212 responded (59%). In most of the nursing homes, no policies existed for routine tetanus immunization. Medical directors graduating from medical school after 1960 and medical directors with more than 50 nursing home patients were more likely to believe that tetanus immunization is cost-effective in nursing home patients. Only 3% of the respondents always immunize their nursing home patients with chronic skin ulcers. We believe tetanus immunization is an uncommon practice in Maryland nursing homes. Nursing home medical directors should establish policies to promote tetanus immunization.

Aged↗
PubMed2000

Immunologic response to a single dose of tetanus toxoid in older people.

OBJECTIVES: Several studies have demonstrated that a large percentage of older people are inadequately immunized against tetanus. The aim of this study was to assess the immunity against tetanus in a group of individuals aged 69 and older and to examine the immune response to a single dose of tetanus toxoid. DESIGN: A convenience sample of 115 residents of a large retirement home, aged 69 and older, was studied. After a blood sample for anti-tetanus antibody titer, a single dose of tetanus toxoid vaccine was administered. Repeat titers were obtained 6 weeks after the vaccination and analyzed by ELISA assay. Antibody levels equal to or greater than 0.1 IU/mL were considered protective. RESULTS: Sixty-seven of 115 (58.3%) individuals had adequate antibody titers. Those individuals who reported having been vaccinated with tetanus toxoid in the past were more likely to be immunized adequately compared with those who reported having never been vaccinated (66.7% vs 39.3%, P = .02). After vaccination, 34 of 46 (73.9%) individuals with inadequate antibody titers became seropositive. Those who remained seronegative had mean prevaccination antibody titers significantly lower than those who seroconverted. Sixteen of 17 (94.1%) persons who reported having been vaccinated in the past and were found to be seronegative developed adequate antibody titers following vaccination, compared with only nine of 16 (56.2%) who reported never having been vaccinated (P = .04). There was no association between seroconversion rate and age, sex, underlying diseases, and army service. CONCLUSIONS: Most individuals will develop an adequate anti-tetanus antibody titer following administration of a single dose of tetanus vaccine. A history of past immunization is a good predictor of becoming adequately immunized. It is important that physicians follow the current recommendations for adult immunization and initiate campaigns to ensure that the older population is protected against tetanus.

Aged↗
PubMed1989

Sequence homology between tetanus and botulinum toxins detected by an antipeptide antibody.

The extent of immunological similarity between tetanus toxin and botulinum toxins A, B, C1, and E was studied by using 10 antibodies produced against synthetic peptides representing different sequences of tetanus toxin, mouse antitetanus serum, and human Tetanus Immune Globulin. Antibodies produced against the synthetic peptides recognized tetanus toxin in an enzyme-linked immunosorbent assay and on Western blots (immunoblots) but did not appear to recognize the native protein. One of the antitetanus peptide antibodies, which was produced against a peptide from the amino terminal, cross-reacted with three of the four botulinum toxins on immunoblots. This antibody, 1, reacted strongly with botulinum toxins B and C1 and weakly with E but did not recognize type A toxin. None of the other peptide antibodies cross-reacted with the botulinum toxins. Mouse antitetanus serum and human Tetanus Immune Globulin did not recognize any of the botulinum toxins on immunoblots. The amino-terminal region of the light chain of tetanus toxin and botulinum toxin types A, B, C1, and E are known to have sequence homology. Our data demonstrate that for tetanus toxin and botulinum toxin types B, C1, and E this region also has immunological homology. Type A, which has the least amount of homology with tetanus toxin in this region, does not share this immunological homology. These data also suggest that although the native structures of tetanus and botulinum toxins have relatively few common immunological determinants, the two toxins may contain short stretches of identical or very similar amino acid sequences.

Amino Acid Sequence↗
PubMed1994

Quality improvement and public health--tetanus immunization in the emergency department.

The administration of tetanus toxoid vaccine to both adults and children represents an often neglected, but medically necessary procedure for patients who receive traumatic injuries to nature's natural surface barrier, the skin. While performing retrospective chart reviews, the collaborative practice environment fostered in the Emergency Department at Reston Hospital Center, (wherein the physician and nursing staff are schooled in Deming's Quality Improvement-FOCUS-PDCA-methodology, and the concepts of "patient care clinical process ownership," and "professional job enlargement and job enrichment" diffuse throughout the Emergency Services Systems design), identified a potential problem with tetanus immunization related to existing standing orders. Initial data collection utilized count-between methodology. Over a 31-day period, 216 patients who required tetanus immunization were identified. Appropriate tetanus toxoid administration was "missed" 20 times, with a median of 9 appropriate tetanus immunizations before an administration was "missed." Flow chart analysis of the tetanus toxioid administration process identified the sources of variation of that process. A pilot PDCA cycle was instituted to redefine the process, control the variability, and measure the results. Upon completion of the third PDCA cycle of 31 days, 367 patients were identified who required tetanus immunization. Appropriate tetanus toxoid administration was "missed" 3 times with a median of 120 appropriate tetanus immunizations before an administration was "missed." Conclusions include: a) The appearance of special cause variation, (diaster situations), must be recognized as having the potential to disrupt healthcare process improvements.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2003

[Two cases of generalized tetanus presenting with dysphagia as an initial symptom].

We describe two patients with generalized tetanus, a 60-year-old man and a 76-year-old woman, presenting with dysphagia as an initial symptom of the disease. Eighty percent of patients with generalized tetanus manifest dysphagia on admission to a hospital. However, dysphagia is rare as an initial symptom. Both our patients had dysphagia as their initial symptom, followed by neck stiffness and trismus. We made a diagnosis of generalized tetanus based on these neurological findings in the absence of an apparent episode of trauma. After the administration of tetanus immunoglobulin on admission, they recovered without exhibiting generalized convulsion, autonomic storm, or any other serious complications. The vaccination of tetanus toxoid cannot maintain sufficient antibody titers more than ten years. Therefore, elderly people are considered susceptible to tetanus. We suggest that tetanus should be considered in the differential diagnosis of dysphagia particularly in elderly patients. We also suggest that treatment of tetanus should be initiated immediately, because tetanus still has a high mortality rate at present.

Aged↗
PubMed1989

Studies on the intoxication pathway of tetanus toxin in the rat pheochromocytoma (PC12) cell line. Binding, internalization, and inhibition of acetylcholine release.

Tetanus toxin was found to be a potent inhibitor of neurosecretion in the rat pheochromocytoma cell line PC12, a system in which biochemical and functional studies could be performed in parallel. Incubation of the cells with 10 nM tetanus toxin (3 h) led to an inhibition of acetylcholine release by 75-80% when evoked by 200 microM veratridine, 1 mM carbachol, or 2 mM Ba2+. The main characteristics of the inhibition process are: 1) the toxin is very potent, with threshold doses of 10 pM; 2) the action of toxin is blocked at low temperature (0 degrees C) and by antitoxin; 3) the effects are dose- and time-dependent; 4) a concentration-dependent lag phase precedes the onset of the inhibitory effects. Thus the PC12 cultures are a valid system for studies on the underlying molecular process in tetanus action. This system was exploited by the use of long term incubation studies to examine the processes responsible for the lag phase. When cells were incubated with 0.1 nM 125I-tetanus toxin, cell-associated toxin reached a plateau of 16 fmol of toxin/mg of protein, yet the toxic effects did not appear until 12 h. Further, PC12 cells were found to rapidly internalize tetanus toxin, with a half-life of 1-2 min, once it was bound to the surface of the cells. Thus, the lag phase results from steps that occur in the intracellular compartment after internalization. An important discovery was that the differentiation state of the PC12 cells was a critical factor in determining sensitivity to tetanus toxin. Cells that were cultured with nerve growth factor for 8-12 days were very sensitive to toxin. In contrast, acetylcholine release from nondifferentiated, autodifferentiated, or dexamethasone-treated cultures was insensitive to tetanus toxin. Since differential expression of high affinity tetanus toxin receptors cannot explain these results, it is concluded that PC12 cells are capable of expressing different forms of excitation-secretion coupling mechanisms. Tetanus toxin should prove a valuable probe to further distinguish these processes.

Acetylcholine↗
PubMed1983

Action of tetanus toxin on cholinergic neuroblastoma X glioma hybrid cells: selective blockade of Ca spikes.

We examined the effect of tetanus toxin on clonal neuroblastoma X glioma hybrid cells, NG108-15, by intracellular microelectrode studies of passive membrane electrical properties and action potentials generated under various conditions. Binding of tetanus toxin to the surface of the cells was demonstrated by indirect immunofluorescent staining but no morphological alteration was observed in tetanus toxin-treated cells under a phase contrast microscope. These is no significant difference between the tetanus toxin-treated and untreated cells in their passive electrical membrane properties, i.e. resting membrane potentials, input resistances, time constants and input capacities. Cells in 120 mM Na+, 2 mM Ca2+ salt solution showed Na spikes, and cells in high Ca2+ (30 mM), Na+-free salt solution showed Ca spikes in response to depolarizing current pulses. While the Na spike was not affected by tetanus toxin, the Ca spike was blocked by the toxin. The minimum dose of tetanus toxin for maximum suppression of the peak potential level of the Ca spike was 250 ng/ml. Addition of tetraethyl ammonium (TEA) to extracellular fluid enhanced the Ca spike in untreated cells. In toxin-treated cells, TEA did not alter the effect of tetanus toxin on the Ca spike. Blockade of the Ca spike by tetanus toxin could be detected even at low extracellular Ca2+ concentration (10 mM) by adding TEA to the extracellular fluid and adjusting the membrane potential to a steady hyperpolarized level (-80 mV) to ensure optimal and uniform electrical responses. The usefulness of NG108-15 hybrid cells for in vitro investigations on the mechanism of action of tetanus toxin was discussed.

Action Potentials↗
PubMed1981

Studies on the adequate composition of diphtheria and tetanus toxoids-with reference to the amounts of toxoids and aluminum adjuvant.

Immune response of man to tetanus and diphtheria-tetanus combined toxoids with different compositions was investigated, with special reference to the long-term immunity. Adsorbed tetanus toxoid with a potency of about 25 IU per human dose endowed a long-lasting immunity sufficient to prevent tetanus to the vaccines of various age groups, when administered in two doses, followed by a booster injection. Two doses of adsorbed diphtheria-tetanus combined toxoid with potencies of about 20 IU per dose for both components were sufficient to give immunity in infants against diphtheria and tetanus. However, a booster injection should be given within a year to endow a long-lasting immunity. In the case of booster immunization of children with a complete history of immunization against diphtheria and tetanus, a potent long-term immunity was endowed by a single injection of diphtheria-tetanus combined toxoid (plain) with 1 and 3.5 IU per dose, for diphtheria and tetanus components, respectively.

Adjuvants, Immunologic↗
PubMedDate not supplied

Seroprevalence of tetanus immunity among noninsulin-dependent diabetes mellitus patients.

Tetanus is a preventable disease that continues to affect people in both developing and developed countries. The aim of the present study was to evaluate the immunity profile to tetanus in patients with Type II diabetes mellitus (DM) and to compare them with healthy controls. The tetanus antitoxin levels in 310 diabetic patients (104 males and 206 females) and in 200 healthy controls (72 males and 128 females) were measured by ELISA (Virotech, Germany). The mean antitoxin concentration in patient and control groups were 0.8238+/-1.61 and 0.9978+/-1.49 IU/ml, respectively. There was a statistically significant difference between the two groups (z=-3.520, P=.0001 and odds ratio was 2.367). There was a definitive inverse correlation between the duration of diabetes and tetanus antibody titers (Spearman's correlation analysis, r=-.155, P=.006). A gender-dependent difference in the susceptibility to tetanus was present in the diabetic group with antibody titers being significantly higher in males compared with females (z=-2.267, P=.023). For both of control (chi(2)=20.207, P=.003) and patient (chi(2)=43.532, P=.0001) groups, there was a significant inverse correlation between the tetanus immunity levels and age. Statistically, a significant drop in antibody titers of both groups was found as the period past from the last immunization increased (Pearson correlation analysis: for patient group r=-.364, P=.0001; for control group r=-.143, P=.044). The tetanus antitoxin levels were significantly increased in individuals who had primary immunization during childhood (for patient group chi(2)=17.191, P=.0001; for control group chi(2)=9.911, P=.007). A significant reduction in the level of antitoxin immunity to tetanus in association with an increased susceptibility to infections in patients with diabetes may implicate the need for improving vaccination rates in this patient group.

Adult↗
PubMed1975

Tetanus and diphtheria antitoxin levels following a hospital-based adult immunization program.

A hospital-based program to immunize adults against tetanus unless specific contraindications to immunization are present has been in effect at Parkland Memorial Hospital since 1959. Adsorbed tetanus toxoid was used from 1959 to 1970, and was replaced at that time by adult type adsorbed combined tetanus/diphtheria toxoid. In the present survey, the titers of diphtheria and tetanus antitoxins were determined in sera from 97 adults admitted to the Medical Service. Titers of diphtheria antitoxin less than 0.0125 units per ml were found in only seven patients and less than 0.0125 units per ml of tetanus antitoxin in only 17 patients. This high prevalence of immunity especially to tetanus appears to reflect our practice of routine immunization of adults. Although the recommended frequency of tetanus boosters has recently been reduced for adults who have completed a full primary immunization series, susceptibility to diphtheria or tetanus or both is not uncommon among adults in the US. Unless contraindications are present, we therefore urge routine immunization of all adults seeking medical care and of all hospital personnel as a means of diminishing the risk of diphtheria and tetanus in those adult populations with a significant incidence of susceptibility to these diseases.

Adolescent↗
PubMed1996

Serum antibodies against haemophilus influenzae type b and tetanus at 2.5 years of age: a follow-up of 2 different regimens of infant vaccination.

In 1990-91 we compared 2 Haemophilus influenzae type b (Hib) conjugate vaccines and 2 different regimens of tetanus vaccination, by vaccinating 142 Swedish infants at ages 3, 5, and 12 months, with either PRP-T (the capsular polysaccharide of Hib conjugated to tetanus toxoid) + D (diphtheria toxoid), or with PRP-OMP (PRP conjugated to an outer membrane complex of meningococcus group B) + DT (diphtheria-tetanus toxoid). In this follow-up, antibodies against Hib and tetanus were analyzed in sera from 133 of the children at the age of 2.5 years. Hib antibodies (> or = 0.06 micrograms/ml) were found in 99% of the children of both groups, but 93% of the PRP-T vaccinees had maintained Hib antibodies > or = 0.15 micrograms/ml, as compared with 80% of the PRP-OMP vaccinees (p < 0.05). In 1992, the batch of PRP-OMP was reported to have questionable immunogenicity. Tetanus toxoid (T) antibodies (> or = 0.01 IU/ml) were found in all sera from both groups. All sera with T antibodies < 0.1 IU/ml showed tetanus toxin neutralizing activity. However, only 75% of children vaccinated with PRP-T had T antibodies > or = 0.1 IU/ml, as compared to 97% of children vaccinated with DT (p < 0.001). In conclusion, Hib and tetanus antibodies were well maintained 18 months after primary vaccination, also in the group vaccinated with the batch of PRP-OMP of somewhat low immunogenicity and in the group of infants receiving their primary tetanus vaccination only by the carrier protein of PRP-T.

Antibodies, Bacterial↗
PubMed1996

Tetanus immunity in an older Australian population.

OBJECTIVE: To evaluate the effectiveness in older Australians of the current tetanus vaccination program. DESIGN: A cross-sectional survey of tetanus immunity (enzyme immunoassay of serum samples) in an older population in New South Wales. Self-reported history of tetanus vaccination was compared with serologically measured immunity. PARTICIPANTS: 430 randomly selected adults, 49 years of age and older, from the Blue Mountains Eye Study population. RESULTS: Fifty-two per cent (95% confidence interval [CI], 47%-57%) of adults 49 years of age and older had protective levels of tetanus antitoxin ( > 0.15 IU/mL). There was a significant decline in the prevalence of immunity with increasing age (chi 2 for linear trend, P = 0.036), and women were less likely to be immune regardless of their age (Mantel-Haenszel weighted odds ratio, 0.65; CI, 0.43-0.92). Thirty-five per cent (95% CI, 31%-40%) of all participants reported that they had been vaccinated in the preceding 10 years. Although self-reported tetanus vaccination history was associated with tetanus immunity, it was neither sensitive nor specific as a test for immunity. CONCLUSIONS: About half the adults 49 years of age and older in the Blue Mountains area of New South Wales do not have protective levels of tetanus antitoxin because of inadequate vaccination coverage in this age group. Vaccination history is not a reliable indicator of tetanus immunity and a system is needed for accurate recording of adult vaccination.

Adult↗
PubMed2002

Tetanus immunity among pregnant women attending antenatal care in Dar es Salaam, Tanzania.

This study was conducted to investigate immunity to tetanus among pregnant women with verbal histories or documentation of having been vaccinated under the current five-dose tetanus toxoid (TT) schedule. It examined sera from 176 pregnant women attending antenatal care at Muhimbili Medical Centre in Dar es Salaam, Tanzania. Tetanus antitoxin level of 0.1 IU/ml was considered protective. Our findings show that 94.9% of women had tetanus antitoxin > or = 0.1 IU/ml. Multivariate analysis revealed that time after last vaccination, TT doses received and TT vaccination status explained 7.5%, 5.7% and 2.3% of variations in tetanus antitoxin levels respectively. Pregnant women with non-protective levels of tetanus antitoxin (5.1%) pose great risks of neonatal tetanus to their newborns and are also susceptible to maternal tetanus. Proper keeping of TT vaccination records is vitally important to avoid hyper-immunisation.

Adolescent↗
PubMed1994

Tetanus in Auckland: a preventable disease.

AIMS: To determine the clinical features, management and outcome for patients admitted to hospital with tetanus in Auckland. METHODS: Medical records of all patients with tetanus admitted to hospitals in Auckland between January 1982 and December 1992 were retrospectively reviewed. RESULTS: Fifteen patients were admitted to hospital during the study period. All patients were more than 40 years old and no patient had a history of more than one tetanus toxoid immunisation before the injury presumed responsible for tetanus. Failure to consider the diagnosis led to delay in starting appropriate treatment in most patients. Eleven patients required mechanical ventilation. The median duration of hospital stay was 44 days. All patients survived. CONCLUSIONS: Tetanus is rare in Auckland and almost exclusively affects those born before 1960 when universal childhood immunisation against tetanus was started. The disease causes significant morbidity which could be avoided by increased efforts to ensure that all persons have completed a full course of immunisation. Universal vaccination against tetanus with regular boosters to maintain immunity would also circumvent the problems encountered with postexposure tetanus prophylaxis.

Adult↗