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PubMed1975

Titration of tetanus antitoxin by passive hemagglutination. I. Titration of guinea-pig antitoxins at various periods of immunization.

An improved technique for passive hemagglutination (HA) for titration of tetanus antitoxin was described. The use of highly purified tetanus toxoid and of improved diluent increased the specificity and reproducibility of the test. Several hundreds of specimens of guinea-pig serum taken at various stages of immunization were titrated by HA and toxin neutralization (NT) in mice. The ratio of HA to NT titers varied significantly depending on the immunization stage; higher at early stages and lower at later stages. The high HA/NT ratio was not due to the IgM antitoxin, which is very rare in guinea pigs. The variation in discrepancy between HA and NT titers decreased considerably by grouping the serum specimens with respect to the stage of immunization. Thus, it is possible to predict the in vivo titer of a tetanus antitoxin accurately enough for clinical study. The HA test may be useful as an alternative method for titrating tetanus antitoxin in the field trials. Moreover, it can be used for the study of characteristics of antitoxins.

Animals↗
PubMed1979

Clinical description of tetanus in squirrel monkeys (Saimiri sciureus).

Nineteen cases of clinical tetanus developed in Bolivian squirrel monkeys (Saimiri sciureus) which were housed in outdoor corrals with soil-based floors. The disease was initially characterized by stiffness in gait followed by extensor rigidity, trismus and opisthotonus. Eleven of the 19 monkeys (58%) had evidence of external wounds. The case fatality rate was 100%. Tetanus accounted for 12% of adult female and 19% of adult male mortalities in the colony. Immunization with tetanus toxoid was effective in reducing the incidence of tetanus.

Animals↗
PubMed2000

[Immunity against diphtheria and tetanus in various age groups after 40 years since implementation of the mass vaccination program].

The aim of this study was to determine immunity against diphtheria and tetanus in various age groups and to compare it with the results of seroepidemiological studies conducted during previous 40 years. The level of diphtheria and tetanus antibody was determined by means of ELISA tests in 1534 sera obtained from persons aged 1-81 years. As elsewhere in Europe, the present study confirms the insufficiency of humoral immunity to diphtheria among Polish adults. Groups with the lowest levels of diphtheria antibody include persons aged 30-60 years (62% protected). Tetanus immunity was highest during the first three decades of life (above 90% protected), and then declined with increasing age. The comparison with results of several serologic surveys performed earlier showed gradually increasing immunity level against tetanus in all age groups.

Adolescent↗
PubMed2001

Influence of placental malaria infection and maternal hypergammaglobulinaemia on materno-foetal transfer of measles and tetanus antibodies in a rural west African population.

Placental malaria infection jeopardizes pregnancy outcome, and its influence may also impair the transplacental transfer of some antibodies. Two hundred and thirteen Gambian mother-baby pairs were studied to determine the influence of placental malaria infection and maternal hypergammaglobulinaemia on transplacental transfer of measles and tetanus antibodies in Gambian population. Placental blood and tissue were collected for placental malaria diagnosis. Cord and maternal sera were tested for total IgG concentration by laser nephelometry and for IgG antibody to tetanus toxoid and measles by ELISA. The prevalence of placental malaria infection was 51.1%. Mothers whose placentae were parasitized had a significantly higher mean total serum IgG (22.0 g/L vs 11.3 g/L, p < 0.001) and measles antibody level (4.02 IU/mL vs 1.21 IU/mL, p < 0.01), but not tetanus antibody, than mothers with non-parasitized placentae. Results of multiple regression analysis showed that placental malaria infection and maternal hypergammaglobulinaemia were associated with the reduction of 72% (95% CI 67.84) and 86% (95% CI 76.91) in transplacental transfer of measles antibody respectively but did not influence the transfer of tetanus antibody. It is concluded that the combined influence of placental malaria infection and maternal hypergammaglobulinaemia is significantly associated with the transfer of impaired measles antibody in this population.

Adult↗
PubMed1995

[Tetanus prophylaxis in injuries. Guidelines for the dental practice].

The severe and often fatal infection of tetanus is very rare in the Netherlands because of the mild Dutch climate and adequate vaccination programme. Nevertheless, in case of wounds, either extra- or intra-orally, tetanus prophylaxis should be considered. The immunity of the individual patient can be estimated by his vaccination record. Dentists see a large number of patients with dental trauma and/or facial wounds. Depending on the immune status of the individual patient, tetanus prophylaxis might be necessary. Especially at risk are patients with inadequate or deficient vaccination, e.g. those who spent their childhood abroad and patients who had their last immunisation over ten years ago. Vaccination in case of wounds should follow a strict protocol to prevent an inadequate tetanus prophylaxis.

Facial Injuries↗
PubMed2003

[Tetanus in 2001].

In 2001, 21 cases of tetanus were registered in Poland. The incidence rate of tetanus was 0.04/100,000 population. No neonatal tetanus cases were recorded. All cases except one occurred among peple of age 50 or more. Case fatality rate associated with tetanus was 33.3% and increased with age. All cases were unvaccinated or vaccination status was unknown. The data show effectiveness of vaccination program, but also show need for promotion of post exposure prophylaxis, especially among older people.

Adolescent↗
PubMed2004

Seroepidemiologic study on pertussis, diphtheria, and tetanus in the Fukuoka area of southern Japan: seroprevalence among persons 0-80 years old and vaccination program.

In Japan, mass vaccination for diphtheria, pertussis, and/or tetanus has been mandated by the Vaccination Law since 1948. In order to evaluate the efficacy of this vaccination policy, we conducted seroepidemiological studies on pertussis, diphtheria, and tetanus among individuals aged 0 - 80 years. The pertussis toxin seropositive rates of the vaccine-eligible groups and vaccine-ineligible groups were 55.0 and 57.9%, respectively. The seropositive rate of each group for diphtheria antitoxin was 76.3 and 75.7%, respectively. The tetanus antitoxin seropositive rates were 91.7 and 10.5%, respectively, showing a significant difference between the two groups (P < 0.001). For the three diseases, variations were seen between age groups in the geometric mean antibody titers due to changes of the vaccination program. The results of this study show that natural Bordetella pertussis infection has occurred more frequently than expected. In order to establish the most appropriate vaccination program for the control of pertussis, diphtheria, and tetanus in Japan, further evaluation is necessary.

Adolescent↗
PubMed2004

Tetanus: an analysis of the prognosticating factors of cases admitted into the medical wards of a tertiary hospital in a developing African country between 1990 and 2000.

This is an analysis of the effects of prognosticating factors on the outcome of patients with tetanus who were seen in our hospital between 1990 and 2000. Tetanus remains a major public health hazard associated with high mortality. A total of 66 cases were analysed with a slight female preponderance. The mortality rate was 26.2% with an age-adjusted fatality rate of 16.2% for those under 40 years of age. This increased to 75% for those patients above 70 years of age. The most common portal of entry was lower limb, specifically the foot, and this was the case in 56%. The socio-economic status of the patients, the immunisation status, the incubation period, the age of the patient, the severity of the spasms, the duration of hospital stay, the type of treatment received and the onset time were found to affect the outcome of the patients. We recommend that health care providers should take every opportunity to review the vaccination status of their parents and provide tetanus vaccine when indicated, and recall when treating injured patients that many middle-aged and older adults are not adequately immunised against tetanus.

Adolescent↗
PubMedDate not supplied

[Determination of tetanus toxin and toxoid by ELISA using monoclonal antibodies].

The procedure of obtaining monoclonal antibodies TT-1, TT-2, and TT-3 against tetanus toxin/toxoid is described. It is shown that both commercial DTP vaccine and tetanus toxoid conjugated with a low-molecular-weight hapten can be used an immunogens. Monoclonal antibodies TT-1 and TT-2 neutralized tetanus toxin in vivo. The monoclonal antibodies obtained were used to design and compare several schemes of quantitative determination of tetanus toxoid and toxin by ELISA. A more sensitive competitive ELISA allowed detecting as much as 0.01 EC/ml toxoid and 50 LD50/ml toxin.

Animals↗
PubMed2004

[Tetanus prophylaxis in general practice].

In response to the report 'Immunisation against tetanus following injuries' from the Dutch Health Council, the Dutch College of General Practitioners, the National Coordinating Body for the Control of Infectious Diseases and The Netherlands Vaccine Institute have drawn up guidelines for tetanus prophylaxis in general practice. The number of situations in which the administration of tetanus immunoglobulin or tetanus vaccine is indicated is now considerably lower. Some of the unclear aspects of the report have been further worked out and translated into definite guidelines. The guidelines are not only useful for general practitioners but deserve to be followed by all doctors treating patients with injuries.

Family Practice↗
PubMed1992

Tetanus.

Tetanus causes approximately 50,000 deaths per year worldwide, the incidence being greatest in undeveloped countries. Once tetanus occurs, the risk of death is substantial. Physician attention to the immunization status of patients who present with wounds, chronic and minor, can improve prevention of tetanus. It should be noted that more than 10% of the US population is not properly immunized against tetanus and that those at greatest risk are females of any age, males older than 50, blacks from the rural South, and those without any military experience.

Humans↗
PubMed2004

[Reported cases of tetanus in the North of Portugal (1993-2002). Missed opportunities for vaccination].

The aim of this study was to motivate health professionals to avoid missed opportunities of vaccination against tetanus. In the North of Portugal, 210 cases of tetanus were reported between 1993 and 2002. Data for this study was collected from the computerised records of statutory reportable diseases (1993-2002) and written reports from local health authorities (2000-2002). Most cases occurred between 55 and 84 years of age. Above the age of 65, females were the most affected (73.7%). All 17 cases (2000-2002) received hospital care. Two deaths were reported. Type and site of injuries were analogous to those already described in the literature. None of the patients had been adequately vaccinated. Almost all cases had attended health services in the 10 previous years. In order to eliminate tetanus, all contacts with health professionals should be an opportunity to check vaccination status and immunise against tetanus as recommended.

Aged↗
PubMed1991

Penicillin-induced hemolytic anemia and acute hepatic failure following treatment of tetanus in a horse.

Acute, severe hemolytic anemia occurred in a horse being treated for tetanus with intravenous penicillin and tetanus antitoxin. During treatment, the horse developed a positive direct antiglobulin test and a high titer (maximum 1:1024) of IgG anti-penicillin antibody. The horse recovered from the tetanus and penicillin induced hemolytic anemia, but later developed acute hepatic failure, probably resulting from the administration of equine origin tetanus antitoxin.

Acute Disease↗
PubMed1988

A house-to-house survey of neonatal tetanus in urban and rural areas in the Gondar region, Ethiopia.

A house-to-house survey of neonatal tetanus was performed in 30 population clusters in Gondar, Northwestern Ethiopia. At the end of the survey 37,219 households were visited and 2010 live births were recalled. Out of the 2010 live-born children 127 had died. Eighty died during the neonatal period. Nine of the neonatal deaths were due to tetanus, giving a neonatal tetanus mortality rate of 4.5/1000 live births. The problem of neonatal tetanus in developing countries, particularly that of Ethiopia, is discussed.

Ethiopia↗
PubMed1988

Tetanus--a continuing problem in minor injuries.

Tetanus is rare in North America because of highly effective specific immunization programs. Nevertheless, 15 patients with generalized tetanus were treated at the Vancouver General Hospital over a 20-year period; 10 of them were over 50 years of age. Two patients had no injury and 12 had suffered only minor wounds. None had received previous immunization and, even after wounding, prophylaxis was unsatisfactory in all cases. Nine patients required intensive care and two died. Positive cultures were obtained in only two cases. Four recommendations are made to prevent tetanus: (a) all wounds should be considered "tetanus-prone", (b) an accurate history of immunization should be obtained, (c) more attention should be given to prophylaxis at the time of injury and (d) patients should record vaccinations.

Adult↗
PubMed1985

Effect of passive immunity to tetanus in DTP vaccinated infants.

Tetanus antitoxin levels in DTP unvaccinated and vaccinated infants whose mothers had either received no dose or two doses of absorbed tetanus toxoid at present pregnancy were determined by the enzyme immunosorbent assay (EIA). It was found that the percentage of protective infants born from non-immunized and immunized mothers were 95.4 and 100 respectively. The transplacental tetanus immunity in infants of immunized mothers was higher than those of non-immunized mothers, however, it was significantly reduced in both groups of infants within two months. After the first dose of DTP vaccine, infants born from non-immunized mothers were able to respond well in producing antibody whereas the infants from immunized mothers were not. In the second and third dose of DTP vaccine both groups of infants had a similar range of tetanus antitoxin.

Diphtheria Toxoid↗
PubMed1972

International collaborative studies on potency assays of diphtheria and tetanus toxoids.

Collaborative studies showed that relative potency assays for a particular type of diphtheria toxoid (adsorbed) and for tetanus toxoid (plain and adsorbed) gave very similar results, whether the assays were carried out by toxin challenge or by antitoxin titration after immunization of experimental animals with graded doses of toxoid. The same numerical results were obtained with a scoring system as with a system based on survivals only. Although skin tests were used on a very limited scale in these studies, it seems likely that they could replace lethal tests for the diphtheria challenge assays.For both tetanus and diphtheria, the adsorbed toxoid gave a higher relative potency when combined with other antigens than as a single toxoid. Both mice and guinea-pigs were used for the lethal challenge test of adsorbed tetanus toxoid. For the single tetanus toxoid the results were the same, but for the combined toxoid (DPT vaccine) the mouse assay results were about twice those of guinea-pig assays.

Animals↗
PubMed1979

Benefits of immunization versus risk factors in tetanus.

The risk of tetanus is universal, but it depends on numerous factors (socio-economic, environmental and biological) which combine to determine the force of infection. Tetanus is a murderous and costly disease. Its morbidity has greatly regressed in industrialized countries (less than 1 case per 100,000, involving mainly aged persons). On the contrary, developing countries are still severely affected (10 to 50 cases per 100,000, involving mainly neonates and children). Tetanus vaccine is one of the most effective, best tolerated and least expensive vaccines. Vaccination is the main weapon for starting disease control in developing countries, and the only way of eradicating tetanus in developed countries. Whatever the socio-economic level may be, some evaluations show that immunization cost is approximately equal to avoided treatment and seroprevention expenditures. The essential benefit of vaccination is the prevention of death, suffering and disability.

Adolescent↗