J Korean Med Sci.  2003 Feb;18(1):11-16. 10.3346/jkms.2003.18.1.11.

Recently Occurring Adult Tetanus in Korea: Emphasis on Immunization and Awareness of Tetanus

• Shin DH
• Yu HS
• Park JH
• Shin JH
• Kim SJ

• KMID: 1099786
• DOI: http://doi.org/10.3346/jkms.2003.18.1.11

Abstract

Since a nationwide childhood vaccination with tetanus toxoid, tetanus has become a rare disease in Korea. However, we recently experienced 17 cases of adult tetanus in a university hospital during a 21-month period. Seventy percent of the patients were female, and the mean age was 63 yr (range, 29-87). The majority (88.2%) of the patients did not get primary vaccinations for tetanus and decennial tetanus-diph-theria toxoid booster. Most patients (88.2%), who sustained acute injury, did not seek medical care for their wounds or did not receive the prophylaxis for tetanus. Tetanus was found most frequently among farmers. Tetanus was diagnosed initially only in 53% of patients. The case-fatality ratio was 23.5%. These cases show that recently occurring tetanus in Korea is a disease, affecting the elderly and the female who may have a lower immunity against tetanus, and the farmers who are likely to be exposed to Clostridium tetani. In addition, diagnosis of tetanus is often delayed in area where cases are seen infrequently. Therefore, improved education among patients and physicians, emphasis of anti-tetanus immunization and awareness of tetanus respectively, may be essential for the prevention of disease and the reduction of its mortality.

Keyword

Tetanus; Immunization

MeSH Terms

Adult
Aged
Aged, 80 and over
Agricultural Workers' Diseases/epidemiology
Diagnostic Errors
Diphtheria-Tetanus-Pertussis Vaccine
Emergency Service, Hospital
Health Education
Health Knowledge, Attitudes, Practice*
Human
Immunization, Secondary/psychology
Immunization, Secondary/utilization*
Korea/epidemiology
Middle Aged
Tetanus/diagnosis
Tetanus/epidemiology*
Tetanus/prevention & control
Tetanus/therapy
Tetanus Antitoxin/therapeutic use
Tetanus Toxoid
Treatment Outcome
Vaccination/utilization*
Wounds, Penetrating/complications