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Tetanus and Tetanus Immunization in Long-Term Care Facilities

Published online by Cambridge University Press:  21 June 2016

David W. Bentley
Affiliation:
Division of Geriatrics, Department of Family Medicine, University of Maryland School of Medicine, Baltimore, Maryland
James P. Richardson*
Affiliation:
Division of Geriatrics, Department of Family Medicine, University of Maryland School of Medicine, Baltimore, Maryland
*
Department of Family Medicine, 405 W. Redwood St., Baltimore, MD 21201

Extract

Tetanus, one of the oldest diseases known to man, continues to exact a tremendous toll worldwide. While the incidence of tetanus has declined dramatically in the United States in this century, more than 50 cases are reported to the Centers for Disease Control and Prevention (CDC) each year. Two thirds of these cases are elderly patients. Some estimate that the actual number of cases may be two to four times greater than the number reported. The overall reported case fatality rate is about 20% to 30%, but is greater than 50% for those older than 60 years.

Type
Topics in Long-Term Care
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1993 

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References

1. Smith, JWG. Tetanus. In: Wilson, G, Miles, A, Parker, MT eds. Topley and Wilson's Principles of Bacteriology, Virology, and Immunity. 7th ed. Vol. 3. Baltimore, MD: Williams and Wilkins; 1984:345368.Google Scholar
2. Centers for Disease Control. Tetanus-United States, 1982-1984. MMWR 1985;34:602, 607611.Google Scholar
3. Centers for Disease Control. Tetanus-United States, 1985-1986. MMWR 1987;36:477481.Google Scholar
4. Centers for Disease Control. Tetanus—United States, 1987 and 1988. MMWR 1990;39:3741.Google Scholar
5. Prevots, R, Sutter, RW, Strebel, PM, Cochi, SL, Hadler, S. Tetanus surveillance-United States, 1989-1990. MMWR CDC Surveill Summ 1992;41:19.Google ScholarPubMed
6. Centers for Disease Control and Prevention. Tetanus fatality—Ohio, 1991. MMWR 1993;42:148149.Google Scholar
7. Sutter, RW. Cochi, SL. Brink, EW. Sirotkin, BI. Assessment of vital statistics and surveillance data for monitoring tetanus mortality, United States, 1979-1984. Am J Epidemiol 1990;131:132142.CrossRefGoogle ScholarPubMed
8. Richardson, JP, Knight, AL. The prevention of tetanus in the elderly. Arch Intern Med 1991;151:17121717.10.1001/archinte.1991.00400090014004CrossRefGoogle ScholarPubMed
9. Alfery, DD, Rauscher, LA. Tetanus: a review. Crit Care Med 1979;7:176181.10.1097/00003246-197904000-00007CrossRefGoogle ScholarPubMed
10. MacWalter, RS, McFadden, JP, Griffiths, RA. Tetanus presenting as hypothermia. J R Soc Med 1986;79:616617.Google ScholarPubMed
11. Nandi, SR, Ghosh, SK. Tetanus in a 92-year-old man. Br J Clin Pract 1988;42:7879.10.1111/j.1742-1241.1988.tb08517.xCrossRefGoogle Scholar
12. Richardson, JP, Knight, AL, Stafford, DT. Beliefs and policies of Maryland nursing home medical directors regarding tetanus immunization. J Am Geriatr Soc 1990;38:13161320.CrossRefGoogle ScholarPubMed
13. Knight, AL, Richardson, IF! Management of tetanus in the elderly. J Am Board Fam Pract 1992;5:4349.Google ScholarPubMed
14. Swartz, MN. In: Davis, BD, Dulbeccc, R, Eisen, HN, Ginsberg, HS, eds. Microbiology. 4th ed. Philadelphia, PA: J.B. Lippincott Co.; 1990:633646.Google Scholar
15. LaForce, FM, Young, LS, Bennett, JV. Tetanus in the United States (1965-1966). N Engl J Med 1969;280:569574.10.1056/NEJM196903132801101CrossRefGoogle ScholarPubMed
16. Centers for Disease Control. Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR 1991;40(RR-10):128.Google Scholar
17. Kishimoto, S, Tornino, S, Mitsuya, H, Fujiwara, H, Tsuda, H. Age-related decline in the in vitro and in vivo synthesis of anti-tetanus toxoid antibody in humans. J Immunol 1980;125:23472352.10.4049/jimmunol.125.5.2347CrossRefGoogle Scholar
18. Yeni, P, Carbon, C, Tremolieres, F, Gibert, C. Serum levels of antibody to toxoid during tetanus and after specific immunization of patients with tetanus. J Infect Dis 1982;145:278.10.1093/infdis/145.2.278CrossRefGoogle ScholarPubMed
19. Ruben, FL, Nagel, J, Fireman, R. Antitoxin responses in the elderly to tetanus-diphtheria (Td) immunization. Am J Epidemiol 1978;108:145149.10.1093/oxfordjournals.aje.a112598CrossRefGoogle ScholarPubMed
20. Solomonova, K, Vizev, S. Secondary response to boostering by purified aluminum-hydroxide-adsorbed tetanus anatoxin in aging and in aged adults. Immunobiology 1981;158:312319.10.1016/S0171-2985(81)80002-2CrossRefGoogle Scholar
21. Simonsen, O, Block, AV, Klserke, A, et al. Immunity against tetanus and response to revaccination in surgical patients more than 50 years of age. Surg Gynecol Obstet 1987;164:329334.Google ScholarPubMed
22. Armitage, KB, Duffy, EG, Mincek, MA, et al. Transient normalization of lymphocyte blastogenic and specific antibody responses following boosting of healthy elderly subjects with tetanus toxoid. J Gerontol 1993;48:M19M25.CrossRefGoogle ScholarPubMed
23. Simonsen, O. Vaccination against tetanus and diphtheria. Dan Med Bull 1989;36:2447.Google ScholarPubMed
24. Smith, DM, Winsemius, DK, Besdine, RW. Pressure sores in the elderly: can this outcome be improved? J Gen Intern Med 1991;6:8193.10.1007/BF02599399CrossRefGoogle ScholarPubMed
25. Adams, SL. Tetanus immunization for nursing home residents. JAMA 1986;256:526.Google Scholar
26. Kane, RL, Ouslander, JG, Abrass, IB. Essentials of Clinical Geriatrics. 2nd ed. New York, NY: McGraw-Hill Information Services co.; 1989445.Google Scholar
27. Magenheim, MJ. Health maintenance in long-term care. In: Katz, PR, Calkins, E, eds. Principles and Practice of Nursing Home Care. New York, NY: Springer Publishing Co.; 1989:231243.Google Scholar
28. Richardson, JP. Health promotion in the nursing home patient. J Am Board Earn Pract 1992;5:127136.Google ScholarPubMed
29. Bentley, DW. Vaccinations. Clin Geriatr Med 1992:8:745760.CrossRefGoogle ScholarPubMed
30. Immunization Practices Advisory Committee (ACIP). General recommendations on immunizatibn. MMWR 1989;38:205227.Google Scholar
31. ACP Task Force on Adult Immunization and Infectious Diseases Society of America. Guide for Adult Immunization. 2nd ed. Philadelphia, PA: American College of Physicians; 1990:9, 111.Google Scholar
32. U.S. Preventive Services Task Force. Adult immunizations. Am Fam Physician 1989;40:143148.Google Scholar
33. Weiss, BP, Strassburg, MA, Feeley, JC. Tetanus and diphtheria immunity in an elderly population in Los Angeles County. Am J Public Health 1983;73:802804.CrossRefGoogle Scholar
34. Reactions to tetanus toxoid. Br Med J 1974;1:48.CrossRefGoogle Scholar
35. Middaugh, JI? Side effects of diphtheria-tetanus toxoid in adults. Am J Public Health 1979;69:246249.10.2105/AJPH.69.3.246CrossRefGoogle ScholarPubMed
36. Statement on tetanus toxoid. Can Med Assoc J 1987;137:734735.Google Scholar
37. Hagen-Coenen, J, Drinka, PJ, Siewert, M. Tetanus-diphtheria vaccinations in a veterans nursing home. J Am Geriatr Soc 1992;40:513514.CrossRefGoogle Scholar
38. Richardson, JP, Knight, AL. Tetanus-diphtheria immunizations in a nursing home population. J Am Geriatr Soc 1992;40:1075.CrossRefGoogle Scholar
39. Richardson, JP, Immunizing nursing home patients against tetanus. Infect Med 1992;9:2427.Google Scholar