Section 17. Infectious Diseases >
Part 5. Bacterial Infections >
Chapter 289. TetanusGary D. Overturf
Topics Discussed: clostridium tetani; infectious diseases; tetanus; tetanus vaccine.
Excerpt:"Tetanus is an acute illness caused
by an exotoxin produced by the vegetative form of Clostridium
tetani. The tetanus bacillus is an anaerobic, gram-positive,
spore-forming organism. It is widely distributed in the soil in most
parts of the world. Clostridium tetani is normally
present in the intestines of horses, cattle, and other herbivora,
and is found in 2% to 30% of normal human fecal
flora. The highest number of colonized persons occurs in agricultural
communities. The tetanus organism is a wound contaminant and does
not cause tissue destruction or inflammation.Tetanus in children is rare in the United States, with fewer
than 20% of cases in persons less than 20 years of age.
Although it has been largely eliminated from the United States, neonatal
tetanus causes more than 400,000 deaths annually worldwide because
of the practice of applying animal excreta to the umbilical stump
for hemostasis. Neonatal tetanus is the cause of 23% to
73% of neonatal deaths and 25% to 30% of
deaths in the first year of life in developing countries. The increasing
use of prophylaxis in the care of wounds of all kinds, and the widespread
use of active immunization have greatly reduced the incidence in
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