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Rudolph's PediatricsRudolph's Pediatrics

Section 17. Infectious Diseases > 

Part 5. Bacterial Infections > 

Chapter 289. Tetanus

Gary D. Overturf
Topics Discussed: clostridium tetani; infectious diseases; tetanus; tetanus vaccine.
Sections: References.
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 older children...."
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