Tetanus: First pediatric case in >30 years in Oregon

Leslie Hanson
March 10, 2019

The report, issued from the Centers for Disease Control, says that the tetanus case is the first pediatric case in the state in nearly 30 years.

OR declared a public health emergency in January amid a measles outbreak. They treated him antibiotics and gave him a shot of a tetanus vaccine (DTaP).

"We had a hard time taking care of this child - watching him suffer - and it is a preventable disease", Guzman-Cottrill said. Seventy people in southwest Washington, a lot of them unvaccinated children, have been diagnosed with the highly contagious viral illness since January 1, as well as a handful of people in Portland, Oregon.

The report, which was written by members of the Oregon Health and Science University Department of Pediatrics and the Oregon Health Authority's Public Health Division, comes after a large measles outbreak in Clark County, Washington, on the Oregon and Washington border.

Unlike measles, which is a virus, someone who has survived a case of tetanus is not immune and can get the illness again if they remain unvaccinated. Almost all of the sick patients hadn't gotten their measles vaccinations.

Tetanus, which is caused by the bacterial toxin C. tetani, is rare in the USA, since it is easily preventable with vaccination.

The tetanus bacterium secretes a toxin that gets into the bloodstream and latches onto the nervous system.

Use of tetanus vaccines and tetanus immune globulin had led to a 95 percent decrease in tetanus cases and 99 percent decrease in tetanus-related deaths since the 1940s, according to the CDC, which recommends that children receive the DTaP vaccine at ages, 2 months, 4 months, 6 months, 15-18 months, and then at 4-6 years old, and that adults receive tetanus and diphtheria (Td) boosters every 10 years.

But it also turns out that - unlike typical children - this boy was unvaccinated, which made him vulnerable to the disease.

The boy was playing outdoors when he got a cut on his forehead.

Six days later, the boy cried as his jaw clenched, his limbs experienced involuntarily spasms and his neck and back started arching. His parents were forced to call emergency medical services, who immediately transported the sick boy to a pediatric hospital. When he was first admitted to the hospital, he was alert - but couldn't open his mouth, the report said.

At the hospital, the boy was placed in a darkened room with minimal stimulation and given ear plugs because stimulation appeared to worsen his spasms.

On day 50, he was able to walk a short distance of 20 feet with assistance. He had severe fevers and his blood pressure and heart rate rose to unsafe levels. It's unclear from the report who covered his hospital expenses. After another three weeks of inpatient rehabilitation and a month at home, he could ride a bike and run - a remarkable recovery, experts said.

In all, the boy's medical charges in the hospital amounted to $811,929 - which did not include the cost of being airlifted to the hospital or of inpatient rehabilitation, according to the CDC.

"The way to treat tetanus is you have to outlast it".

The U.S. Centers for Disease Control and Prevention published a case study on the 6-year-old boy's medical ordeal on Friday. "In contrast, the cost of one DTaP dose is somewhere around $24-$30 a dose, and this illness could have been prevented with five doses of DTaP vaccine".

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