Tetanus in a vaccinated soil expert - a case report

BACKGROUND

Tetanus is a life-threatening vaccine-preventable disease found more commonly in tropical climates. It accounted for up to 60 deaths annually until the introduction of the tetanus toxoid. It is now rare in Canada by immunization. This study aims to describe a case of tetanus in Saskatchewan with possible occupational exposure.

CASE REPORT

We describe the case of a vaccinated soil expert with tetanus resulting from skin abrasions. This report highlights the early diagnosis, atypical presentation with possible vaccine attenuation and management approach, including acute care, intensive care unit referral, surgical management and physical rehabilitation. We also describe the public health management provided in this case. Despite the severity, the patient returned to his previous home environment with minimal motor sequelae.

CONCLUSION

Occupational exposure to tetanus is an important risk, even in regions where the disease is rare. Prevention through vaccination is a key public health intervention that must be encouraged to avoid health complications that are often fatal.

Nursing a critically ill tetanus patient in an intensive care unit in Zambia

The global incidence of tetanus has been gradually reducing. Improvements in vaccination and health education programmes and the World Health Organization campaign to eradicate maternal and neonatal tetanus have all resulted in fewer presentations globally. Unfortunately, tetanus mortality remains a significant problem for many developing countries, owing to inadequate vaccination programmes or to conflict or humanitarian disasters during which vaccination programmes are stopped or there is sporadic cover. This case study explores the care of a tetanus patient in an intensive care unit in Zambia, a lower-middle-income country in sub-Saharan Africa.

An alternative treatment approach in tetanus: Botulinum toxin

Tetanus is a preventable infectious disease caused by tetanus toxin (tetanospasmin) produced by Clostridium tetani. Tetanus is still an important health problem in low- and middle-income countries (LMICs). Botulinum toxin administration is a treatment approach that has been used in recent years to reduce rigidity and spasms in tetanus patients. This case report focuses on its efficacy.