A Brief Note On Tetanus And The Pediatric Emergency Department

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Assessment of Tetanus Risk in the Pediatric Emergency Department
Anthony R. Arredondo, DO
Resident, Department of Pediatrics,
University of Texas Health Sciences Center San Antonio
Daniel J. Dire, MD, FACEP, FAAP, FAAEM
Clinical Professor, Departments of Emergency Medicine and Pediatrics,
University of Texas Health Sciences Center San Antonio
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Tetanus is a life-threatening but preventable disease that is characterized by an acute onset of painful muscular contractions (usually in a descending pattern, starting with trismus or lockjaw) and generalized rigidity.1 It is caused by the toxin of Clostridium tetani, a spore-forming bacterium. The spores can be found in soil, dust, and in human and animal feces, entering the body through breaks in the skin and germinating under low-oxygen conditions .1,2 The most successful intervention against tetanus in history is its prevention by means of an effective vaccine which has led to a dramatic fall in the incidence of tetanus.3
Tetanus occurs in all parts of the world most frequently in hot and wet climates where the soil contains a lot of organic matter. Although rare in the United States (US), with an average of 29 reported cases per year from 1996 through 2009, it has not been eradicated by vaccination programs.2 While early diagnosis and intervention are lifesaving, prevention is the ultimate management strategy.4 According to the US Center for Disease Control (CDC), nearly all cases of tetanus are among people who have never

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