title: [Prevention of tetanus in the hospital first-aid service].
abstract: It has been well known that every wound can become infected by C. tetani. Up to now, the antitetanic prophylaxis and/or therapy were based on empirical criteria, not capable of guaranteeing protection for the wounded. In fact: a) the type of wound and the environment in which the trauma occurred cannot exclude the possibility of infection owing to the ubiquity of the tetanic spore; b) the anamnestic data are often not reliable; c) repeated doses of tetanus anatoxin administered according to different vaccination schedules could give unexpected results; d) the protective effects of a vaccination declines in time in a manner different from one individual to another; e) there are subjects who do not acquire protection even after a vaccination treatment given according to schedule (low responders); f) the excessive number of recall doses of anatoxin, in some subjects can exhibit hypersensitivity side effects. Therefore, for each wounded patient a rational intervention of antitetanus prophylaxis is necessary, based on the rapid determination of antitetanus antibody level. A correlation has been documented between titre of antibody determined by the passive haemoagglutination test (HA) and neutralization test. The HA assay can be a useful tool (because of its easy application and rapidity of the results) in discriminating in wounded patients what type of rational therapeutic approach must be performed.
mesh_terms: D000906:Antibodies / Q000032:analysis; D004636:Emergency Service, Hospital; D006386:Hemagglutination Tests; D006801:Humans; D007116:Immunization, Passive; D012306:Risk; D013742:Tetanus / Q000276:immunology / Q000517:prevention & control*; D013743:Tetanus Antitoxin / Q000627:therapeutic use; D013745:Tetanus Toxoid / Q000009:adverse effects; D014611:Vaccination
chemical_list: D000906:Antibodies; D013743:Tetanus Antitoxin; D013745:Tetanus Toxoid
vernacular_title: Prevenzione contro il tetano nel servizio di pronto soccorso ospedaliero.