title: Recently occurring adult tetanus in Korea: emphasis on immunization and awareness of tetanus.
abstract: Since a nationwide childhood vaccination with tetanus toxoid, tetanus has become a rare disease in Korea. However, we recently experienced 17 cases of adult tetanus in a university hospital during a 21-month period. Seventy percent of the patients were female, and the mean age was 63 yr (range, 29-87). The majority (88.2%) of the patients did not get primary vaccinations for tetanus and decennial tetanus-diphtheria toxoid booster. Most patients (88.2%), who sustained acute injury, did not seek medical care for their wounds or did not receive the prophylaxis for tetanus. Tetanus was found most frequently among farmers. Tetanus was diagnosed initially only in 53% of patients. The case-fatality ratio was 23.5%. These cases show that recently occurring tetanus in Korea is a disease, affecting the elderly and the female who may have a lower immunity against tetanus, and the farmers who are likely to be exposed to Clostridium tetani. In addition, diagnosis of tetanus is often delayed in area where cases are seen infrequently. Therefore, improved education among patients and physicians, emphasis of anti-tetanus immunization and awareness of tetanus respectively, may be essential for the prevention of disease and the reduction of its mortality.
authors.affiliation: Department of Internal Medicine, Chonnam National University, Medical School, 8 Hak-dong, Dong-gu, Gwangju 501-757, Korea. dhyeon@chonnam.ac.kr
authors.forename: Dong Hyeon
authors.initials: DH
authors.lastname: Shin
authors.forename: Ho Sung
authors.initials: HS
authors.lastname: Yu
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Park
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Shin
authors.forename: Sei Jong
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000382:Agricultural Workers' Diseases / Q000453:epidemiology; D003951:Diagnostic Errors; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D004636:Emergency Service, Hospital; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007117:Immunization, Secondary / Q000523:psychology / Q000706:statistics & numerical data*; D007723:Korea / Q000453:epidemiology; D008875:Middle Aged; D013742:Tetanus / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D013743:Tetanus Antitoxin / Q000627:therapeutic use; D013745:Tetanus Toxoid; D016896:Treatment Outcome; D014611:Vaccination / Q000706:statistics & numerical data*; D014950:Wounds, Penetrating / Q000150:complications
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D013743:Tetanus Antitoxin; D013745:Tetanus Toxoid