title: Diagnosis of tetanus by an otorhinolaryngologist and immunity against tetanus among adults on the island of Crete.
abstract: BACKGROUND
  Tetanus (lockjaw) is a rare disease in developed countries.
  
  
  METHODS
  An otorhinolaryngologist can be the first physician to see a patient with tetanus. In our department, we have seen 10 such cases presenting with head and neck symptoms. We report 2 of these cases followed by an investigation of the immune status of the adult Cretan population against tetanus using 200 random patients who visited our clinic.
  
  
  RESULTS
  A negative history of complete childhood immunization was recorded in 37% of individuals. Of the male population, 88.5% had received active immunization during adulthood, although 47% had received all three doses. Only 12.6% of the females had received full-dose immunization during adulthood. Overall, only 8.5% of the studied population had received either complete immunization or a scheduled booster dose during the last decade.
  
  
  CONCLUSIONS
  In many cases, an otorhinolaryngologist can be the first physician to examine a patient with tetanus. The incidence of the disease in Crete, Greece, is significantly higher than in most parts of developed countries.
authors.affiliation: Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece. dkyrmiz@yahoo.com
authors.forename: Dionysios E
authors.initials: DE
authors.lastname: Kyrmizakis
authors.forename: Alexandros D
authors.initials: AD
authors.lastname: Karatzanis
authors.forename: Antonios
authors.initials: A
authors.lastname: Liolios
authors.forename: Chariton E
authors.initials: CE
authors.lastname: Papadakis
authors.forename: Antonios A
authors.initials: AA
authors.lastname: Benakis
authors.forename: John G
authors.initials: JG
authors.lastname: Bizakis
authors.forename: George A
authors.initials: GA
authors.lastname: Velegrakis
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D010036:Otolaryngology; D013742:Tetanus / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000628:therapy; D014611:Vaccination