title: [Management and new current French recommendations for tetanus care].
abstract: Tetanus is an acute severe disease induced by an exotoxin, often lethal. All cases occur in untreated or inadequately vaccinated patients and mainly in elderly patients who accumulate many risk factors. The current management of wounds faced difficulties in the assessment of immunization status and wound risks status. Indeed, all injuries can potentially lead to tetanus. Minor risks and chronic wounds are mainly found as tetanus cause. Vaccination remains the key element in reducing the morbidity and mortality associated with tetanus. It is estimated that the vaccine's coverage is fairly good, but decreases with age. To improve tetanus prevention, new vaccine recommendations have been established which recommend vaccine's injections at fixed age, but their impact seems to be limited especially in the elderly. The immunochromatographic tests have demonstrated cost-effectiveness in the Emergency department settings. They are currently not available outside hospital while general practionners also face a significant risk. Effectiveness of these tests should be studied in outpatients population including cost-effectiveness.
authors.affiliation: Pôle de gériatrie polyvalente, Centre gérontologique départemental, Marseille, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Nicolai
authors.affiliation: Pôle de gériatrie polyvalente, Centre gérontologique départemental, Marseille, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Farcet
authors.affiliation: Pôle de gériatrie polyvalente, Centre gérontologique départemental, Marseille, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Molines
authors.affiliation: Pôle de gériatrie polyvalente, Centre gérontologique départemental, Marseille, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Delalande
authors.affiliation: Pôle de gériatrie polyvalente, Centre gérontologique départemental, Marseille, France, EA3279, Évaluation des systèmes de soins-santé perçue, Université de la Méditerranée, Marseille, France, Département de médecine interne et maladies infectieuses, Hôpital européen, Marseille, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Retornaz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D013742:Tetanus / Q000191:economics / Q000517:prevention & control / Q000628:therapy*; D013745:Tetanus Toxoid / Q000008:administration & dosage*; D014611:Vaccination; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy
chemical_list: D013745:Tetanus Toxoid
keywords: immunochromatographic tests; older patients; tetanus; vaccine