Tetanus in New Zealand children: Intensive care management of a vaccine preventable disease.
OBJECTIVE
To review management of children admitted with tetanus to Starship Children's Hospital from 2000 to 2013.


METHODS
Retrospective chart review of children aged 0-15 years admitted to Starship Children's Hospital with tetanus from 2000 to 2013. Follow-up of immunisation status was via the National Immunisation Register and/or phone contact with patient's primary health care provider.


RESULTS
Four cases of tetanus occurred, all in unimmunised children. All four required paediatric intensive care unit admission (length of stay (LOS) 2.5-7 weeks) for ventilatory support; three required tracheostomy. Specific tetanus treatment included metronidazole, tetanus immunoglobulin and antispasmodic medications such as magnesium sulphate and benzodiazepines. Three remain partially or unimmunised following discharge.


CONCLUSIONS
Tetanus in children is a rare but preventable life-threatening disease, requiring costly intensive care management. Immunisation is cheap and effective in preventing tetanus and should be offered to all children, including tetanus cases for their future protection.
Department of Paediatric Infectious Diseases, Starship Children's Hospital, Auckland, New Zealand.
Sophie Ch
SC
Wen
Paediatric Intensive Care Unit, Starship Children's Hospital, Auckland, New Zealand.
Catherine
C
Webb
Paediatric Intensive Care Unit, Starship Children's Hospital, Auckland, New Zealand.
Fiona
F
Miles
Department of Paediatric Infectious Diseases, Starship Children's Hospital, Auckland, New Zealand.
Elizabeth
E
Wilson
D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009520:New Zealand; D013742:Tetanus / Q000188:drug therapy* / Q000517:prevention & control*
immunisation; intensive care; paediatric; tetanus