On June 29, 2012, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s first death from tetanus. The case was a 71-year-old male who resided in southern Taiwan. During early June, the case injured his toes with rusted components of a machine when lifting the machine. On June 12, as a result of attending to the wound by himself and not seeking medical assistance, he developed difficulty in swallowing, lockjaw, and pain in the neck. Subsequently, he sought medical attention at a clinic. On June 13, he sought further medical attention at the emergency department at a hospital and was hospitalized in the intensive care unit for treatment. On June 21, he passed away despite the best efforts of medical personnel.

Tetanus is a disease caused by a type of bacteria called Clostridium tetani (C. tetani) that can live in many different substances such as soil and animal and human waste. The incubation period ranges from 3 to 21 days. Infection generally occurs when the spores enter the body through an injury or woundand often involves a cut or deep puncture wound. As the infection progresses, abdomen rigidity, muscle spasms, specifically opisthotonos, and risus sardonicus develop. Prolonged muscular action causes sudden, powerful, and painful contractions of muscle groups. Death can occur in severe cases.

According to the surveillance data collected by Taiwan CDC, since the implementation of tetanus vaccination, the number of tetanus death has been almost 0 for the past decade and the average number of tetanus cases reported each year is about ten. One death from tetanus occurred in 2005, 2006, 2011 and 2012, respectively. Two deaths from tetanus were reported in 2010. In Taiwan, the existing routine childhood vaccination schedule recommends a dose of DTaP-Hib-IPV vaccine to children 2, 4, 6 and 18 months of age and an a dose of Td vaccine to children prior to elementary school entry. The vaccine efficacy can last more than ten years. Older children and adults can receive a booster dose (Tdap) every ten years after completion of the initial childhood series.

Taiwan CDC advises the public to take protective measures against tetanus when cleaning up after a disaster and seek prompt medical attention at a hospital when wound contamination is suspected. The doctor can determine if a patient needs tetanus toxoid based on whether the patient has previously received DTP or DT vaccine. If the risk of infection is high, the doctor can prescribe either tetanus immune globulin (TIG) or tetanus antitoxin (TAT) as treatment. Emergency stockpiles of the aforementioned medicines are available at all major hospitals.