Background

Tetanus is a non–communicable disease contracted through exposure to the spores of the bacteria Clostridium tetani, which exists worldwide in soil and in animal intestinal tracts, and as such can contaminate many surfaces and substances. It is characterized by generalized rigidity and convulsive spasms of skeletal muscles. Tetanus occurring during pregnancy or within 6 weeks of the end of pregnancy is called “maternal tetanus”, while tetanus occurring within the first 28 days of life is called “neonatal tetanus”.

People of all ages can get tetanus but the disease is particularly serious in newborns and elders. Tetanus is rare in Taiwan, with an average of 15–20 reported cases each year.

WHO estimated that neonatal tetanus killed about 49,000 newborn children in 2013, a 94% reduction from the situation in 1988 when an estimated 787,000 newborn babies died of tetanus within their first month of life. Taiwan has no reported case in recent years.

Epidemiology

Tetanus occurs worldwide and is more common in warmer climates where the soil contains a lot of organic matter.It is not contagious from person to person, since the national vaccination program was implemented, there are now around 10 to 24 Tetanus reported cases annually in Taiwan and no confirmed NT case has been reported since 1996 apart from a child born to a foreign mother in 2001.

Tetanus/ Neonatal Tetanus (NT) Surveillance in Taiwan

1. Taiwan National Infectious Disease Statistics System  Tetanus and Neonatal Tetanus
2. Rewards for physicians who report confirmed NT cases.
3. Investigations of newborns delivered outside hospitals－Neonatal Tetanus

Prevention and Control

1. Immunization with tetanus toxoid containing vaccine.
2. Comprehensive care for pregnant women before, during and after delivery.
3. Surveillance system. 

FAQs

1.     What is Tetanus?
Tetanus is caused by an infection with the bacterium Clostridium tetani, which is commonly found in soil, dust, and manure. The bacteria generally enter through a break in the skin such as a cut or puncture wound by a contaminated object. Diagnosis is based on the presenting signs and symptoms. The disease does not spread between people.

2.     What are the symptoms of infection?

Tetanus is characterized by painful muscular contractions, primarily of the masseter and neck, and secondarily of trunk muscles. Common symptoms of tetanus include abdominal rigidity, opisthotonus, risus sardonicus and tight jaw.

3.     Who are the high risk group of Tetanus?

• (1)Workers in frequent contact with soil, sewage, and domestic animals.
• (2)Members of the military forces.
• (3)Older adults who are currently at highest risk for tetanus.
• (4)Unvaccinated women of childbearing age and their newborns.