Tetanus in the United States: A Review of the Problem

Abstract

A review, on a national scope, of this highly fatal infectious disease has not been made since 1939. Reported-case and registered-death data for the United States for 1947-55 are the basis of the review, along with localized epidemiologic studies. Despite increasing knowledge on prevention and treatment of this infection, incidence of tetanus has shown little change in the past decade. The concentration of cases is in the southern states. Mortality data show a slightly declining trend; however, the death-case ratio remains about 60 deaths per 100 cases reported. The frequency of deaths is 5 to 6 times higher among non-whites than among whites. The highest death rate occurs in the age group under 1 year, particularly among infants under 28 days of age. Thirteen southern states account for most of these deaths. The 2 immediate problems, tetanus infections following apparently minor wounds, and neonatal tetanus, emphasize the need for universal immunization early in childhood, In areas where tetanus neonatorum is prevalent, the incidence may be reduced by active immunization of the expectant mother.