One case of tetanus was reported during 2008. The case occurred in a 42-year-old white, non-Hispanic female with no history of tetanus and diphtheria toxoid (Td) within the previous 10 years. She sustained a puncture wound to her foot from a tack in her yard. No immediate medical attention was sought. Symptoms began 11 days after sustaining the wound, progressing from trismus to stiffness in the neck and shoulders, to spasms and cramping of leg muscles. The case-patient was hospitalized 2 days after symptom onset, and received tetanus immune globulin (TIG) and Td. All symptoms resolved within 2 weeks of onset.
This case highlights the importance of routine vaccination against tetanus including a primary series (4 properly spaced doses of Td in persons younger than 7 years of age, or 3 doses in persons 7 years of age and older) and boosters every 10 years. Tetanus cases often result from minor wounds for which individuals did not seek immediate medical attention. Wounds contaminated with soil present the greatest risk.
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