NZPHR Vol 8 No 8 Aug 2001
Tuesday 7th September 2010
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Contents and Lead Article
Contents- Epidemiology of tetanus in New Zealand reinforces value of vaccination
- AIDS and HIV infection in 2000
- Cryptosporidiosis autumn peak in 2001 higher than in previous years
- Surveilllance and control notes
Epidemiology of tetanus in New Zealand reinforces value of vaccination
This paper reports on New Zealands first infant tetanus case for 35 years. It also reviews long-term trends in tetanus epidemiology using notification data for the period 1921-2000 and hospitalisation and mortality data for the period 1948-2000. Prior to 1960, there was a median of 21 cases per year. Following the introduction of routine infant immunisation against tetanus in 1960, the number of cases fell progressively to a median of two per year. The number of tetanus hospitalisations and deaths also fell markedly over time. Prior to 1960 most cases were male and age specific rates were highest for children less than 15 years. After 1960 there was a 99% reduction in disease rates among children. In the last twenty years, approximately half (48.3%) of all cases have been over the age of 65 years and nearly two thirds (63.8%) have been female. The case described here is a 15 month unvaccinated female from Northland admitted to hospital in April 2001 with a history of fever and breathing difficulties. She developed trismus and opisthotonos and a diagnosis of tetanus was made. She received human tetanus immune globulin and supportive treatment and required ventilation for 11 days. These findings highlight two important requirements for the prevention of tetanus: the need to achieve high coverage levels in the childhood population, and the importance of adult vaccination, particularly for those over 65 years of age who may have missed primary tetanus vaccination.
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