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Published On: Mon, Mar 11th, 2013

Taiwan CDC reports tetanus death in elderly diabetic woman

The Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s first death from tetanus in a 75-year-old female who had a history of diabetes and high blood pressure, according to a recent Taiwan CDC press release.

Credits:   CDC/ AFIP/ C. Farmer

Credits: CDC/ AFIP/ C. Farmer

According to health officials, she got a puncture wound to her foot while cleaning up coconut leaves around her residence. On the following day, she sought medical attention at a clinic where she received antibiotics and a dose of tetanus toxoid for treatment. One week later, her puncture wound became infected, red and swollen.

Subsequently, when she developed swallowing difficulty, neck stiffness and opisthotonos, she was transferred to a hospital and diagnosed with tetanus. Immediately, she was transferred to a medical center and hospitalized in the intensive care unit. Despite the best efforts of medical personnel, the family requested the patient to be discharged from the hospital. Unfortunately, she passed away the next day. 

Tetanus is caused by a very potent toxin produced by the anaerobic bacterium, Clostridium tetani. The spores of this organism are very resistant to environmental factors and are found widely distributed in soil and in the intestines and feces of horses, sheep, cattle, dogs, cats, rats, guinea pigs, and chickens. Manure-treated soil may contain large numbers of spores. In agricultural areas, a significant number of human adults may harbor the organism.

These spores are usually introduced into the body through a puncture wound contaminated with soil, street dust, animal bites or animal or human feces, through lacerations, burns or trivial unnoticed wounds or by injecting contaminated drugs. So many times, you hear about concern over stepping on a rusty nail; however, the rust has nothing to do with tetanus. At this point, the spores germinate into the bacteria, which multiply and produce toxin.

Depending on the extent of the wound, the incubation of tetanus is around 10-14 days.

Some of the common symptoms of tetanus are lockjaw, followed by stiffness of the neck, difficulty in swallowing, and rigidity of abdominal muscles. Other symptoms include elevated temperature, sweating, elevated blood pressure, and episodic rapid heart rate. Spasms may occur frequently and last for several minutes. Spasms continue for 3–4 weeks. The typical features of a tetanus spasm are the position of opisthotonos and the facial expressions known as “risus sardonicus”. The death rate for this disease ranges from 10-80% depending on age and quality of care.

This disease in not transmitted from person to person. Even if you had tetanus and recovered, this potent toxin produces no immunity.

Prevention of tetanus is through vaccination.

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About the Author

- Writer, Co-Founder and Executive Editor of The Global Dispatch. Robert has been covering news in the areas of health, world news and politics for a variety of online news sources. He regularly writes about infectious disease news for Examiner.com and administers the Outbreak News section of The Global Dispatch.

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