The child was playing on a farm when he cut his head on something. His parents cleaned and stitched the wound at home, but alarming symptoms emerged six days later.
For more than 30 years in Oregon in the US, cases of tetanus in children were almost mythical - studied in textbooks but never seen in person - thanks to the effectiveness of pediatric vaccination programs.
He was airlifted to a pediatric hospital, where he was diagnosed with tetanus. It was the first instance of the life-threatening neuromuscular disease in a child in Oregon in more than three decades."Fortunately, the emergency department physicians immediately recognised the symptoms of severe tetanus," Judith Guzman-Cottrill, an author of the report and a pediatrics professor at Oregon Health & Science University, toldin an email.
Still, the arching of the boy's neck and back worsened. His blood pressure shot up, and he became feverish. Doctors inserted a tube in his windpipe so a ventilator could help with his breathing, and treated him with neuromuscular-blocking drugs to reduce his muscle spasms. He would remain on those drugs for more than a month, and in the intensive care unit for a total of 47 days.
"The patient was in the intensive care unit, in critical condition, for over six weeks," Guzman-Cottrill said. "The complex and prolonged care led to the high treatment cost. In contrast, the cost of one DTaP dose is somewhere around $24-$30 a dose, and this illness could have been prevented with five doses of DTaP vaccine."
In the 1940s, there were about 500 to 600 cases of tetanus reported in the United States annually, according to the nonprofit Immunization Action Coalition. That was also around when both anti-tetanus immunoglobin and the tetanus vaccine became widely used, a practice that has led to a 95 percent decrease in tetanus cases and a 99 percent decrease in tetanus-related deaths since the 1940s, according to the CDC.
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