Since a nationwide childhood
vaccination with
tetanus toxoid,
tetanus has become a
rare disease in
Korea. However, we recently experienced 17 cases of
adult tetanus in a
university hospital during a 21-month period. Seventy percent of the
patients were
female, and the mean age was 63 yr (range, 29-87). The majority (88.2%) of the
patients did not get primary
vaccinations for
tetanus and decennial
tetanus-diph-theria
toxoid booster. Most
patients (88.2%),
who sustained acute
injury, did not seek
medical care for their
wounds or did not receive the prophylaxis for
tetanus.
Tetanus was found most frequently among
farmers.
Tetanus was diagnosed initially only in 53% of
patients. The case-fatality ratio was 23.5%. These cases show that recently occurring
tetanus in
Korea is a
disease, affecting the
elderly and the
female who may have a lower
immunity against
tetanus, and the
farmers who are likely to be exposed to
Clostridium tetani. In addition,
diagnosis of
tetanus is often delayed in area where cases are seen infrequently. Therefore, improved
education among
patients and
physicians, emphasis of anti-
tetanus immunization and
awareness of
tetanus respectively, may be essential for the prevention of
disease and the reduction of its
mortality.