Thursday, 21 March, 2019

CDC: Unvaccinated boy diagnosed with tetanus, hospitalized almost 2 months

Kid in a hospital Enlarge Image Shutterstock
Celia Hoffman | 10 March, 2019, 18:24

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While many who are in support of the movement turned their nose up at the World Health Organisation for listing anti-vaxxers as one of the top ten threats to global health in 2019, a recently published case study details the first paediatric case of tetanus in over 30 years in Oregon, US, found in an unvaccinated child.

The report, released by the Centers for Disease Control and Prevention on Thursday, reveals that the boy cut his forehead while playing on a farm back in 2017.

Six days after the OR boy got the cut, according to the CDC report, he had "episodes of crying, jaw clenching, and involuntary upper extremity muscle spasms", then had arching in his back and neck as well as more spasms.

Soon he was having trouble breathing, at which point his parents contacted emergency services and the boy was airlifted to the hospital.

At the hospital, the boy developed jaw muscle spasms - one of the primary symptoms of tetanus, and from which the disease draws its more common name: lockjaw.

Tetanus is an infection caused by spores of the Clostridium tetani bacteria in the environment that enter the body through contaminated wounds or new puncture wounds, such as stepping on a nail.

After the boy was diagnosed, treatment began. He was not taken to any medical facility, and his would was cleaned and sewn up at home. He was also given a drug called tetanus immune globulin, which contains antibodies that can fight the bacterial infection, and admitted to the pediatric intensive care unit.

The child remained on a ventilator and a neuromuscular blocker for over a month and spent time "in a darkened room with earplugs and minimal stimulation" as per reports. Three days later he was able to walk 20 feet-but he needed assistance.

Luckily, the boy made a full recovery.

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A month after inpatient rehabilitation, the boy was able to go back to his normal activities, including running and bicycling. That care included sedation, intubation, mechanical ventilation and later, rehabilitation.

While the patient was in the hospital, his doctors administered a dose of the DTaP vaccine to protect against future cases of diphtheria, tetanus, and pertussis, also known as whooping cough. But "despite extensive review of the risks and benefits of tetanus vaccination by physicians, the family declined the second dose of DTaP and any other recommended immunizations", the authors write. On day 44 of his hospital stay, he came off the ventilator and tolerated drinking clear liquids.

Under Oregon law, parents may forgo vaccinations for philosophical reasons.

Tetanus is part of the CDC's, but in this case the boy was unvaccinated. Other symptoms include stiff neck and abdominal muscles, difficulty swallowing, and painful, involuntary muscle spasms.

This case was particularly worrying for disease prevention experts not only in OR, but across the country, as tetanus has remained more OR less unheard of since vaccines were made available to everyone back in the 1940s. Today, only about 30 cases are reported every year.

The total bill for his inpatient care was $811,929, Guzman-Cottrill and her colleagues said. A great majority of young children and babies are sufficiently vaccinated.

Lawmakers in OR and Washington are considering bills to end non-medical exemptions for childhood vaccines due to a Pacific Northwest measles outbreak.

A new report published by the Centers for Disease Control and Prevention details the harrowing story of a child in OR who contracted tetanus because he wasn't vaccinated. Uninsured or underinsured children may be eligible to receive vaccines at no cost through the Vaccines For Children program.

While a tetanus vaccine was in development as early as the 1920s, it wasn't given to children regularly until the late-1940s.

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