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. 1998;76(1):47–54.

Epidemiology of tetanus in the Marches Region of Italy, 1992-95.

E Prospero 1, R Appignanesi 1, M M D'Errico 1, F Carle 1
PMCID: PMC2305633  PMID: 9615496

Abstract

Reported is the incidence of tetanus in the Marches Region of Italy for the period 1992-95. Data were obtained from both the regional public health committee's notification forms for infectious diseases and from hospital clinical records. A total of 36 cases were examined, comprising 7 males (19.4%) and 29 females. The raw annual incidence was 6.3 per million population; the standardized incidence for females was four times greater than that for males (9.2 and 2.4 per million population annually, respectively). The patients' ages varied from 31 years to 88 years (median, 73.5 years). The incidence among subjects older than 65 years was approximately ten times greater than that among younger individuals. Chronic wounds, such as trophic lesions, represented the site of tetanus infection in 14.3% of cases whose infection entry point was identified. Treatment of the 36 cases required a total of 1239 hospital days, of which 58.7% were in intensive care and 29.6% were in infectious diseases departments. The raw annual mortality rate for the period considered was 0.7 per million population; the case-fatality ratio was 11%. The results of our study confirm the limits of the current Italian immunization programmes, which exclude a large portion of the population from antitetanus protection.

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Selected References

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  1. Balestra D. J., Littenberg B. Tetanus immunization in adults. JAMA. 1994 Dec 28;272(24):1900–1901. doi: 10.1001/jama.272.24.1900. [DOI] [PubMed] [Google Scholar]
  2. Bistoni F., Marconi P., Perito S., Bastianini L., Antenucci R., Pitzurra M. Turkey red blood cell passive haemagglutination assay as guideline for specific prevention of tetanus in injured persons. Bull World Health Organ. 1985;63(5):905–914. [PMC free article] [PubMed] [Google Scholar]
  3. Buratta A., CArreri V., Porro Dé Somenzi C. Andamento epidemiologico del tetano in Lombardia. Boll Ist Sieroter Milan. 1980 Nov 30;59(5):405–410. [PubMed] [Google Scholar]
  4. Cellesi C., Rossolini G. M., Dirienzo G., Petrini R., Marsili C., Addari P., Zanchi A. Antitetanus immunity in a sample of adult population from the Siena area (Italy). Boll Ist Sieroter Milan. 1988;67(2):149–155. [PubMed] [Google Scholar]
  5. Dietz V., Galazka A., van Loon F., Cochi S. Factors affecting the immunogenicity and potency of tetanus toxoid: implications for the elimination of neonatal and non-neonatal tetanus as public health problems. Bull World Health Organ. 1997;75(1):81–93. [PMC free article] [PubMed] [Google Scholar]
  6. Dixon A. M., Bibby J. A. Tetanus immunisation state in a general practice population. BMJ. 1988 Sep 3;297(6648):598–598. doi: 10.1136/bmj.297.6648.598. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dobson A. J., Kuulasmaa K., Eberle E., Scherer J. Confidence intervals for weighted sums of Poisson parameters. Stat Med. 1991 Mar;10(3):457–462. doi: 10.1002/sim.4780100317. [DOI] [PubMed] [Google Scholar]
  8. Fagiolo U., Amadori A., Biselli R., Paganelli R., Nisini R., Cozzi E., Zamarchi R., D'Amelio R. Quantitative and qualitative analysis of anti-tetanus toxoid antibody response in the elderly. Humoral immune response enhancement by thymostimulin. Vaccine. 1993 Oct;11(13):1336–1340. doi: 10.1016/0264-410x(93)90104-6. [DOI] [PubMed] [Google Scholar]
  9. Galazka A., Kardymowicz B. Tetanus incidence and immunity in Poland. Eur J Epidemiol. 1989 Dec;5(4):474–480. doi: 10.1007/BF00140144. [DOI] [PubMed] [Google Scholar]
  10. Giannico L., Ballada D. Epidemiologia del tetano in Italia. Strategia della profilassi attiva d'obbligo nei confronti della popolazione. Boll Ist Sieroter Milan. 1980 Nov 30;59(5):397–404. [PubMed] [Google Scholar]
  11. Grabenstein J. D., Smith L. J., Carter D. W., Engler R. J., Evans R., 3rd, Summers R. J. Comprehensive immunization delivery in conjunction with influenza vaccination. Arch Intern Med. 1986 Jun;146(6):1189–1192. [PubMed] [Google Scholar]
  12. Grasso G. M., Schioppa F., Ribera G. Immunità antitetanica in popolazione anziana di alcune regioni dell'Italia meridionale. Nuovi Ann Ig Microbiol. 1987 May-Aug;38(3-4):225–234. [PubMed] [Google Scholar]
  13. Hutchison B. G., Stoddart G. L. Cost-effectiveness of primary tetanus vaccination among elderly Canadians. CMAJ. 1988 Dec 15;139(12):1143–1151. [PMC free article] [PubMed] [Google Scholar]
  14. Izurieta H. S., Sutter R. W., Strebel P. M., Bardenheier B., Prevots D. R., Wharton M., Hadler S. C. Tetanus surveillance--United States, 1991-1994. MMWR CDC Surveill Summ. 1997 Feb 21;46(2):15–25. [PubMed] [Google Scholar]
  15. Kishimoto S., Tomino S., Mitsuya H., Fujiwara H., Tsuda H. Age-related decline in the in vitro and in vivo syntheses of anti-tetanus toxoid antibody in humans. J Immunol. 1980 Nov;125(5):2347–2352. [PubMed] [Google Scholar]
  16. Murphy S. M., Hegarty D. M., Feighery C. S., Walsh J. B., Williams Y., Coakley D. P. Tetanus immunity in elderly people. Age Ageing. 1995 Mar;24(2):99–102. doi: 10.1093/ageing/24.2.99. [DOI] [PubMed] [Google Scholar]
  17. Percy A. S., Kukora J. S. The continuing problem of tetanus. Surg Gynecol Obstet. 1985 Apr;160(4):307–312. [PubMed] [Google Scholar]
  18. Ribero M. L., Gastaldi G., Fara G. M. Ongoing tetanus prophylaxis of injured patients in five hospital emergency rooms. Boll Ist Sieroter Milan. 1985;64(1):70–76. [PubMed] [Google Scholar]
  19. Richardson J. P., Knight A. L. The prevention of tetanus in the elderly. Arch Intern Med. 1991 Sep;151(9):1712–1717. [PubMed] [Google Scholar]
  20. Rosmini F., Gentili G., Wirz M., Collotti C., Panà A., Terzi I., Conti S., Pasquini P. Immunity to tetanus among Italians born between 1956 and 1963. Eur J Epidemiol. 1987 Sep;3(3):302–307. doi: 10.1007/BF00149740. [DOI] [PubMed] [Google Scholar]
  21. Rosmini F., Wirz M., Gentili G., Collotti C., Rossino Ricci M., Franco E., Terzi I., Pasquini P. Year of birth, sex and residence, as "determinants" of tetanus incidence and immunity in Italy. Eur J Epidemiol. 1987 Dec;3(4):377–380. doi: 10.1007/BF00145648. [DOI] [PubMed] [Google Scholar]
  22. Ruben F. L., Fireman P. Follow-up study: protective immunization in the elderly. Am J Public Health. 1983 Nov;73(11):1330–1330. doi: 10.2105/ajph.73.11.1330. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Ruben F. L., Nagel J., Fireman P. Antitoxin responses in the elderly to tetanus-diphtheria (TD) immunization. Am J Epidemiol. 1978 Aug;108(2):145–149. doi: 10.1093/oxfordjournals.aje.a112598. [DOI] [PubMed] [Google Scholar]
  24. Squarcione S., Vellucci L., Virtuani L., D'Amato S. Andamento del tetano in Italia negli anni 1991-1993 [corrected]. Ann Ig. 1993 Nov-Dec;5(6):415–420. [PubMed] [Google Scholar]
  25. Thorley J. D., Holmes R. K., Sanford J. P. Tetanus and diphtheria antitoxin levels following a hospital-based adult immunization program. Am J Epidemiol. 1975 May;101(5):438–443. doi: 10.1093/oxfordjournals.aje.a112111. [DOI] [PubMed] [Google Scholar]
  26. Yeni P., Carbon C., Tremolieres F., Gibert C. Serum levels of antibody to toxoid during tetanus and after specific immunization of patients with tetanus. J Infect Dis. 1982 Feb;145(2):278–278. doi: 10.1093/infdis/145.2.278. [DOI] [PubMed] [Google Scholar]

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