Vaccine-Preventable Diseases

Tetanus

Tetanus is an acute and often fatal disease caused by an extremely potent neurotoxin produced by Clostridium tetani. The organism is ubiquitous in soil but has also been detected in the intestines of animals and humans. Wounds that are contaminated with soil or animal/human feces and that are associated with tissue injury and necrosis are most frequently associated with tetanus. Cases related to injection drug use, animal bites and lacerations have been reported as well as rare cases occurring after bowel surgery or bronchoaspiration of soil and feces. In North America, approximately 27% of cases occur in people who do not report any antecedent injury.

Epidemiology

Tetanus is rare in Canada. During the 1920s and 1930s, 40 to 50 deaths from tetanus were reported annually. With the introduction of tetanus toxoid in Canada in 1940, morbidity and mortality rapidly declined (see Figure 15). Between 1980 and 2004, the number of cases reported annually ranged from 1 to 10, with an average of 4 per year. During this period, person ≥60 years of age accounted for 49% of the cases, and 57% were males. No cases were reported among neonates. The immunization status of most of the reported cases was not known. Birth in a foreign country was indicated for 11% of 53 cases with known data. Only five deaths have been reported since 1980, the last in 1997.

Tetanus immunization programs are highly effective, provide long-lasting protection and are recommended for the whole population. However, serosurveys suggest that a substantial proportion of Canadians have nonprotective tetanus antitoxin levels. Factors associated with lack of immunity to tetanus include increasing age, birth outside Canada and absence of immunization records. Continued attention should be given to improving tetanus immunization in these groups.

Source: Canadian Immunization Guide, 7^th edition, 2006

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Links to more information

Guidelines and Recommendations

• For information about Tetanus vaccine, see the Canadian Immunization Guide, 7^th edition 2006

Information Sheets

• Childhood Immunization - It's Your Health

Travel Medicine Program

• Immunizations Recommended for Travel Outside of Canada