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| LETTER TO EDITOR |
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| Year : 2016 | Volume
: 4
| Issue : 1 | Page : 25 |
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Tetanus is not the past: It still exists
Basavraj S Nagoba1, Vilas Jahagirdar2, Nasira Sheikh3
1 Department of Microbiology, MIMSR Medical College, Latur, Maharashtra, India
2 Department of Microbiology, Government Medical College, Miraj, Maharashtra, India
3 Department of Microbiology, Dr. V. M. Medical College, Solapur, Maharashtra, India
| Date of Web Publication | 31-Mar-2017 |
Correspondence Address:
Basavraj S Nagoba
Department of Microbiology, MIMSR Medical College, Latur - 413 512, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2214-207X.203544
How to cite this article:
Nagoba BS, Jahagirdar V, Sheikh N. Tetanus is not the past: It still exists. J Patient Saf Infect Control 2016;4:25 |
Madam,
We read with a great interest a letter entitled, 'Tetanus and gas gangrene: Things of the past?' by Mathur.[1] Based on the results of no isolation of Clostridium tetani from a total of 6688 pus/tissue samples and a total of 18,892 blood samples processed anaerobically from trauma patients often presenting with grossly soiled wounds/intestinal injuries, it has been concluded that there is the gradual elimination of tetanus in India, even in high-risk population. As the trauma followed by contamination of the wound is the most common cause of tetanus, this is the justified conclusion of her study.
We do agree with the first part of the statement of the author that there is the gradual elimination of tetanus in India, but not with the second part of the statement that there is the gradual elimination of tetanus in India, even in high-risk population. Since the introduction of the vaccination programme in 1961, there has been a significant decline in the number of cases of tetanus. This is the truth in the Western world.[2] Because of increased coverage of immunisation with Diphtheria pertussis tetanus (DPT) and post-exposure prophylaxis with tetanus toxoid, the incidence has also declined dramatically from the developing world including India. However, this is more true about the urbanised developing world where there is an increased coverage of immunisation and where there is the realisation of the importance of immunisation by population. It is more so in India, where in rural/tribal areas, the importance of immunisation is not yet fully realised by population, and hence, the isolated cases of tetanus are still reported from developing countries including India.[3],[4],[5],[6],[7] Even a few cases of tetanus have been reported from India in individuals who have received a complete course of immunisation.[8]
The non-immunised and inadequately immunised individuals from rural/tribal areas still carry the higher risk of tetanus. Hence, the tetanus is not the past although not frequent like earlier days, it still exists in India, especially in rural/tribal areas emphasising not only on vaccination but also on health education of people residing in these areas of India where the importance of vaccination is not yet realised.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Mathur P. Tetanus and gas gangrene: Things of the past? J Patient Saf Infect Control 2015;3:25-6.  [Full text] |
| 2. | Sanford JP. Tetanus – Forgotten but not gone. N Engl J Med 1995;332:812-3. |
| 3. | Ogunkeyede SA, Fasunia AJ, Adeosun AA, Lasisi OA. Otogenic tetanus: Continuing clinical challenge in the developing country. J Rhinolaryngo Otol 2013;1:87-90. |
| 4. | Adeel M, Rajput SA, Awan MS, Arain A. A case of otogenic tetanus. BMJ Case Rep 2012;2012. pii: Bcr0320125976. |
| 5. | Ugwu GI, Okolugbo NE. Otogenic tetanus: Case series. West Afr J Med 2012;31:277-9. |
| 6. | Ganesh M, Sheikh NK, Shah P, Mehetre G, Dharne MS, Nagoba BS. Detection of Clostridium tetani in human clinical samples using tetX specific primers targeting the neurotoxin. J Infect Public Health 2016;9:105-9. |
| 7. | Tullu MS, Deshmukh CT, Kamat JR. Experience of pediatric tetanus cases from Mumbai. Indian Pediatr 2000;37:765-71. |
| 8. | Lodha R, Sareen A, Kumar RM, Arora NK. Tetanus in immunized children. Indian Pediatr 2000;37:223-4. |
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