http://www.cdc.gov/mmwr/preview/mmwrhtml/00053713.htm

My comments on article above
124 cases in 3 years. Read carefully. Still isn't written real well - I
hate when they use %% and you don't know the real numbers. There are
graphs on the webpage with tiny, tiny writing that help a little. If
they were graded on their writing skills presenting this type of info
they'd get a D.

That works out to be 41 cases in 1 year. One child with an insect bite.
The key here for me is how many people DO NOT GET TETANUS - aren't
vaccinated, aren't up to date on vaccines, get insect bites, work in
the soil, etc. You have to keep this all in perspective. Also a lot of
drug users here.

1. But the key paragraph to me - which I didn't know - was this....
"Tetanus remains a clinical diagnosis because confirmatory laboratory
tests are not available for routine use. Isolation of the organism from
wounds is neither sensitive nor specific: anaerobic cultures of tissues
or aspirates usually are not positive, and the organism might be grown
from wounds in the absence of clinical signs and symptoms of disease
(37-39)." So how do we know any of these people actually had 'tetanus'
- what about that insect bite - was it tetanus at all or poison/venom?

2. Also...."The number of cases derived from passive reporting by
physicians to local and state health departments underestimates the
true incidence of tetanus in the United States. Completeness of
reporting for tetanus mortality has been estimated at 40%, while
completeness of reporting for tetanus morbidity may be lower (36).
Although tetanus mortality reporting is incomplete, reported tetanus
deaths are representative of all tetanus deaths (36). Because fatal
cases are more likely to be reported than nonfatal ones, possible
changes in reporting practices do not appear to explain the decreased
number of reported cases among older adults, who are more likely to
have severe disease." This paragraph doesn't totally make sense but
what I get is that reporting for tetanus mortality is 40% and reporting
of tetanus morbidity (occurance) is less. SO IF THE DOCS DON'T EVEN
REPORT TETANUS, YOU THINK THEY REPORT VACCINE REACTIONS?? The paragraph
about tetanus mortality being incomplete but the deaths are
representative of all deaths - how on earth do that know that. See what
I mean....

3. And this "Tetanus is preventable through both routine vaccination
and appropriate wound management. " WOUND MANAGEMENT!!!!