Accelerated stability test has been applied for predicting self-life of national standard serum tetanus anti-toxin (SAT). Samples of the tetanus antitoxin were kept at - 20°C, 4°C, 22°C, 37°C and 45°C for 6 months and their potency was estimated by using the toxin neutralization method on mice. There was relationship between the potency change and the self- life of serum tetanus antitoxin by using Arrhenius equation. The results demonstrated that the self-life of the national standard serum tetanus antitoxin was 9 years and 6 months when stored at -20°C.
Tetanus Antitoxin ; Diagnosis

A retrospective study was performed with 52 case -reports of neonatal tetanus and 97 without neonatal tetanus during the year 1995-2002 at Bacgiang provincial hospital. In the province Bacgiang, there were children with neonatal tetanus in every rural district, the highest incidence in Lucnam District_28,8%,in Langgiang District_15,8%, the lowest in Yenthe District_ 1,9% and none in Dongson District. The signs of disease were jawbone stiffness, sucking cease, umbilical wet and fetidness, spasm, dyspnoe and pale face. Mortality _55,4% . With a short incubation of 0 to 7 days, the mortality was 19 folds higher than that of the group of above 7days incubation. Risk factors: unprepared delivery, delivery at home, cutting umbilical cord and dressing by dirty instruments and materials...
Epidemiology ; Diagnosis ; Risk Factors ; Tetanus

In order to obtain knowledge and information on tetanus occurrence in Korea, an analytical survey from a public health point of view and clinical aspect was carried out for hospitalized patients in four general hospitals in Korea from January 1, 1974, to December 31, 1983. The results showed that 175 among a total of 543 tetanus patients died m the hospitals, with a fatality rate of 24.1 percent. However, the patients discharged against the doctor's advice were not included in these death cases. Sex ratio of tetanus patients between male and female was 3:1. Home delivery in neonate tetanus patients and laceration, and abrasion in non-neonate tetanus patients were the dominant causes of death. Foot wound was the most dominant cause of death in the latter. Clinical features of tetanus patients on admission were sucking failure and dysphagia (50.8%), convulsion (53.8%) and trismus (50.8%). The tetanus patients expired mainly due to respiratory and cardiac failure. In the treatment of tetanus patients, airway (58.3%), intubation (45.3%) and tracheostomy (9.7%) were applied.
Female ; Human ; Infant, Newborn ; Korea ; Male ; Pregnancy ; Prognosis ; Tetanus*/diagnosis ; Tetanus*/therapy

Since a nationwide childhood vaccination with tetanus toxoid, tetanus has become a rare disease in Korea. However, we recently experienced 17 cases of adult tetanus in a university hospital during a 21-month period. Seventy percent of the patients were female, and the mean age was 63 yr (range, 29-87). The majority (88.2%) of the patients did not get primary vaccinations for tetanus and decennial tetanus-diph-theria toxoid booster. Most patients (88.2%), who sustained acute injury, did not seek medical care for their wounds or did not receive the prophylaxis for tetanus. Tetanus was found most frequently among farmers. Tetanus was diagnosed initially only in 53% of patients. The case-fatality ratio was 23.5%. These cases show that recently occurring tetanus in Korea is a disease, affecting the elderly and the female who may have a lower immunity against tetanus, and the farmers who are likely to be exposed to Clostridium tetani. In addition, diagnosis of tetanus is often delayed in area where cases are seen infrequently. Therefore, improved education among patients and physicians, emphasis of anti-tetanus immunization and awareness of tetanus respectively, may be essential for the prevention of disease and the reduction of its mortality.
Adult ; Aged ; Aged, 80 and over ; Agricultural Workers' Diseases/epidemiology ; Diagnostic Errors ; Diphtheria-Tetanus-Pertussis Vaccine ; Emergency Service, Hospital ; Health Education ; Health Knowledge, Attitudes, Practice* ; Human ; Immunization, Secondary/psychology ; Immunization, Secondary/utilization* ; Korea/epidemiology ; Middle Aged ; Tetanus/diagnosis ; Tetanus/epidemiology* ; Tetanus/prevention & control ; Tetanus/therapy ; Tetanus Antitoxin/therapeutic use ; Tetanus Toxoid ; Treatment Outcome ; Vaccination/utilization* ; Wounds, Penetrating/complications

Tetanus is a neurologic disease which features the muscle spasm as the hallmark. It is an infectious disease with high mortality rate triggered by tetanospasmin produced by Clostridium tetani. This report concerns incidence of tetanus consequent to oriental medical care such as acupuncture and moxibustion. Although the tetanus occurrence has shown a remarkable decline since nationwide vaccinations in some of the developed countries, including Korea, it still remains to be an important issue, to be dealt within Korea, as the majority of the patients are old aged and Korean population is rapidly becoming an aging society. Furthermore, since more elders are coming to rely on Oriental medicine in Korea, the Korean elders are at a higher risk than elsewhere. The lack of medical experiences, including those in oriental medical field, has been hindering early diagnosis of Tetanus. This study aims to encourage rapid and accurate decisions in diagnosis and treatment through reviewing symptoms particularly specific to tetanus, and also to arouse attention to the riskiness of invasive procedures involving skin puncture.
Acupuncture ; Aged ; Aging ; Clostridium tetani ; Communicable Diseases ; Developed Countries ; Early Diagnosis ; Humans ; Incidence ; Korea ; Medicine, East Asian Traditional ; Metalloendopeptidases ; Moxibustion ; Punctures ; Skin ; Spasm ; Tetanus ; Tetanus Toxin ; Vaccination

BACKGROUND: Point-of-care-testing (POCT) kits for tetanus toxoid antibody are used in emergency departments to evaluate the immunization status of patients with tetanus. The objective of this study was to evaluate the analytical performance and the utility of SD BIOLINE tetanus kit (Standard Diagnostic Inc., Yongin, Korea), as a POCT. METHODS: A total of 326 peripheral blood specimens (whole blood, 319; serum, 326) from healthy subjects and patients were used. SD BIOLINE tetanus kit was evaluated for precision, accuracy, effect of specimens, operator variance, and the total processing time. The results from SD BIOLINE tetanus kit were compared with those from 2 quantitative ELISA kits. RESULTS: Compared with ELISA kits, SD BIOLINE tetanus kit revealed a sensitivity of 88-97%, specificity of 87-92%, positive predictive value of 81-89%, negative predictive value of 90-98%, and kappa agreement of 0.78-0.82. SD BIOLINE tetanus kit also showed an excellent precision and a high accuracy. It showed a high concordance rate between whole blood and serum specimens. The total processing time of SD BIOLINE tetanus kit was 30-40 min. CONCLUSIONS: SD BIOLINE tetanus kit showed an excellent analytical performance. With its rapid turnaround time and the ease of handling and interpretation, SD BIOLINE tetanus kit seems appropriate for the evaluation of tetanus immunization status as a POCT device. However, education for operators and standardized guidelines for result interpretation should be emphasized.
Antibodies, Bacterial/blood ; Enzyme-Linked Immunosorbent Assay ; Humans ; Point-of-Care Systems ; *Reagent Kits, Diagnostic ; Reproducibility of Results ; Sensitivity and Specificity ; Tetanus/*diagnosis/prevention & control ; Tetanus Toxoid/*immunology

Tetanus is a neurologic disorder, characterized by increased muscle tone and spasms, that is caused by tetanospasmin, a powerful protein toxin elaborated by Clostridium tetani. In the modern society, tetanus is a rare disease, but it has a high mortality on attack and it 's diagnosis depends on the clinical symptoms. The treatment for tetanus is an injection of human tetanus immunoglobulin (HTIG) to neutralize the circulating tetanospasmin, to control breathing, and to provide systemic supportive care. Recently, the 500 unit of HTIG is recommended. We report one case of generalized tetanus that was treated with 500 units of HTIG. The patient was discharged without complications.
Clostridium tetani ; Diagnosis ; Humans* ; Immunoglobulins* ; Mortality ; Nervous System Diseases ; Rare Diseases ; Respiration ; Spasm ; Tetanus*

No abstract available.
Aged ; Anti-Infective Agents/therapeutic use ; Drug Therapy, Combination ; Foot Injuries/*complications ; Humans ; Male ; Muscle Relaxants, Central/therapeutic use ; Tetanus/diagnosis/drug therapy/*microbiology ; Tetanus Toxoid/therapeutic use ; Treatment Outcome ; Trismus/diagnosis/drug therapy/*microbiology ; Wounds, Stab/*complications

INTRODUCTIONInjecting drug abusers are vulnerable to many infectious complications. We describe a case of tetanus in a Singaporean who regularly abused buprenorphine.

CLINICAL PICTUREA 49-year-old male was hospitalised for progressive generalised spasms associated with dysarthria and opisthotonus. Tetanus was diagnosed clinically.

TREATMENTSupportive management was instituted in the intensive care unit (ICU). Toxicology samples tested positive for buprenorphine.

OUTCOMEHe recovered rapidly and was transferred out of the ICU after 8 days. Retrospective questioning confirmed parenteral abuse of buprenorphine.

CONCLUSIONThis case highlights an uncommon and potentially lethal complication of parenteral drug abuse.

Buprenorphine ; Disease Progression ; Dysarthria ; Humans ; Male ; Middle Aged ; Singapore ; Substance Abuse, Intravenous ; Substance-Related Disorders ; complications ; Tetanus ; diagnosis ; etiology ; therapy

PURPOSE: Tetanus is difficult for emergency physician to diagnosis at an early stage because of its low incidence and atypical initial clinical features. Therefore, we reviewed the clinical features of 54 tetanus cases and attempted to identify factors associated with prognosis in order to improve early diagnosis and treatment. METHODS: We carried out a retrospective chart review of 54 adult tetanus patients who presented to the ED of Chonnam National University Hospital between January 1996 and December 2005. We collected information on demographics, SAPS II score, clinical feature, course of infection and prognosis. We divided the patients to two groups according to the survival and compared their data statistically. RESULTS: Fifty four patients, 33 men and 21 women, were included in the study. The mean age was 50.97+/-15.95. The most common initial diagnosis in ED were electrolyte imbalance (n=15), neck and facial dystonia (n=9). The mean incubation period was 10.27+/-6.47 days. The initial SPAS II score 17.29+/-8.45 and the Wood score was 3.12 +/-1.47. Most commonly symptom was dyspnea and dysarthria. Twenty one patients were supported by mechanical ventilation, and the duration of mechanical ventilation was 5.92+/-4.52 days. On multivariate logistic regression analysis, four variables were found to be associated with the prognosis: incubation period, Wood score, Time interval from initial symptom to mechanical ventilation, initial SAPS II. CONCLUSION: Four variables correlated well with the prognosis: Incubation period, Wood score, Time interval from initial symptom to mechanical ventilation, initial SAPS II score.
Adult ; Demography ; Diagnosis ; Dysarthria ; Dyspnea ; Dystonia ; Early Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Incidence ; Jeollanam-do ; Logistic Models ; Male ; Neck ; Prognosis ; Respiration, Artificial ; Retrospective Studies ; Tetanus* ; Wood