Seroprevalence of Tetanus Antibodies Among Adults Older Than 65 Years☆,☆☆,★,★★
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INTRODUCTION
More than 1 million deaths per year worldwide are attributable to tetanus. Most cases occur in developing countries, with more than 50% in the neonatal population.1 However, with adequate immunization practices, tetanus is a preventable disease. Tetanus immunization became widely available to the U.S. civilian population after successful immunization programs in the military during World Wars I and II. This has markedly decreased the number of tetanus cases as an increasing number of children
MATERIALS AND METHODS
A convenience sample of 129 patients aged 65 years or older was recruited from a large urban comprehensive geriatric care center; 118 were outpatients and 11 were admitted to the inpatient unit from the outpatient clinic. All patients attending the clinic from November 15, 1994, through December 22, 1994, and from March 24, 1995, through April 10, 1995, were eligible for the study. Only patients who declined to participate were excluded. This center provides a broad range of medical and social
RESULTS
The mean age for all participants was 78 years (range, 65 to 97 years); there were 92 female (71%) and 37 male (29%) patients. Of the study population, 64 (50%) did not have adequate antibody titers to tetanus toxin (95% confidence interval [CI], 41% to 59%; Figure 1). The mean age of patients without protective titers was the same as for those with protective titers (78.5 versus 78.0 years, respectively, P=.58). Among the female patients, 54 (59%) did not have adequate titers, compared with 10
DISCUSSION
Although a rare disease in the United States, tetanus is still a public health concern. With recognition of the characteristics of populations at risk, immunization practices can be directed accordingly. The results of this study, the first to use the most recently revised standards for measurement of tetanus antibody titers, indicate that a significant percentage of elderly patients do not have protective levels of tetanus antibodies. Although other studies have reached the same conclusion in
Acknowledgements
The authors thank Dr Phillip McPherson, Dr Vibhu Narang, and Dr Helen Weiss.
References (11)
Tetanus: Forgotten but not gone
N Engl J Med
(1995)Surveillance of tetanus–United States, 1989-1990
MMWR Morb Mortal Wkly Rep
(1992)Tetanus–United States, 1987 and 1988
MMWR Morb Mortal Wkly Rep
(1990)Tetanus–United States, 1985-1986
MMWR Morb Mortal Wkly Rep
(1987)- et al.
A population-based serologic survey of immunity to tetanus in the U.S
N Engl J Med
(1995)
Cited by (0)
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From the Department of Emergency Medicine, Long Island Jewish Medical Center*, and the Department of Geriatric Medicine, Parker Jewish Geriatric Center‡, New Hyde Park, and the Albert Einstein College of Medicine, Bronx, New York.
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Partially supported by a grant from ENZO Labs of Farmingdale, Long Island, New York.
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Reprints not available from the authors.
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Reprint no. 47/1/73678