Open AccessTetanus in England and Wales, 1984–2000
Author(s) -
A. A. Rushdy,
Joanne White,
Mary Ramsay,
Natasha S. Crowcroft
Publication year - 2003
Publication title -
epidemiology and infection
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.992
H-Index - 109
eISSN - 1469-4409
pISSN - 0950-2688
DOI - 10.1017/s0950268802007884
Subject(s) - tetanus , medicine , vaccination , incidence (geometry) , neonatal tetanus , pediatrics , immunization , vaccination policy , demography , environmental health , immunology , physics , antigen , sociology , optics
A review of national tetanus surveillance in England and Wales during 1984-2000 was undertaken to evaluate the surveillance system and national vaccination policy. Hospital Episode Statistics for tetanus in England for fiscal years 1989/90-1995/6 were also examined to estimate under-reporting. A total of 175 cases of tetanus were reported, giving an annual incidence of 0.20 per million, the lowest levels ever recorded. The highest incidence was in those aged over 64 years (0.66 per million) with no significant sex difference. Twenty (11%) cases were reported in people who were eligible for routine childhood vaccination. Outdoor injuries were the commonest reported exposure risk. Tetanus case under-reporting was estimated as 54-64%. We conclude that GPs should ensure that all their patients are fully vaccinated, targeting those born before 1961. High childhood tetanus vaccination coverage remains a priority. As the disease becomes rarer, enhanced tetanus case surveillance is essential for tetanus immunization policy evaluation.