People died from tetanus-related complications in recent years, the Centers for Disease Control and Prevention said on April 16.
From 2009 to 2023, 47 states and the District of Columbia reported 402 tetanus cases, CDC researchers said in a paper published by the agency’s quasi-journal. Thirty-seven of those cases resulted in death, including one in 2023 and two in 2021.
Twenty-two of the deaths were among females. Fifteen were among females aged 80 or older.
None of the deceased were younger than 18. Two of the deaths were among those between the ages of 18 and 49; four were among those aged 50 to 64; the rest were among elderly individuals.
Tetanus is a disease caused by a toxin produced when one is exposed to a bacterium, typically through a contaminated wound. Symptoms can include difficulty swallowing, spasms, and seizures.
Cases involve a doctor’s diagnosis, since there are no laboratory tests to confirm infection.
Of the 402 cases recorded from 2009 to 2023, about a quarter happened among people aged 18 to 34. Another 23 percent happened among people aged 35 to 49. And another 26 percent occurred among people aged 50 to 79.
With the relatively low number of cases among older people, and how the elderly made up the bulk of the deaths, the case fatality rate was the highest, 63.3 percent, for those 80 years old and older. The second-highest case fatality rate was 30.8 percent for people aged 65 to 79.
Thirty patients were hospitalized, and 25 entered intensive care. Many received mechanical ventilation, and some received post-exposure tetanus immune globulin.
The number of tetanus cases and deaths has plummeted over the decades, with the CDC attributing the drop to adding a tetanus vaccine to the childhood vaccination schedule and recommending it for older people during the 1960s.
Children are advised to receive five doses of a diphtheria, tetanus, acellular pertussis vaccine by the time they turn 7, and a dose of the tetanus, diphtheria, acellular pertussis vaccine when they are 11 or 12.
For the 16 deceased in recent years with known vaccination status, eight had received no vaccine doses, and eight had received one or two doses, according to the CDC. The other 21 had unknown status.
The bacteria that cause tetanus are “ubiquitous in the environment, and despite being preventable, tetanus remains a risk for those who are unvaccinated, undervaccinated, or who do not receive recommended wound management,” the CDC researchers said. They recommended routine vaccination as well as prompt identification and treatment of tetanus-prone injuries.
The researchers reported no conflicts of interest.
In a separate paper also released by the CDC on Thursday, researchers said that just four children in the United States had tetanus in 2024, and that none of those had received a vaccine. They said that all the children were hospitalized and eventually recovered.