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| Division of Public Health Services Disease Handbook for Childcare Providers | |
| Bureau of Infectious Disease Control REVISED –January 2018 | |
| TETANUS | |
| Tetanus is a bacterium that lives in the soil and | |
| can enter the body through a cut or wound. The | |
| bacteria produce a poisonous substance – | |
| exotoxin – that causes the clinical illness. | |
| Who gets this disease? | |
| Tetanus occurs almost exclusively in | |
| unimmunized or inadequately immunized | |
| persons. Previously having tetanus does not result | |
| in immunity to subsequent infections. Vaccination | |
| is required after initial recovery. | |
| How is it spread? | |
| Unlike other vaccine-preventable diseases, tetanus | |
| is not spre ad from person- to-person. It occurs | |
| when the bacterium in soil or dust is introduced | |
| into the body through a wound. | |
| What are the symptoms? | |
| The poisonous exotoxin produced by the | |
| Clostridium tetani bacteria causes muscles to go | |
| into spasms of the face/neck, abdomen, or area | |
| where the initial infection occurred. Paralysis and | |
| death can result. Sometimes tetanus is called | |
| “lockjaw”. | |
| How can Tetanus be prevented? | |
| The Advisory Committee on Immunization | |
| Practices (ACIP) recommends immunizing | |
| children against tetanus – along with diphtheria | |
| and pertussis – beginning as early as six weeks of | |
| age. The diphtheria-tetanus-acellular pertussis | |
| (DTaP) vaccine is required for both childcare | |
| and school attendance. The five dose series should | |
| be completed at 2 months, 4 months, 6 months, | |
| and 15-18 months, and 4-6 years of age | |
| Tdap/Tetanus diphtheria and acellular pertussis | |
| should be given once between the ages of 11- 18 | |
| years. Booster doses of tetanus -diphtheria toxoid | |
| (Td) vaccine every 10 years after finishing the | |
| childhood primary immunization series are | |
| necessary to maintain protection against tetanus. | |
| Tdap is available as a one time dose for adults | |
| who have not recently received a tetanus vaccine. | |
| Also, it is important to be sure that all cuts, | |
| scrapes and puncture wounds are cleaned well | |
| with soap and water. Consult your healthcare | |
| provider for need of tetanus vaccine after a | |
| wound. | |
| Who should be excluded? | |
| There is no need for the child or the childcare | |
| worker to be excluded as tetanus is not spread | |
| from person-to-person. | |
| Reportable? | |
| Yes, tetanus is reportable by New Hampshire law | |
| to the Division of Public Health Services, Bureau | |
| of Infectious Disease Control at (603) 271-4496. | |