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Unvaccinated Oregon boy had ‘severe’ tetanus

12 March 2019
Unvaccinated Oregon boy had ‘severe’ tetanus

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An unvaccinated six-year-old boy from OR required treatment costing more than US$800,000 after he was diagnosed with tetanus in the state's first case of the disease in 30 years, according to a new report.

A 6-year-old boy in OR fell down while playing on a farm and cut his forehead-and if he'd had his standard childhood shots, you wouldn't be reading about him.

The boy was airlifted to a pediatric medical center.

Tetanus is an uncommon but very serious neuromuscular disease caused by the bacterium Clostridium tetani.

After the boy was diagnosed, treatment began. He was still undergoing spasms, so he was sedated, placed on a ventilator to help him breathe, and a tube was placed in his trachea. The wound was cleaned and sutured at home.

Case study co-author Dr. Carl Eriksson, an assistant professor of pediatric critical care at Oregon Health & Science University, who was involved in the boy's treatment, wrote in an email to TIME that severe tetanus cases are very rare in the US, where vaccination effectively prevents such conditions. He also developed opisthotonus, or the arching of the neck and back.

On the fifth day of this ordeal, doctors had to perform a tracheostomy-a surgery to create an opening in the neck to help a patient breathe.

At that point, the doctors were able to wean him off the drugs for muscle spasms over five days. On day 44, his ventilator support was discontinued, and he tolerated sips of clear liquids. On Day 57, he was transferred from the pediatric hospital to a rehabilitation center, where he spent two-and-a-half weeks.

In total, the boy had to spend approximately eight weeks in the hospital followed by another 17 in a rehabilitation centre before he was able to resume normal activities, such as biking and running.

All in all, the medical care cost more than $800,000, and that's not even including the air transport, ambulance costs or the inpatient care.

He was also given a dose of the diphtheria, tetanus and pertussis (DTaP) vaccine, as well as tetanus immune globulin, a medication made up of antibodies against the infection.

While doctors gave the boy an emergency dose of tetanus vaccine when he was brought to the hospital, his parents elected not to give him a second dose, or any other recommended vaccinations, before their child left inpatient care. It's unclear from the report who covered his hospital expenses. But despite all they'd been through, his parents declined that shot, along with all other recommended vaccinations. The signs and symptoms of the infection manifest about three to 21 days after it has entered the body.

Tetanus in the United States is nearly unheard of today. Today, only about 30 cases are reported every year.

The child's case "comes amid a measles outbreak in Washington and OR that has sickened 75 people, a lot of them unvaccinated children", the Oregonian reported. A great majority of young children and babies are sufficiently vaccinated. The boy's family did not vaccinate him before the incident and refused doctors' counsel to vaccinate him after he recovered, according to a report by the Centers for Disease Control and Prevention. However, vaccines have been the one thing that we've had in pediatrics that have completely changed the face of kids' health.