Unvaccinated six-year-old boy gets tetanus; treatment costs US$800K

Alicia Farmer
March 9, 2019

The report, issued from the Centers for Disease Control, says that the tetanus case is the first pediatric case in the state in nearly 30 years.

Despite the recommendation of doctors, the child's parents refused a second dose of the DTaP vaccination and other vaccines.

"This is an very bad disease, but. we have had a mechanism to completely prevent it, and the reason that we have virtually no cases anymore in the United States is because we vaccinate, literally, everyone".

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 USA, where vaccination effectively prevents such conditions.

Liberal-leaning OR and Washington have some of the nation's highest statewide vaccine exemption rates, driven in part by low vaccination levels in scattered communities and at some private and alternative schools.

Dr. Judith Guzman-Cottrill, a pediatric infectious disease doctor at OHSU, says she had never before seen a case of tetanus and never expected to see one in her career.

"Upon hospital arrival, the child had jaw muscle spasms", the report stated.

"We had a hard time taking care of this child - watching him suffer - and it is a preventable disease", Guzman-Cottrill said.

Lawmakers in OR and Washington are considering bills to end non-medical exemptions for childhood vaccines due to a Pacific Northwest measles outbreak.

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Unlike measles, which is a virus, someone who has survived a case of tetanus is not immune and can get the illness again if they remain unvaccinated.

Tetanus spores exist everywhere in the soil.

About 30 people contract tetanus each year nationwide, according to the CDC, and 16 people died of it between 2009 and 2015.

OR lawmakers are now debating a bill that would remove all but exemptions issued for medical reasons and require children be fully vaccinated in order to attend school. The boy's wound was treated and sutured at home. Six days later, he began clenching his jaw, arching his neck and back and had uncontrollable muscle spasms. Once he had difficulty breathing, he was transported by air to a pediatric medical center, where he was diagnosed with tetanus, according to the CDC. He indicated he wanted some water but couldn't open his mouth enough to drink it.

To control his spasms, the child was set up in darkened room with ear plugs and minimal stimulation. His heart raced, his blood pressure went up, and his body temperature spiked to almost 105 degrees Fahrenheit.

On day 44, he was taken off breathing support and he could take small sips of liquids.

On day 50, he was able to walk a short distance of 20 feet with assistance.

The charges totaled $811,929, although this excludes additional costs of air transportation, inpatient rehabilitation, and ambulatory follow-up costs, according to the report.

Use of tetanus vaccines and tetanus immune globulin had led to a 95 percent decrease in tetanus cases and 99 percent decrease in tetanus-related deaths since the 1940s, according to the CDC, which recommends that children receive the DTaP vaccine at ages, 2 months, 4 months, 6 months, 15-18 months, and then at 4-6 years old, and that adults receive tetanus and diphtheria (Td) boosters every 10 years.

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