Boy Who Wasn't Immunized For Tetanus Spent 57 Days In Oregon Hospital

Alicia Farmer
March 10, 2019

But after six days, he was being treated for tetanus, an enormously painful, sometimes fatal infection that is caused by bacterial spores found in the soil and that is completely preventable with vaccine.

The young boy went through a severe, life-threatening illness.

All in all, this first totally preventable pediatric case in OR in more than three decades required 57 days of inpatient acute care, including 47 days in the intensive care unit. The next thing they know, the boy's neck and back started arching and his whole body became stiff with continuous muscle contractions.

The tetanus case of this boy is the first in more than 30 years in Oregon.

"This is an 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".

By the time he was transferred out of the ICU, the boy needed help walking 20 feet.

He was given a tetanus immune globulin as well as the diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine, and then taken to the pediatric intensive care unit to be treated in a darkened room with ear plugs and minimal stimulation due to his spasms, according to the report.

The child's care - not including the air ambulance and inpatient rehabilitation - cost almost $1 million, about 72 times the mean for a pediatric hospitalization in the US, the paper noted.

On day 54, his tracheostomy was removed. It's unclear from the report who covered his hospital expenses.

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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.

To prevent tetanus, Health Canada recommends infants and children should receive a combined vaccine that protects them from five different diseases, including tetanus, at two months, four months, six months, and 18 months.

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.

The inpatient charges amassed to more than $800,000, and despite the child receiving a vaccine at the hospital, the family declined the second dose along with other recommended immunizations.

Tetanus is an acute neuromuscular disease caused by the bacterium Clostridium tetani.

Anywhere from three to 21 days after infection, symptoms appear: muscle spasms, lockjaw, difficulty swallowing and breathing and seizures.

"The CDC report says tetanus vaccines have contributed to a" 95 percent decline in the number of tetanus cases and a 99 percent decrease in the number of tetanus-related deaths since the 1940s". The health agency said teenagers should get another booster shot at age 14 to 16.

A medical paper published Friday by the U.S. Centers for Disease Control and Prevention details the 2017 case, which was the first pediatric tetanus case in the state in more than 30 years.

The World Health Organization has identified "vaccine hesitancy" as one of the top 10 global health threats for 2019. Almost all of the sick patients hadn't gotten their measles vaccinations. "Vaccination is one of the most cost-effective ways of avoiding disease - it now prevents 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved".

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