Oregon Saw First Pediatric Tetanus Case In More Than 30 Years

Enlarge this image

Enlarge this image

On day 47, he was moved out of the ICU and into an intermediate care unit at the hospital.

The 2017 case is the first case of pediatric tetanus in OR in more than 30 years because of widespread childhood immunization against it began in the 1940s.

On Friday, a Centers for Disease Control and Prevention report discussed an unvaccinated child in OR who spent weeks at a hospital in 2017 after getting a tetanus infection.

The incident happened in 2017, when the boy cut his forehead while playing outside on a farm.

Within six days of receiving the cut, which was cleaned and sutured at home, the boy began episodes of muscle spasms and jaw clenching, followed by opisthotonus, arching of the neck and back.

An unvaccinated OR boy who spent eight weeks in intensive care and nearly died after contracting tetanus was cared for by a medical team of more than 100 people.

Doctors in Portland, Oregon, who treated the child declined to provide any further information about the family at a news conference Friday, citing medical privacy laws. When he arrived, he asked for water but could not open his mouth. Physicians sedated and intubated him because the spasms of his diaphragm and larynx were causing breathing problems.

Because sound and light increased the intensity of his symptoms, the patient was kept in a darkened room with ear plugs and minimal stimulation. His blood pressure shot up, and he became feverish.

The young son of anti-vaccine parents endured excruciating pain and spent 47 days in pediatric intensive care after contracting tetanus, a devastating bacterial infection easily prevented by vaccines. On day 54, his tracheostomy was removed, and 3 days later, he was transferred to a rehabilitation center for 17 days.

He was stuck in the hospital for 57 days. But his family was hit with an $811,929 hospital bill, "excluding air transportation, inpatient rehabilitation, and ambulatory follow-up costs".

It was the first time that Dr. Judith Guzman-Cottrill, the pediatric infectious disease expert who treated the child, had ever seen tetanus because of widespread vaccination against it in the U.S. And it took another month after his rehab before he was back to his old activities, including running and riding a bike.

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. While talking about the vaccines, the CDC also recommends that children are given five doses of the DTaP vaccine at two, four and six months of age, at 15-18 months of age and at four to six years of age.

Tetanus, which is caused by the bacterial toxin C. tetani, is rare in the US, since it is easily preventable with vaccination.

Anywhere from three to 21 days after infection, symptoms appear: muscle spasms, lockjaw, difficulty swallowing and breathing and seizures. In fact, since the 1940s and the advent of the tetanus vaccine and wound management techniques, the United States has experienced a 95 percent decline in the number of tetanus cases and a 99 percent decrease in tetanus-related deaths. Booster shots are recommended every 10 years through adulthood.

Doctors gave the child a diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) during the course of his eight-weeks of treatment, which the CDC estimated to cost over $800,000.

Chelsea Manning in custody after refusing to testify on WikiLeaks
Spotify will now come pre-installed on Samsung devices