The case of an Oregon boy diagnosed with Tetanus shows how vaccination can save lives and nearly a million dollars, too.
A report from the Centers for Disease Control and Prevention, released Friday, March 8, details the dark experience of the unvaccinated child and the surprising response of the family in the end.
How It Began
The then 6-year-old boy hit his forehead while playing on a farm and suffered from lacerations. He went home and had his wounds cleaned and sutured. Everything seemed normal until the sixth day of the injury. At that point, he was observed to cry, clench his jaws, and had unintentional muscle spasms in his upper limbs. The next thing they know, the boy's neck and back started arching and his whole body became stiff with continuous muscle contractions. The boy struggled with his breathing later that day, prompting his parents to call emergency medical help. The medical crew transported him via air to a specialty pediatric facility.
When the boy arrived at the hospital, he still had jaw spasms. He was alert and even requested for water. The problem was he could not open his mouth. His breathing was declining because his throat muscles and diaphragm were also having spasms. The medical team subsequently sedated, intubated, and hooked him up to a mechanical ventilator.
What Happened During The Hospitalization?
The doctors diagnosed the boy with tetanus and prescribed him to stay in the hospital for about eight weeks. They also included rehabilitation in the care plan, before he could go back to his normal activities.
In the hospital, the boy had to stay in the intensive care unit. He had to wear earplugs and the medical staff had to keep his room as dark and as quiet as possible to prevent any stimulation, which may trigger spasms. He also received vaccination against tetanus.
Throughout his hospital stay, the boy received several intravenous medications for pain, fever, infection, and blood pressure control. He showed good response to the treatments and was finally released from the intensive care unit on day 47. Seven days later, his rehabilitative care began.
What Is Tetanus?
Tetanus is a bacterial infection affecting the brain and muscles. The causative bacterium, Clostridium tetani, which is usually found in soil, can enter the body through open wounds or any disruption in the skin. The signs and symptoms of the infection manifest about three to 21 days after it has entered the body.
The bacteria do not usually grow from wounds when tested in the laboratory. The diagnosis of tetanus is then made based on what the patient presents clinically. In the case of this boy, the bacterium C. tetani was not detected from wound culture testing. A negative result, however, does not mean that tetanus should be counted out.
Family Declines Second Dose Of Vaccine
After a total of 57 days in the hospital and nearly a million dollars ($811,929 to be exact) in medical bills, the family declined to give the boy the recommended second dose of tetanus vaccine, as well as other immunizations. The decision was made even after the doctors presented a thorough education on the benefits and possible risks of the vaccine.
A Look At Tetanus Vaccines
The tetanus case of this boy is the first in more than 30 years in Oregon. Although he recovered fully and is now back to his normal daily living, the news sparks medical professionals anew in promoting the importance of getting vaccinated. The fact that the bacteria is passed on through direct contact from an infected person, unlike flu, the public cannot rely on other people being immunized.
"Thus, routine vaccination for all, plus boosters, are very important to prevent disease," lead author Judith Guzman-Cottrill told Gizmodo.
Vaccination against tetanus is incorporated in a DTaP (diphtheria and tetanus toxoids and acellular pertussis) series, given in five doses at different ages. The first three doses are given to eligible children during the second, fourth, and sixth months of age. The remaining doses are administered at 15-18 months and at 4 to 6 years. CDC states that those who do not have insurance to cover the immunization expenses may avail of the vaccine for free via the Vaccine for Children program.
Extensive use of the vaccine has resulted in a 95 percent drop in tetanus cases and 99 percent decrease in deaths linked to tetanus.
Total health care costs of adult tetanus cases may range from $22,229 to $1,024,672. The boy's case is close to the maximum cost documented. The question now is, will this report instigate a massive change of minds and hearts against vaccination in general or will it take another similar case to do just that?
