JiscMail Logo
Email discussion lists for the UK Education and Research communities

Help for ACAD-AE-MED Archives


ACAD-AE-MED Archives

ACAD-AE-MED Archives


ACAD-AE-MED@JISCMAIL.AC.UK


View:

Message:

[

First

|

Previous

|

Next

|

Last

]

By Topic:

[

First

|

Previous

|

Next

|

Last

]

By Author:

[

First

|

Previous

|

Next

|

Last

]

Font:

Proportional Font

LISTSERV Archives

LISTSERV Archives

ACAD-AE-MED Home

ACAD-AE-MED Home

ACAD-AE-MED  May 2004

ACAD-AE-MED May 2004

Options

Subscribe or Unsubscribe

Subscribe or Unsubscribe

Log In

Log In

Get Password

Get Password

Subject:

Re: Tetanus

From:

Max Hills <[log in to unmask]>

Reply-To:

Accident and Emergency Academic List <[log in to unmask]>

Date:

Sat, 22 May 2004 20:24:08 +0100

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (166 lines)

A problem is that we are relying on individuals' recall regarding
vaccines they have received.  I conducted a questionnaire which was
deployed in the waiting room of the Trinity College Dublin Student
Health Service.  The Student Health service is frequented mainly by
students of the University so the population studied was young
(18-52yrs, mean22.71yrs) and (hopefully!) well-educated.  The
questionnaire was voluntary and we received 228 responses.

With regard to tetanus vaccination status, 19.7% could not remember
whether they had received tetanus vaccine or booster in the last 10
years.  13.6% of respondents could not remember whether they had
received Meningitis C vaccine or not, despite this vaccination programme
having occurred in the preceding two years in a nationwide campaign.  As
the list will know, no vaccine exists for Hep C, despite this 19.7% of
respondents believed they were protected against this infectious
disease. (A number of respondents who were studying medicine stated that
they were covered and course of study had no influence on how
respondents answered this question).  These and other results suggested
that a large number of patients really don't know their true vaccination
status (and that many don't know that they don't know!)

This study was part of an overall project which examined the utility of
an internet based vaccination registry, which would allow doctors to
update the current vaccine status of patients online from any
internet-connected computer, using a simple web interface.

Further information is available on request.

Max Hills.
Emergency Medicine Trainee.

-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Ray McGlone
Sent: 22 May 2004 15:38
To: [log in to unmask]
Subject: Re: Tetanus


Authors

Porter JD. Perkin MA. Corbel MJ. Farrington CP. Watkins JT. Begg NT.

Institution

Public Health Laboratory Service, Communicable Disease Surveillance
Centre, London, UK.

Title

Lack of early antitoxin response to tetanus booster.

Source

Vaccine. 10(5):334-6, 1992.

Abstract

Tetanus immune globulin (TIG) continues to be recommended in persons
with tetanus-prone wounds who have incomplete or unknown tetanus
immunization status. The aim of this study was to determine whether,
following a booster dose of tetanus toxoid in adults who had not been
immunized in the previous 10 years, there was an antitoxin response to
tetanus toxoid booster within 4 days. Thirty-one adults were
investigated, baseline levels for tetanus antitoxin assayed using an
ELISA technique, and an injection of adsorbed tetanus toxoid (0.5 ml)
given. Blood samples for tetanus antitoxin levels were taken at daily
intervals for the 4 days following immunization. Tetanus boosters
following the primary course but before the present study did not
significantly increase the levels of pre-study tetanus antitoxin and
following the study booster there was no difference between the preboost
levels and the levels on days 1 to 4. This finding indicates that the
present recommendations for the use of TIG in tetanus-prone wounds are
appropriate.





Putting these two papers together it would seem that a booster given to
a patient following a previous completed primary immunisation will get
an adequate antibody levels by 4 days but if the immunisation is
incomplete or unknown then a booster won't give adequate cover.



Ray McGlone





----- Original Message -----
From: "Ray McGlone" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, May 21, 2004 11:34 PM
Subject: Tetanus


> I was wondering what people were doing on the ground regarding tetanus

> immunisation. We hadn't had a tetanus case in our area for over 20
> years until one case last year and now another one this year. The last

> case was
a
> 35 yr old who had had 5 boosters last one being as a teenager (full
course),
> the person developed tetanus about two weeks after a thorn injury
> whilst gardening. The person did not attend A&E at the time of the
> injury.
>
> But on the current advice (enclosed) she would not have been offered a

> tetanus booster if she had attended A&E. I must admit that I still
> offer a booster if the wound is "tetanus prone" if they have not had a

> booster within 10 years. In the study below adequate circulating
> levels of
antitoxin
> were acheived within 4 days of the booster.
>
> What do other people do?
>
> Ray McGlone
> A&E Lancaster
>
> Authors
> Simonsen O. Kjeldsen K. Heron I.
>
> Title
> Immunity against tetanus and effect of revaccination 25-30 years after

> primary vaccination.
>
> Source
> Lancet. 2(8414):1240-2, 1984 Dec 1.
>
> Local Messages
> Held at BMA Library
>
> Abstract
> Fall off in tetanus immunity and the effect of late revaccination were

> investigated in a randomly selected group of Danes aged 25-30. Routine

> reinforcing doses of tetanus toxoid are not customary in Denmark
> except at injury and when there are certain occupational risks. 11% of

> the total
group
> of 418 had antitoxin titres below that required for protection (ie,
> less than 0.01 IU/ml, determined by neutralisation technique). In
> those who had received only primary vaccination an exponential fall
> off in immunity was seen, and 25-30 years after primary vaccination,
> 28% had serum antitoxin concentrations below the level of protection.
> Up to 30 years after primary vaccination, one reinforcing dose of
> tetanus toxoid adsorbed by aluminium hydroxide was sufficient to
> induce protective titres of antitoxin. There were no serious
> side-effects and it was concluded that routine reinforcing doses of
> tetanus toxoid should be given before the age of 20 in Denmark
and
> other countries where primary vaccination is given in the first years
> of life.
>

Top of Message | Previous Page | Permalink

JiscMail Tools


RSS Feeds and Sharing


Advanced Options


Archives

May 2024
April 2024
March 2024
February 2024
January 2024
December 2023
November 2023
October 2023
September 2023
August 2023
July 2023
June 2023
May 2023
April 2023
March 2023
February 2023
January 2023
December 2022
November 2022
September 2022
July 2022
February 2022
January 2022
October 2021
September 2021
August 2021
June 2021
May 2021
April 2021
March 2021
April 2020
March 2020
February 2020
September 2019
March 2019
April 2018
January 2018
November 2017
May 2017
March 2017
November 2016
February 2016
January 2016
December 2015
August 2015
June 2015
May 2015
April 2015
March 2015
February 2015
January 2015
December 2014
October 2014
September 2014
July 2014
June 2014
May 2014
April 2014
February 2014
December 2013
November 2013
October 2013
September 2013
July 2013
June 2013
May 2013
April 2013
March 2013
February 2013
January 2013
December 2012
November 2012
October 2012
September 2012
August 2012
July 2012
June 2012
May 2012
April 2012
March 2012
February 2012
January 2012
December 2011
November 2011
August 2011
July 2011
June 2011
May 2011
April 2011
March 2011
February 2011
December 2010
November 2010
October 2010
September 2010
August 2010
July 2010
June 2010
May 2010
April 2010
March 2010
February 2010
January 2010
December 2009
November 2009
October 2009
September 2009
August 2009
July 2009
May 2009
March 2009
February 2009
January 2009
December 2008
November 2008
October 2008
September 2008
August 2008
July 2008
June 2008
May 2008
April 2008
March 2008
February 2008
January 2008
December 2007
November 2007
October 2007
September 2007
August 2007
July 2007
June 2007
May 2007
April 2007
March 2007
February 2007
January 2007
December 2006
November 2006
October 2006
September 2006
August 2006
July 2006
June 2006
May 2006
April 2006
March 2006
February 2006
January 2006
December 2005
November 2005
October 2005
September 2005
August 2005
July 2005
June 2005
May 2005
April 2005
March 2005
February 2005
January 2005
December 2004
November 2004
October 2004
September 2004
August 2004
June 2004
May 2004
April 2004
March 2004
February 2004
January 2004
December 2003
November 2003
October 2003
September 2003
August 2003
July 2003
June 2003
May 2003
April 2003
March 2003
February 2003
January 2003
December 2002
November 2002
October 2002
September 2002
August 2002
July 2002
June 2002
May 2002
April 2002
March 2002
February 2002
January 2002
December 2001
November 2001
October 2001
September 2001
August 2001
July 2001
June 2001
May 2001
April 2001
March 2001
February 2001
January 2001
December 2000
November 2000
October 2000
September 2000
August 2000
July 2000
June 2000
May 2000
April 2000
March 2000
February 2000
January 2000
December 1999
November 1999
October 1999
September 1999
August 1999
July 1999
June 1999
May 1999
April 1999
March 1999
February 1999
January 1999
December 1998
November 1998
October 1998
September 1998


JiscMail is a Jisc service.

View our service policies at https://www.jiscmail.ac.uk/policyandsecurity/ and Jisc's privacy policy at https://www.jisc.ac.uk/website/privacy-notice

For help and support help@jisc.ac.uk

Secured by F-Secure Anti-Virus CataList Email List Search Powered by the LISTSERV Email List Manager