Narrative review: Tetanus-a health threat after natural disasters in developing countries

Majid Afshar*, Mahesh Raju, David Ansell, Thomas P Bleck

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

68 Scopus citations

Abstract

Tetanus is an expected complication when disasters strike in developing countries, where tetanus immunization coverage is often low or nonexistent. Collapsing structures and swirling debris inflict numerous crush injuries, fractures, and serious wounds. Clostridium tetani infects wounds contaminated with dirt, feces, or saliva and releases neurotoxins that may cause fatal disease. Clusters of infections have recently occurred after tsunamis and earthquakes in Indonesia, Kashmir, and Haiti. The emergency response to clusters of tetanus infections in developing countries after a natural disaster requires a multidisciplinary approach in the absence of an intensive care unit, readily available resources, and a functioning cold-chain system. It is essential that injured people receive immediate surgical and medical care of contaminated, open wounds with immunization and immunoglobulin therapy. Successful treatment of tetanus depends on prompt diagnosis of clinical tetanus, treatment to ensure neutralization of circulating toxin and elimination of C. tetani infection, control of spasms and convulsions, maintenance of the airway, and management of respiratory failure and autonomic dysfunction.

Original languageEnglish (US)
Pages (from-to)329-335
Number of pages7
JournalAnnals of internal medicine
Volume154
Issue number5
DOIs
StatePublished - Jan 1 2011

ASJC Scopus subject areas

  • Internal Medicine

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