Tetanus: First pediatric case in >30 years in Oregon

Credit PA

The boy's hospital stay alone, not counting costs for air-lifting, the rehab center and follow-up care, resulted in charges totaling nearly $812,000 - 72 times more than the average USA pediatric hospitalization, the case study says.

The report, authored by doctors at Oregon Health and Science University and the Oregon Health Authority, states the child, a 6-year-old boy, was playing outdoors at a farm when he sustained a forehead laceration.

Six days after the OR boy got the cut, according to the CDC report, he had "episodes of crying, jaw clenching, and involuntary upper extremity muscle spasms", then had arching in his back and neck as well as more spasms.

It was only when his breathing became more hard later that day that his parents contacted emergency services, and he was air-transported to the nearest paediatric hospital.

The child would have jaw muscle spasms upon arriving at the hospital and couldn't open his mouth to ingest water.

Tetanus is caused by the bacterium Clostridium tetani, which is found in soil and produces a toxin that causes painful muscle contractions.

After the boy was diagnosed, treatment began. His difficulty breathing continued and doctors had to sedate him and insert an assistive breathing tube. He also had his wound cleaned and treated again, the CDC said.

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.

As his back and neck spasming worsened, the boy developed a racing heartbeat, high blood pressure, and a fever of 105 degrees Fahrenheit.

Credit PA
Credit PA

On the fifth day of this ordeal, doctors had to perform a tracheostomy-a surgery to create an opening in the neck to help a patient breathe. On day 44, his ventilator support was discontinued, and he tolerated sips of clear liquids. Three days later he was able to walk 20 feet-but he needed assistance. On Day 57, he was transferred from the pediatric hospital to a rehabilitation center, where he spent two-and-a-half weeks.

Luckily, the boy made a full recovery.

In all, the boy's medical charges in the hospital amounted to $811,929 - which did not include the cost of being airlifted to the hospital or of inpatient rehabilitation, according to the CDC.

Amid outbreaks of preventable childhood illnesses, one unvaccinated OR boy's nightmarish encounter with tetanus should serve as a cautionary tale for "anti-vaxxer" parents, doctors say.

Despite the recommendation of doctors, the child's parents refused a second dose of the DTaP vaccination and other vaccines.

However, his parents are still standing by their decision not to vaccinate.

"Because of the effectiveness of vaccines, many people have never seen a severe case of a vaccine-preventable illness", Eriksson says. The bacteria often enter the body through wounds contaminated with dirt, feces, or saliva, or wounds caused by an object-like a nail or a needle-puncturing the skin.

The diagnosis was childhood tetanus, the first documented case in OR in over 30 years. Today, only about 30 cases are reported every year.

The child's case "comes amid a measles outbreak in Washington and OR that has sickened 75 people, majority unvaccinated children", the Oregonian reported.



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