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Unvaccinated Oregon boy almost dies from tetanus — in state’s first case in 3 decades

In the hospital the boy was given the first dose of the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine. After he recovered, his parents refused to let him receive the second dose of DTaP — or any other recommended immunizations.

tetanus shot
The CDC currently recommends a five-dose series of tetanus shots for children, starting at two months and ending at six years, as well as a booster shot every 10 years for adults.
REUTERS/Shannon Stapleton

In a report published Friday by the Centers for Disease Control and Prevention (CDC), doctors from Oregon tell the distressing story of a 6-year-old boy who contracted tetanus because his parents didn’t have him vaccinated.

The boy, who almost died, spent 57 days in the hospital, most of it in intensive care, followed by 17 more days in a rehabilitation center.

The hospital charges alone added up to more than $800,000.

Fortunately — thanks to excellent medical care — the boy appears to have fully recovered.

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This was the first case of tetanus in a child in Oregon in more than 30 years. But similar incidents may become more common as parents — like those of this boy — refuse to let their children receive vaccines.

The Oregon story comes with a depressing afterward regarding that issue: The boy’s parents are still anti-vaccine.

Once common, now rare

Tetanus is an infection that is caused when spores of a bacterium, Clostridium tetani, enter the body through breaks in the skin. The spores are everywhere in the environment, including in soil, dust and animal feces.

The spores produce a toxin, tetanospasmin, which damages the nerves that control muscles. That damage leads to life-threatening symptoms, which usually appear within three to 21 days after the infection begins.

The main symptoms are stiffness in the jaw (which can make opening the mouth difficult); stiffness in the neck and abdomen; painful, involuntary muscle spasms (which can cause the neck and back to become very arched and make it difficult to swallow and breathe); fever (a temperature of 104 degrees Fahrenheit or higher); seizures; and a rapid heartbeat.

The CDC currently recommends a five-dose series of tetanus shots for children, starting at two months and ending at six years, as well as a booster shot every 10 years for adults.

U.S. cases of tetanus have fallen by 95 percent, and deaths from the infection have plummeted by 99 percent, since routine inoculation against the infection began in the 1940s.

An average of 30 cases now occur in the U.S. each year. Almost all are among children who didn’t receive the recommended tetanus vaccines or adults who aren’t current on their booster shots.

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Between 2009 and 2015, 16 Americans died from tetanus, according to the CDC. All of those cases were among adults aged 55 and older.

Tetanus is not contagious, which makes it unusual among vaccine-preventable diseases.

Starting with a simple cut

The boy’s ordeal, which took place in 2017, began when he cut his forehead while playing outdoors on a farm. His parents washed and sutured the wound. (Yes, they actually stitched it up themselves.)

Six days later, the boy began crying, clenching his jaw and having extreme muscle spasms, including ones that caused involuntary arching of his back and neck. Later that day, he also began to have trouble breathing. His parents called emergency medical service personnel, who airlifted the boy to the Oregon Health & Science University hospital in Portland.

When he arrived at the hospital, the boy was alert and asked for water, but he couldn’t open his mouth to drink. Muscle spasms were also making it difficult for him to breathe.

The boy was sedated and put on a ventilator. The air was pumped into his lungs through a tracheostomy, a surgically made hole through the child’s windpipe. The boy also received intravenous medications to control his pain, blood pressure and muscle spasms. In addition, he was given the first dose ofthe diphtheria, tetanus, and acellular pertussis (DTaP) vaccine.

Because noise, bright lights and other stimulation can worsen the symptoms of tetanus, the boy was fitted with earplugs and placed in a quiet, darkened room.

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Successful, but expensive

He stayed in intensive care for 47 days, and then remained in the hospital for another 10 days. Once discharged from the hospital, he went immediately to a rehabilitation center, where he stayed for 17 days.

Within a month after leaving the rehabilitation center, the boy had returned to his normal activities, including running and biking.

The cost of the hospital stay (not including the air transportation or the inpatient rehabilitation) totaled $811,929, the doctors write.

By comparison, the cost of a single DTaP vaccine is between $24 and $30. All five recommended doses would have cost no more than $150.

The doctors do not say who paid for the child’s medical costs.

A lesson not learned

This story is, ultimately, a happy one. Although he experienced weeks of considerable pain and trauma, the boy did recover.

But the story is also an enormously frustrating one, and not just because of the unnecessary suffering and costs associated with the child’s illness.

After the boy recovered from his near-fatal bout with tetanus, the parents still refused to let him receive the second dose of DTaP — or any other recommended immunizations.

As the doctors explained to the parents, having tetanus does not protect you against future infections. Only receiving a complete course of DTaP vaccines does that.

But the parents persisted with their antagonism toward vaccines. So the boy could develop tetanus again.

FMI: The full report on the boy’s illness was published in the March 8 issue of the CDC’s Morbidity and Mortality Weekly Report, where it can be read in full.