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Tetanus in the Elderly

Paul Rousseau, MD
Arch Intern Med. 1992;152(8):1727. doi:10.1001/archinte.1992.00400200149036.
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To the Editor.—  Preventive health care is a relatively ignored discipline of geriatric medicine, consequently I applaud the publication of the article on tetanus in the elderly by Richardson and Knight.1 Although rare in the general population, most deaths secondary to tetanus occur among older persons, augmenting the importance of preventive immunization. However, Table 3 in the article by Richardson and Knight is not what the Advisory Committee of Immunization Practices guidelines suggest for tetanus prophylaxis in wound management; rather, the Committee advises that patients with an unknown history of tetanus immunization or less than three doses of tetanus toxoid and a wound that is not clean receive an injection of tetanus toxoid and tetanus immune globulin (Table 1).Prophylactic immunization is an elemental component of geriatric care; however, several studies2-5 suggest that tetanus immunization is lamentably inadequate. Accordingly, clinicians must become cognizant of the potential for tetanus


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