1985 Volume 59 Issue 7 Pages 701-707
Trends of tetanus mortality (1947-1982) and case fatality (1940-1982) were investigated based on Vital Statistics of the Ministry of Health & Welfare and clinical records collected by the authors from various sources, respectively. There were 21, 916 fatal cases during 1947-1982. The mortality rate per105 population declined from 2.84 (2221 cases) in 1947 to 0.98 (887 cases) in 1955 and to 0.02 (26 cases) in 1982. The neonatal tetanus mortality per 105 live births made a more rapid decline from 36.1 in 1947 to 0.67 in 1970 and to O in 1979. This rapid decline of neonatal tetanus mortality was inversely related to the increase of babies born at medical institutions instead of at homes. The rapid decline of neonatal tetanus mortality contributed largely to the rapid decline of overall tetanus mortality.
The analysis of the fatal cases indicated relative preponderance of aged people among the total cases in recent years. The patients aged 40 years and more occupied 24% in 1950 but they occupied more than 70% in recent years. The decline of mortality in the age group of 0-10 years excluding neonates was related to the general use of DTP vaccine from 1969.
There was a conspicuous decline in case fatality from about 40-50% during 1940-1970 to 20 and then to 10% in the following decades. This was attributed to therecent trends of treating tetanus patients in the intensive care units where almost moribund patients destined to die in the past decades have come to be successfully treated employing curarisation and artificial respiration.
