Inspite of immunization, TETANUS remains a disease with a high morbidity and mortality rate. Tetanus has been still occurred more frequently in developing countries where immunization programs are inadequate. In Korea, there is a routine
immunuzation
schedule with diphtheria, pertussis, and tetanus (DPT) vaccines at 2,4,6 month after tirth and booster at 18 month. But further prophylactic programs are not exist. Moreover, we have usually used only passive immunization, tetanus antitoxin,
tetanus
antitoxin, as a prophylactic regimen for injured patients instead of guidelines of Center for Disease Control.
The purpose of this study was to assess the baseline tetanus immunity state and to suggest the proper immunization schedule and adequate prophylactic guideline for injured patients in Korea. One hundred thirty one trauma patients from emergency
department of Severance hospital from September to November of 1993 were included. Antitetanus antibody titers of the patients were analyzed by ELISA assay. The mean antitetanus antibody titer was 0.728±0.236 IU/mL. The titers were diminished
rapidly
with age. In pediatric group (age under 15), the mean titer was 3.251±0.426 IU/mL and in geriatric group (age over 64), the mean titer was 0.007±0.002 IU/mL which was below the minimal protective antibody titer (0.01 IU/mL). While all of the
pediatric
patients have protective antibody titer, only 69.2% of young adults (15-39, n=65), 56.7% of adults (40-64, n=30), and 57.2% of geriatrics (>65, n=14) have protective antibody titer.
Our results suggest that tetanus prophylaxis is unnecessary in the age under 14. In other age groups, however, our data strongly support the need of prophylaxis.
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