Although tetanus is a vaccine-preventable illness and the World Health Organisation (WHO) has declared that India has reached the elimination stage in dealing with it, the prevalence of tetanus is still a major concern in Karnataka.
Doctors, who are seeing an average of at least six cases a month here, say it still remains a difficult disease to treat, with high morbidity and mortality. This is mainly because most cases either report late, or are not vaccinated.
A study published last month in the Indian Journal of Paediatrics on the ‘Re-emergence of Tetanus: Epidemiological Features, Clinical Profile and Outcome from South India’, by doctors from the State-run Indira Gandhi Institute of Child Health in Bengaluru, only corroborates the fact that the prevalence of tetanus continues to be a major concern in Karnataka.
Recommend immunisation A team of doctors, comprising Vykuntaraju K. Gowda, Basavaraja G. Veerappa, Anusha Handral and Asha Benakappa, has recommended that the incidence of tetanus can be reduced with an effective immunisation programme.
Pointing out that boys are more affected than girls, Dr. Vykuntaraju, the lead author of the study, told The Hindu that it could be because boys are inherently more “mischievous” and tend to play outdoors, and therefore medical attention is sought more commonly for them.
The study analysed eight children aged between two to 11 years treated at the hospital from January 2014 to January 2015 and found that only two of the eight children had received three primary doses of DPT vaccine. Three of the eight died due to complications.
Dr. Vykuntaraju said it is important for doctors to ensure that their patients receive the required vaccination for tetanus.
Adult cases, too Tetanus is also a concern among adults, especially farm labourers and workers from rural areas. At the Epidemic Diseases Hospital, another State-run facility, doctors are seeing an average of five adult tetanus cases a month.
Hospital Medical Superintendent Ansar Ahmed, who had seen six cases of tetanus in October, of which two died, said almost all the patients were either farmers or agricultural labourers from the neighbouring villages in and around Sira, Tumkur, Raidurga, and even Kurnool and Hindupura.
The doctor attributed this to the general attitude among people to ignore micro injuries or apply cow dung or mud to the injury. “Minor injuries suffered by farmers while harvesting or working in the fields are the entry point for the tetanus bacteria to get into the body,” he said.
Maternal and neonatal tetanus State Deputy Director (Immunisation) Ramachandra Bairy claimed that Karnataka had reached the elimination stage in maternal and neonatal tetanus. Elimination means there is less than one tetanus case per 1,00,000 live births.
“Tetanus cases were earlier seen among newborns, and the cause was mainly unhealthy practices in rural areas, such as the application of cow dung and mud to the umbilical cord of the newborn when the mother delivered the baby at home. Now, due to increased institutional deliveries, there are hardly any maternal and neonatal tetanus cases. Childhood immunisation is also effectively carried out,” he said.
