@entity116 is a life-threatening but preventable disease caused by the toxin of @entity3336 , a ubiquitous, spore-forming, gram-positive bacillus found in high concentrations in soil and animal excrement. Reported @entity116 cases have declined >95%, and deaths from @entity116 have declined >99% in the United States since 1947, when the disease became reportable nationally. To update a previous report and to determine the populations at greatest risk for the disease, CDC analyzed cases reported to the National Notifiable Diseases Surveillance System (NNDSS) during 2001--2008. This report summarizes the results of that analysis, which found that 233 @entity116 cases were reported during 2001--2008; among the 197 cases with known outcomes, the case-fatality rate was 13.2%. Average annual incidence during that period was 0.10 per 1 million population overall and 0.23 among @entity1 aged >= 65 years. Incidence among Hispanics was nearly twice that among non-Hispanics, a difference accounted for by 16 cases among Hispanic injection drug users (IDUs). Among the 92 @entity1 for whom @entity116 toxoid-containing (TT) vaccination status was available, 37 (40.2%) had received no doses of TT vaccine. Thirty (15.4%) of 195 @entity1 had @entity6 , and 27 (15.3%) of 176 were IDUs. Of 51 @entity1 with an acute wound and a surveillance report complete enough to evaluate @entity116 prophylaxis, 49 (96.1%) had not received appropriate prophylaxis. @entity116 remains a rare but life-threatening disease in the United States. Health-care providers should ensure up-to-date TT vaccination of all their @entity1 , especially @entity1 aged >= 65 years, @entity1 with @entity6 , and injection drug users.

XXXX surveillance --- United States, 2001-2008.

@entity1 :: ('9606', 'Species') :: ['patients', 'persons'] @entity116 :: ('MESH:D013746', 'Disease') :: ['tetanus', 'Tetanus'] @entity3336 :: ('1513', 'Species') :: ['Clostridium tetani'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes']
@entity116 :: (MESH:D013746,Disease) :: ['Tetanus']
