Because they've received a series of tetanus vaccines in childhood as well as the occasional tetanus booster, their bodies have plenty of protective antibodies. Reported tetanus cases in the United States often number no more than 100 a year. But people in the developing world are less likely to receive tetanus vaccines and they suffer the consequences. Newborns are particularly vulnerable. During the first few weeks of life, their only defense against pathogens comes from antibodies imported from their mothers' breast milk.
Infants born to nonimmunized mothers are tetanus cases waiting to happen.
One dirty knife or soiled bandage on the umbilical stump is all it takes. Today neonatal tetanus accounts for over half of the more than 500,000 cases worldwide. In my quick exam of Eduardo, I hadn't seen a scratch. I suspected tetanus, but there's no definitive diagnostic test for the disease because the toxin hides away in the central nervous system. To confirm my suspicion, I needed to exclude the possibility that another condition was mimicking tetanus symptoms.