Tetanus occurs worldwide but due to effective methods of prevention, it is sporadic and relatively uncommon in the U. S. A. and most developed countries. During the period 1989-1990, there were 117 cases reported from 34 states in the U. S. A. An average of 50 cases per year continue to be reported to the U. S. Centers for Disease Control and Prevention . Tetanus occasionally follows surgical procedures. Cases have followed injuries considered too trivial for medical consultation. Tetanus is not directly transmitted from person to person.
Primary immunization is indicated even after recovery.
Methods of control of tetanus include complete immunization with tetanus toxoid and intensive post-injury care and evaluation of puncture and other vulnerable wounds. While immunization against tetanus is universally recommended regardless of a person's age, it is especially important for workers in contact with soil, sewage and domestic animals, members of the military forces, policemen and others with greater than usual risk of traumatic injury, and older adults who are currently at highest risk for tetanus and tetanus-related mortality. After the initial basic series has been completed, single booster doses elicit high levels of immunity. For adults, the tetanus toxoid is generally administered together with diphtheria toxoid. For a previously non-immunized individual, a primary series of 3 doses of adsorbed tetanus and diphtheria toxoids is given.