Contents

19 Tetanus

19.3 Epidemiology

The incidence of tetanus reflects the effectiveness of the local immunisation programme, with low incidence in regions with high immunisation coverage. A person with tetanus is not infectious to others, and vaccination provides individual protection only, with no herd immunity. Suffering tetanus does not confer immunity. See section 19.5.2.

19.3.1 New Zealand epidemiology

One case of tetanus was notified in New Zealand in 2013 and two cases were notified in 2012. This is similar to the number of cases notified each year since 2002 (between zero and two cases each year), except in 2010, when seven cases were notified (Figure 19.1).1 In 2012 one case was in the 5–9 years age group and the other in the 70 years and over age group. The child was not vaccinated and the adult was vaccinated over 20 years ago.

Ministry of Health data for 2013 recorded five hospitalisations (four females aged 60 years or older and one male in the 5–9 years age group) with tetanus as the primary reason for admission. This indicates that not all cases are notified, as illustrated in Figure 19.1 below.

Figure 19.1: Tetanus hospitalisations 1970–2013, tetanus notifications 1980–2013 and tetanus deaths 2000–2011

Figure 19.1: Tetanus hospitalisations 1970–2013, tetanus notifications 1980–2013 and tetanus deaths 2000–2011

Source: Ministry of Health (hospitalisations and deaths) and the Institute of Environmental Science and Research (notifications)

Older adults without a primary course

Universal tetanus vaccine was introduced in 1960 (see Appendix 1). Of the 21 tetanus cases between 2001 and 2012, 17 were in adults. Of these, two were vaccinated (15 to 20 years previously), five were unvaccinated, and 10 had an unknown vaccination status. Nine of the individuals with an unknown vaccination status were born before 1960 and are therefore less likely to have received a primary series of tetanus vaccine.

Children

Between 2001 and 2012 there were four cases of tetanus in children aged between 1 and 9 years. None of the children were vaccinated.