Annals of Emergency Medicine
Volume 43, Issue 3 , Pages 305-314 , March 2004

Tetanus immunity and physician compliance with tetanus prophylaxis practices among emergency department patients presenting with wounds

  • David A Talan, MD

      Affiliations

    • Department of Medicine, Divisions of Emergency Medicine and Infectious Diseases, Olive View–University of California–Los Angeles Medical Center, Sylmar, CA, USA
    • Corresponding Author InformationAddress for correspondence: David A. Talan, MD, Olive View–University of California–Los Angeles Medical Center, 14445 Olive View Drive, North Annex, Sylmar, CA 91342; 818-364-3107; fax 818-364-3268
    • ,
  • Fredrick M Abrahamian, DO

      Affiliations

    • Department of Medicine, Divisions of Emergency Medicine and Infectious Diseases, Olive View–University of California–Los Angeles Medical Center, Sylmar, CA, USA
    • ,
  • Gregory J Moran, MD

      Affiliations

    • Department of Medicine, Divisions of Emergency Medicine and Infectious Diseases, Olive View–University of California–Los Angeles Medical Center, Sylmar, CA, USA
    • ,
  • William R Mower, MD, PhD

      Affiliations

    • Emergency Medicine Center, University of California–Los Angeles Medical Center, Los Angeles, CA, USA
    • ,
  • Kumar Alagappan, MD

      Affiliations

    • Department of Emergency Medicine, Long Island Jewish Medical Center, New Hyde Park Island, NY, USA
    • ,
  • Brian R Tiffany, MD, PhD

      Affiliations

    • Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ, USA
    • ,
  • Charles V Pollack Jr., MA, MD

      Affiliations

    • Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ, USA
    • Dr. Pollack is currently affiliated with the Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA.
    • ,
  • Mark T Steele, MD

      Affiliations

    • Department of Emergency Medicine, Truman Medical Center, University of Missouri–Kansas City, Kansas City, MO, USA
    • ,
  • Lala M Dunbar, MD, PhD

      Affiliations

    • Department of Emergency Medicine, Charity Medical Center, Louisiana State University, New Orleans, LA, USA
    • ,
  • Mary D Bajani, PhD

      Affiliations

    • National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
    • ,
  • Robbin S Weyant, PhD

      Affiliations

    • National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
    • ,
  • Steven M Ostroff, MD

      Affiliations

    • National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

Received 26 June 2003 ,Revised 19 September 2003 ,Accepted 24 September 2003.

References 

    References
  1. Centers for Disease Control and Prevention . Tetanus surveillance: United States, 1995-1997. MMWR Morb Mortal Wkly Rep. 1998;47:1–13
  2. Centers for Disease Control and Prevention . Tetanus surveillance: United States, 1998-2000. MMWR Morb Mortal Wkly Rep. 2003;52:1–8
  3. Gergen PJ, McQuillan GM, Kiely M, et al.  A population-based serologic survey of immunity to tetanus in the United States. N Engl J Med. 1995;332:761–766
  4. McQuillan GM, Kruszon-Moran D, Deforest A, et al.  Serologic immunity to diphtheria and tetanus in the United States. Ann Intern Med. 2002;136:660–666
  5. Centers for Disease Control and Prevention . Tetanus among injecting-drug users: California, 1997. MMWR Morb Mortal Wkly Rep. 1998;47:149–151
  6. Brand DA, Acampora D, Gottlieb LD, et al.  Adequacy of antitetanus prophylaxis in six hospital emergency rooms. N Engl J Med. 1983;309:636–640
  7. Immunization Practices Advisory Committee . Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR Morb Mortal Wkly Rep. 1991;40:1–28
  8. McComb JA. The prophylactic dose of homologous tetanus antitoxin. N Engl J Med. 1964;270:175–178
  9. Simonsen O, Bentzon MW, Heron I. ELISA for the routine determination of antitoxic immunity to tetanus. J Biol Stand. 1986;14:231–239
  10. Melville-Smith ME, Seagroatt VA, Watkins JT. A comparison of enzyme-linked immunosorbent assay (ELISA) with the toxin neutralization test in mice as a method for the estimation of tetanus antitoxin in human sera. J Biol Stand. 1983;11:137–144
  11. Sanford JP. Tetanus: forgotten but not gone. N Engl J Med. 1995;332:812–813
  12. Alagappan K, Rennie W, Narang V, et al.  Immunologic response to tetanus toxoid in geriatric patients. Ann Emerg Med. 1997;30:459–462
  13. Centers for Disease Control and Prevention . Notice to readers: shortage of tetanus and diphtheria toxoids. MMWR Morb Mortal Wkly Rep. 2000;49:1029–1030
  14. American College of Emergency Physicians . Tetanus immunization recommendations for persons seven years of age and older: American College of Emergency Physicians. Ann Emerg Med. 1986;15:1111–1112

☆ Author contributions: DAT, GJM, KA, BRT, CVP, MTS, LMD, RSW, and SMO conceived and designed the study. FMA, KA, BRT, CVP, MTS, and LMD acquired the data. WRM, DAT, and FMA analyzed and interpreted the data. DAT and FMA drafted the manuscript. WRM and FMA conducted the statistical analysis. MDB conducted the serologic testing. DAT obtained funding. DAT, KA, BRT, CVP, MTS, LMD, RSW, and SMO provided administrative, technical, and material support. DAT, FMA, KA, BRT, CVP, MTS and LMD supervised the study. All authors take responsibility for the paper as a whole.Supported by a research grant from Bayer Biological Products, Research Triangle Park, NC.Dr. Talan, Dr. Abrahamian, Dr. Moran, and Dr. Alagappan have received speaking honoraria and research grants from Bayer. Dr. Dunbar has received research grants from Bayer.Reprints not available from the authors.

PII: S0196-0644(03)01051-5

doi: 10.1016/j.annemergmed.2003.09.017

Annals of Emergency Medicine
Volume 43, Issue 3 , Pages 305-314 , March 2004

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