- A 6-year-old boy in Oregon contracted tetanus and had to fight for his life for 57 days in hospital to survive the ordeal.
- The child was unvaccinated, his family part of the growing trend of "anti-vaxxers" - adults who refuse to vaccinate their children - in the US.
- A new case report by the Centers for Disease Control and Prevention (CDC) details the boy's fight for survival. It took him more than 7 weeks to be able to walk 6 metres.
- All told, the boy's treatment totaled more than R11 million in care costs. But upon his recovery, the boy's parents refused a follow-up tetanus shot.
Two years ago, a 6-year-old boy was playing outside on a farm in Oregon and cut his forehead open - not something that remarkable in the grand scheme of typical childhood injuries.
His wound was sewn up and cared for at home, and the family put the incident in their rear-view mirror.
Until six days later.
Almost a week after the incident, the child's jaw clenched up and muscles spasmed, and soon he had trouble breathing. His parents were forced to call emergency medical services, who immediately transported the sick boy to a paediatric hospital.
He was stuck in the hospital for 57 days.
It turns out the child had contracted tetanus, a neuromuscular disease caused by a type of bacteria that enters the skin through open cuts. Tetanus is preventable with a tetanus vaccine, and widespread immunisation has lead to a 95% decline in the number of tetanus cases in the US since the 1940s, according to the CDC.
But it also turns out that - unlike typical children - this boy was unvaccinated, which made him vulnerable to the disease.
In a new report, the Centers for Disease Control and Prevention, outlined this boy's case - the first case of paediatric tetanus in Oregon in more than 30 years.
He was put on a ventilator in a darkened hospital room and remained in inpatient care for more than 8 weeks
When he arrived at the hospital, the boy's jaw muscles were spasming uncontrollably. He wanted water but was unable to open his mouth to ask for it, according to the CDC report. His back and neck muscles arched and spasmed.
After administering the tetanus vaccine, doctors had to sedate the child.
They put him in a darkened room with earplugs in because any type of stimulation - light, sound, or movement - made his muscle spasms worse.
As his back and neck spasming worsened, the boy developed a racing heartbeat, high blood pressure, and a fever of 40.5 degrees. Doctors had to put him on a ventilator for 44 days.
Fortunately, the boy's condition started to improve. By about six weeks he was sipping clear liquids, and a week later he could walk 6 metres unassisted. A month after he was released from care, the boy was back to running and biking.
All told, the boy spent 57 days in inpatient acute care, including 47 days in the intensive care unit, the report stated.
And the costs totaled more than R11 million excluding the boy's air ambulance transport, inpatient rehabilitation, and follow-ups.
While doctors gave the boy an emergency dose of tetanus vaccine when he was brought to the hospital, his parents elected not to give him a second dose, or any other recommended vaccinations, before their child left inpatient care.
"When I read that, my jaw dropped. I could not believe it. That's a tragedy and a misunderstanding, and I'm just flabbergasted," William Schaffner, chair at the Department of Preventive Medicine at the Vanderbilt University School of Medicine, told the Washington Post.
"This is an awful disease, but ... we have had a mechanism to completely prevent it, and the reason that we have virtually no cases anymore in the United States is because we vaccinate, literally, everyone," Schaffer added.
'Anti-vaxxers', like this boy's parents, are a public health threat, according to the World Health Organisation
The boy's parents are part of a growing movement of "anti-vaxxers" - parents who refuse to vaccinate their children because of concerns over the vaccines' safety or potential links to autism. According to the World Health Organisation, "vaccine hesitancy" is one of the top 10 threats to global health this year.
Oregon is one of 17 states that allow personal and philosophical exemptions from vaccines, which permit individuals who hold conscientious objections to one or more shots not to get them or let their children get them.
This tetanus case comes on the heels of Washington's measles outbreak, which sickened at least 47 kids and young adults in Clark County, Washington. Nearly all of the sick patients hadn't gotten their measles vaccinations.
With the measles virus, if a patient survives the illness, they are immune to future incidents.
But with tetanus, that's not the case. A child can get tetanus again and again if he's unvaccinated, and doesn't get booster shots over time.
The CDC recommends that children receive a tetanus vaccine shot at 2, 4, and 6 months of age, then another dose between 15 and 18 months of age, and finally a fifth dose between 4 and 6 years of age.
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