About Tetanus

Tetanus is a toxin produced by the bacterium Clostridium tetani (C tetani).1,2 The spores produced by the bacteria cause an acute, life-threatening disease because they are extremely resistant to both heat and many chemical agents that are used to eliminate bacteria.1  

For more information, recommendations, and guidelines, visit the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP).

Tetanus infection occurs when1,3:

  • Spores gain access into the body through a wound
  • The spores then transform to active bacteria

Tetanus-Prone Wounds4

Tetanus-prone wounds are wounds sustained more than 6 hours before surgical treatment or at any point after injury that show 1 or more of the following:

  • Puncture-type wound
  • Significant devitalized tissue
  • Evidence of sepsis
  • Contamination with soil/manure that could contain tetanus organisms
  • Burns
  • Frostbite
  • High-velocity missile wounds
 

Certain persons are at a significantly higher risk of being infected5-8:

  • Immigrants and visitors
  • Patients born prior to vaccination series being mandatory
  • Intravenous (IV) drug users
  • Patients with diabetes
  • Patients with chronic wounds

Watch a video to learn more about tetanus.

With effective immunization programs in place, tetanus incidence has declined, but it has not been eradicated in the United States.

Postexposure Prophylaxis (PEP)

Guide to tetanus prophylaxis in routine wound management5

According to the most recent CDC tetanus surveillance data, an analysis of sufficiently complete case reports of patients with acute wounds who sought medical care revealed that 96% did not receive recommended PEP.2

An animal bite or severe dirty wound would leave patients at risk for tetanus.2,9

Download the ACIP guidelines for more information on specific patients.

In patients with an uncertain or incomplete immunization history for tetanus, the vaccine alone is not enough. According to the CDC, the use of a tetanus immune globulin (TIG) may, if promptly administered, reduce the potentially life-threatening risk of tetanus when administered concomitantly with the tetanus vaccine.7

HyperTET S/D, along with wound cleaning and debridement, provides immediate protection. 

This allows the vaccine the time needed to establish active immunity for your patients in high-risk situations.7,10

Find out which patients are considered high risk.

The Importance of TIG in PEP7,10-12

With a short incubation period of 8 days on average, the rapid immune protection provided by HyperTET S/D is critical for patients who need a TIG.

QUICK FACTS

  • During 1998-2000, the fatality rate for reported tetanus in the United States was 18%7
  • Almost all reported cases of tetanus are in persons who have either never been vaccinated or who completed a primary series but have not had a booster in the preceding 10 years7
  • It is possible to get tetanus more than once; people recovering from tetanus should receive the full vaccination series7

Learn more about other Hypermunes.

HyperTET® S/D (tetanus immune globulin [human]) is indicated for prophylaxis against tetanus following injury in patients whose immunization is incomplete or uncertain.

HyperTET S/D should be given with caution to patients with a history of prior systemic allergic reactions following the administration of human immunoglobulin preparations.

In patients who have severe thrombocytopenia or any coagulation disorder that would contraindicate intramuscular injections, HyperTET S/D should be given only if the expected benefits outweigh the risks.

Slight soreness at the site of injection and slight temperature elevation may be noted at times. Sensitization to repeated injections of human immunoglobulin is extremely rare. In the course of routine injections of large numbers of persons with immunoglobulin, there have been a few isolated occurrences of angioneurotic edema, nephrotic syndrome, and anaphylactic shock after injection. Administration of live virus vaccines (eg, MMR) should be deferred for approximately 3 months after tetanus immune globulin (human) administration.

HyperTET S/D is made from human plasma. Products made from human plasma may contain infectious agents, such as viruses and theoretically, the Creutzfeldt-Jakob disease (CJD) agent that can cause disease. There is also the possibility that unknown infectious agents may be present in such products.

Please see full Prescribing Information for HyperTET S/D.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.


References:

  1. Centers for Disease Control and Prevention. Tetanus. In: Hamborsky J, Kroger A, Wolfe S, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Washington, DC: Public Health Foundation; 2015:341-352. https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/tetanus.pdf. Accessed July 1, 2019.
  2. Centers for Disease Control and Prevention. Tetanus surveillance—United States, 2001-2008. MMWR Morb Mortal Wkly Rep. 2011;60(12):365-369.
  3. Centers for Disease Control and Prevention. Diphtheria, tetanus, and pertussis vaccine safety. https://www.cdc.gov/vaccinesafety/vaccines/dtap-tdap-vaccine.html. Updated October 27, 2015. Accessed July 1, 2019.
  4. World Health Organization. Prevention and management of wound infection. https://www.who.int/hac/techguidance/tools/guidelines_prevention_and_management_wound_infection.pdf. Accessed July 1, 2019.
  5. Alagappan K, Poland GA. Special report: best practices for tetanus vaccination and treatment. A supplement to Infectious Disease Special Edition (IDSE) and Pharmacy Practice News. 2019.
  6. Alagappan K, McGowan J, Declaro D, Ng D, Silverman RA. Tetanus antibody protection among HIV-infected US-born patients and immigrants. Int J Emerg Med. 2008;1(2):123-126.
  7. Liang JL, Tiwari T, Moro P, et al. Prevention of pertussis, tetanus, and diphtheria with vaccines in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2018;67(2):1-44.
  8. Faulkner AE, Tiwari TSP. Tetanus. In: Centers for Disease Control and Prevention. Manual for the Surveillance of Vaccine-Preventable Diseases. Atlanta, GA: Centers for Disease Control and Prevention; 2008. https://www.cdc.gov/vaccines/pubs/survmanual/chpt16-tetanus.html. Accessed July 1, 2019.
  9. Baddour LM, Harper M. Patient education: animal bites (beyond the basics). UpToDate website. http://www.uptodate.com/contents/animal-bites-beyond-the-basics. Updated February 15, 2017. Accessed February 18, 2019.
  10. HyperTET S/D (tetanus immune globulin [human]) Prescribing Information. Grifols.
  11. Abrahamian FM. Tetanus: an update on an ancient disease. Infect Dis Clin Pract. 2000;9(6):228-235.
  12. Siegrist CA. Vaccine immunology. In: Plotkin SA, Orenstein WA, Offit PA, eds. Vaccines. 6th ed. China: Saunders; 2013:17-36.