Tulchinsky T H, Friedman J B, Acker C, Ben David A, Slater P E
Personal and Community Preventive Health Services, Ministry of Health, Jerusalem, Israel.
Isr J Med Sci. 1990 Aug;26(8):438-42.
During the 1950s tetanus was a major public health concern in Israel, with incidence rates of up to 2/100,000 occurring predominantly among farmers and infants (tetanus neonatorum). These rates have declined considerably since then, with an average of 2 cases per year in recent years, and 5 cases in 1988. There has been a major decline in tetanus incidence in Judea/Samaria and Gaza, due to a successful vaccination program reaching over 90% of infants and schoolchildren and to educational programs. In Judea/Samaria and Gaza, prevention of tetanus neonatorum has improved as a result of the increasing number of hospital deliveries (now 62% in the West Bank and 80% in Gaza), and the widespread immunization of pregnant women and adolescent girls of childbearing age. Special efforts were given to the education of traditional birth attendants (dayas). Prevention of adult tetanus was achieved through immunization of high school students and laborers. Recent cases in all three areas are equally distributed between newborns and elderly persons. Because of the persistence of the incidence of tetanus, a review of Israel's immunization policy is indicated, focusing on high risk groups such as Bedouin women of childbearing age and the elderly.
20世纪50年代，破伤风是以色列主要的公共卫生问题，发病率高达十万分之二，主要发生在农民和婴儿（新生儿破伤风）中。从那时起，发病率大幅下降，近年来平均每年有2例，1988年有5例。由于一项成功的疫苗接种计划覆盖了超过90%的婴儿和学童以及教育计划，朱迪亚/撒马利亚和加沙的破伤风发病率大幅下降。在朱迪亚/撒马利亚和加沙，由于医院分娩数量增加（目前约旦河西岸为62%，加沙为80%）以及孕妇和育龄少女的广泛免疫，新生儿破伤风的预防情况有所改善。对传统助产士（达亚斯）进行了特别教育。通过对高中生和劳动者进行免疫接种，预防了成人破伤风。最近在这三个地区的病例在新生儿和老年人中分布均匀。由于破伤风发病率持续存在，有必要对以色列的免疫政策进行审查，重点关注育龄贝都因妇女和老年人等高风险群体。
