Tetanus in Victoria, 1957-1980. Review of 106 patients managed in one hospital.

The records of 106 patients with tetanus who received treatment in Fairfield Hospital, Melbourne, over a 24-year period were reviewed. There were 19 deaths, all before 1975, and mortality was highest in patients over 60 years of age. During the second half of the study period, very few young people with tetanus were admitted to hospital, whereas the admission rate of those over 40 years of age was constant. Sixty-four patients were known not to be immunized; 19 patients had received at least one prior dose of tetanus toxoid. Ninety-one patients had identifiable injuries, most of which were minor. Medical treatment for an injury was given to 43 patients; 35 of these received tetanus prophylaxis, but only eight received tetanus immunoglobulin. In the last six years of the survey, improved treatment techniques have helped to reduce the mortality from tetanus. The accumulated experience at Fairfield Hospital provides a basis for the proposal that all patients with tetanus in Victoria should be referred to one hospital for management.