Reid P M, Brown D, Coni N, Sama A, Waters M
Addenbrookes Hospital, Cambridge, United Kingdom, Accident Service.
J Accid Emerg Med. 1996 May;13(3):184-5. doi: 10.1136/emj.13.3.184.
To emphasise that tetanus still occurs in the United Kingdom, particularly in elderly people-as illustrated by two case reports-and to examine the state of tetanus immunity in elderly people.
111 elderly people (over 65 years) were studied: 43 males, mean age 77.7 years, range 67-94; 68 females, mean age 81.3 years, range 67-95. They were either attending the accident service or were hospital inpatients. An attempt was made to obtain an immunisation history and antitetanus antibody titres were measured.
Immunisation history was uncertain and unreliable. Measurement of antibody titres showed that they were inadequate to ensure protection in 50% of those studied. Low levels were particularly prevalent in the over 80 age group and in females. Questioning about military service confirmed that this had predominantly involved males.
Elderly people are at risk of contracting tetanus and should be targeted for community immunisation. Extra precautions in the form of passive immunisation with human anti-tetanus immunoglobulin should be used in this age group in addition to the usual wound management measures when the elderly sustain tetanus prone injuries.
强调破伤风在英国仍有发生，尤其是在老年人中——两项病例报告说明了这一点——并研究老年人破伤风免疫状况。
对111名老年人（65岁以上）进行了研究：43名男性，平均年龄77.7岁，年龄范围67 - 94岁；68名女性，平均年龄81.3岁，年龄范围67 - 95岁。他们要么是前往事故服务部门就诊，要么是住院患者。尝试获取免疫史并检测破伤风抗体滴度。
免疫史不确定且不可靠。抗体滴度检测表明，50%的研究对象其抗体水平不足以确保获得保护。低水平在80岁以上年龄组和女性中尤为普遍。关于兵役情况的询问证实，服过兵役的主要是男性。
老年人有感染破伤风的风险，应将其作为社区免疫的目标人群。当老年人遭受易引发破伤风的损伤时，除了常规的伤口处理措施外，该年龄组还应采用人抗破伤风免疫球蛋白进行被动免疫的额外预防措施。
