to 15 [5:40 years of age. 166 229 Diphtheria uncommon in US, but C. diphtheriae continues to circulate in US areas where the disease previously was endemic. 100 105 166 228 Reported worldwide, particularly in tropical countries; 166 endemic in many countries in Asia, the South Pacific, the Middle East, and Eastern Europe and in Haiti and Dominican Republic. 115 Consult CDC Travelers' Health website () for information regarding where diphtheria is endemic. 115 During the 1920s (before widespread immunization against diphtheria was initiated) there were approximately 100,000 200,000 cases of diphtheria and 13,000 15,000 diphtheria-related deaths each year in the US. 166 Most diphtheria cases occur in individuals unvaccinated or incompletely vaccinated against the disease. 100 105 166 Tetanus is a potentially fatal disease caused by a neurotoxic exotoxin (tetanospasmin) produced by Clostridium tetani . 105 113 114 115 166 C. tetani spores are ubiquitous in the environment worldwide; found in soil and in intestinal tracts of humans and animals (e.g., horses, sheep, cattle, dogs, cats, rats, guinea pigs, chickens). 100 105 115 166 195 The spores can contaminate open wounds, especially puncture wounds or those with devitalized tissue; anaerobic wound conditions allow spores to germinate and produce exotoxins that disseminate through blood and lymphatic system. 105 166 195 Neonatal tetanus (tetanus neonatorum) occurs in infants born under nonsterile conditions to inadequately vaccinated women; infection usually involves a contaminated umbilical stump and occurs because infant does not have passively acquired maternal antibodies against tetanus. 100 105 166 195 205 Obstetric tetanus occurs within 6 weeks after delivery or termination of pregnancy because of contaminated wounds or abrasions or unclean deliveries or abortions. 205 Generalized tetanus is characterized by rigidity and convulsive muscle spasms that usually involve the jaw (lockjaw) and neck and then become generalized. 105 115 166 195 Tetanus occurs worldwide; 115 166 reported most frequently in densely populated regions in hot, damp climates with soil rich in organic matter. 166 Marked decrease in mortality from tetanus occurred in US from the early 1900s to the late 1940s when immunization against tetanus became part of routine childhood immunization. 166 Average of 29 cases reported each year in US from 2001 through 2008 (case fatality rate 13%). 166 Most US cases occur following an acute wound, usually a puncture or contaminated, infected, or devitalized wound. 166 Almost all reported cases occur in individuals unvaccinated or inadequately vaccinated against the disease. 105 115 166 USPHS Advisory Committee on Immunization Practices (ACIP), AAP, and others recommend routine primary and booster immunization against diphtheria, tetanus, and pertussis in all individuals 6 weeks of age. 100 105 195 196 199 200 201 205 Combination preparation containing antigens for all 3 diseases (DTaP) preferred for primary and booster immunization against these diseases in infants and children 6 weeks through 6 years of age, unless pertussis antigens contraindicated or should not be used. 100 105 166 199 Use DT for primary or booster immunization against diphtheria and tetanus only when DTaP cannot be used. 100 105 114 166 199 Td usually preparation of choice for primary and booster immunization against diphtheria and tetanus in individuals 7 years of age. 100 105 196 199 200 205 However, to reduce morbidity associated with pertussis, ACIP, AAP, and others recommend that a single dose of tetanus toxoid and reduced diphtheria toxoid and acellular pertussis vaccine adsorbed (Tdap) be used in place of a required primary or booster dose of Td in all individuals 7 years of age who have not previously received Tdap, unless pertussis antigens contraindicated or should not be used. 105 195 196 199 200 201 205 234 235 236 237 238 Use Td for subsequent primary or booster doses. 105 195 196 199 200 201 205 236 Combined active immunization with a preparation containing tetanus toxoid adsorbed and passive immunization with tetanus immune globulin (TIG) is used to prevent tetanus in individuals with tetanus-prone wounds who are inadequately vaccinated against tetanus or whose tetanus vaccination status is uncertain. 100 105 112 113 166 195 196 205 (See Postexposure Prophylaxis of Tetanus under Uses.) DT and Td not indicated for treatment of diphtheria or tetanus. 113 114 Because diphtheria and tetanus infections may not confer immunity against the diseases, initiate or complete primary immunization against diphtheria and tetanus at the time of recovery in any previously unvaccinated or incompletely vaccinated individual. 100 105 166 Preexposure Vaccination Against Tetanus and Diphtheria in High-risk Groups Pregnant women should be adequately immunized against tetanus and diphtheria; protection against these diseases is conferred to their infants through transplacental transfer of maternal antibody. 100 105 195 205 Ideally, complete primary immunization and administer appropriate booster doses prior to pregnancy. 100 105 195 205 To ensure protection (especially against maternal and neonatal tetanus), primary immunization or booster doses of Td can be given during second or third trimester of pregnancy (and before 36 weeks of gestation). 100 105 195 For previously unvaccinated or incompletely vaccinated pregnant women, ACIP and others recommend that a dose of Tdap be substituted for a required Td dose, preferably during third trimester (optimally between 27 and 36 weeks of gestation). 200 238 In addition, to ensure protection against pertussis, these experts recommend give a dose of Tdap during each pregnancy, regardless of prior vaccination history. 200 238 (See Pregnancy under Cautions.) Health-care personnel should have documentation of age-appropriate primary immunization with a preparation containing diphtheria and tetanus toxoids and booster doses of Td every 10 years. 235 A single dose of Tdap also recommended for all health-care personnel (regardless of age) if they have not previously received a dose. 235 For health-care personnel without documentation of primary immunization, give 3-dose vaccination series using Tdap for first dose and Td for subsequent primary and booster doses. 235 For previously vaccinated health-care personnel who have not received Tdap, give a single dose of Tdap as soon as feasible, regardless of interval since last Td dose; 235 use Td for subsequent booster doses. 235 Travelers who are unvaccinated or incompletely vaccinated against diphtheria and tetanus should receive remaining recommended doses prior to travel. 115 Because tetanus, diphtheria, and pertussis occur worldwide, 115 CDC recommends that travelers be adequately immunized against all 3 diseases before leaving US. 115 Adults, adolescents, and children 7 through 10 years of age who are unvaccinated or incompletely vaccinated should receive a single dose of Tdap followed by remaining recommended doses of Td according to the usual age-appropriate catch-up vaccination schedule. 115 Adults and adolescents 11 years of age who were previously vaccinated but have not received Tdap should receive a single dose of Tdap (instead of Td) for booster dose. 115 When indicated to provide protection against pertussis before travel, Tdap may be administered regardless of interval since last dose of Td. 115 If necessary to complete vaccination series before departure, adults, adolescents, and children can receive an accelerated immunization schedule using age-appropriate minimum intervals between doses. 115 (See Dosage under Dosage and Administration.) Postexposure Prophylaxis of Diphtheria Postexposure vaccination in household and other close contacts of an individual with culture-confirmed or suspected diphtheria. 100 105 166 Regardless of vaccination status, all household and other close contacts of an individual with culture-confirmed or suspected diphtheria should promptly receive anti-infective postexposure prophylaxis (single IM dose of penicillin G benzathine or oral erythromycin given for 7 10 days). 100 105 166 228 Take samples for cultures prior to giving the anti-infective and continue to observe individual for 7 days for evidence of disease. 100 166 228 In addition, those who previously received]} FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx Availability Prescription only C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Manufacturer Sanofi-Aventis U.S. LLC Drug Class Vaccine combinations Related Drugs Tetanus Prophylaxis Boostrix (Tdap) , Tetanus Toxoid Adsorbed , tetanus toxoid , Adacel (Tdap) , Pediarix , Tenivac (Td) , Infanrix (DTaP) , Decavac (Td) , Daptacel (DTaP) , More... Diphtheria Prophylaxis Boostrix (Tdap) , Adacel (Tdap) , Pediarix , Tenivac (Td) , Decavac (Td) , Infanrix (DTaP) , Daptacel (DTaP) , diphtheria and tetanus toxoids / pertussis, acellular , Pentacel , More... Diphtheria toxoid / tetanus toxoid Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first!} } expenses
main Diphtheria and Tetanus Toxoids Adsorbed, Tetanus and Diphtheria Toxoids Adsorbed professional
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