[CJ]

According to "Principals and Explorations in Microbiology" by J Black 4th ed. after 4 to 10 days of incubation symptoms of Tetanus begin. A veteran nurse reported an ER patient showing symptoms of Tetanus one day after exposure from a puncture.

Anyone have any similar experiences? Do you think this is possible?

[This message has been edited by CJ (edited October 18, 2000).]

[LerRN95]

A veteran nurse reported an ER patient showing symptoms of Tetanus one day after exposure from a puncture.

Anyone have any similar experiences? Do you think this is possible?

*******
I have never heard of this. Maybe the CDC could help you on this.

[MollyJ]

I'm a nurse who has worked the ED and in public health and I have a little handbook that I personally think should be in all ED's. It is called _Control of Communicable Disease in Man- and in a page or two it gives you the straight and basic line on communicable disease. It is published APHA, the American Public Health Association. From the 15 th ed (1990), it says that incubation period is usually 3-21 days, although it may range from 1 day to several months, depending on the character, extent and local of the wound, average 10 days. Most cases occur within 14 days. In the general, shorter incubation periods are associated with more heavily contaminated wounds, more severe disease and a worse prognosis.

In my state several years ago we had two cases in one year, which is a notable incidence of disease and BOTH were in elderly people who had not maintained their tetanus vaccination status. ED nurses get a "gold star in their crown" for every Td booster they give, doncha know?

[babs_rn]

Given that Td boosters are indicated within 72 hours of exposure, it would be a (fortunately) rare incidence for the bacteria to move that quickly. Is the patient immunocompromised? That's the only explanation I would have for that. Perhaps on some immunosuppressants or have an as yet undiagnosed condition such as HIV. That's my best guess, anyway.

Babs