An unvaccinated 6-year-old OR boy was hospitalized for two months for tetanus and nearly died of the bacterial illness after getting a deep cut while playing on a farm, according to a case study published Friday by the U.S. Centers for Disease Control and Prevention. Doctors diagnosed him with tetanus and gave him a dose of the vaccine.
The child sustained a forehead laceration while playing outdoors on a farm; the wound was cleaned and sutured at home. When he started struggling to breathe, his parents realized he needed help and called for emergency medical services.
The boy was airlifted to a pediatric medical center.
When the boy arrived at the hospital, he still had jaw spasms.
According to the Mayo Clinic, "tetanus is caused by a toxin made by spores of bacteria, Clostridium tetani, found in soil, dust and animal feces". Doctors inserted a tube in his windpipe so a ventilator could help with his breathing, and treated him with neuromuscular-blocking drugs to reduce his muscle spasms.
Because sound and light increased the intensity of his symptoms, the patient was kept in a darkened room with ear plugs and minimal stimulation.
As his back and neck spasming worsened, the boy developed a racing heartbeat, high blood pressure, and a fever of 105 degrees Fahrenheit.
The doctor, Carl Eriksson also told NBC News that the boy required mechanical ventilation along with multiple medications so as to control the severe spasms that were occurring due to the tetanus infection.
On day 44, he was taken off breathing support and he could take small sips of liquids. On Day 57, he was transferred from the pediatric hospital to a rehabilitation center, where he spent two-and-a-half weeks.
A month after inpatient rehabilitation, the boy was able to go back to his normal activities, including running and bicycling.
The child's care - not including the air ambulance and inpatient rehabilitation - cost almost $1 million, about 72 times the mean for a pediatric hospitalization in the USA, the paper noted.
Vaccination against tetanus is incorporated in a DTaP (diphtheria and tetanus toxoids and acellular pertussis) series, given in five doses at different ages.
The case report reads: "Despite extensive review of the risks and benefits of tetanus vaccination by physicians, the family declined the second dose of (the vaccine) and any other immunization".
"It was hard to take care of him, to watch him suffer", says Judith Guzman-Cottrill, a pediatric infectious-disease physician who co-authored the article in the CDC's online journal Morbidity and Mortality Weekly Report. The signs and symptoms of the infection manifest about three to 21 days after it has entered the body.
For more than 30 years in OR, cases of tetanus in children were nearly mythical - studied in textbooks but never seen in person - thanks to the effectiveness of pediatric vaccination programs. Today, only about 30 cases are reported every year.
The report states the costs for the child's inpatient care totaled more than $800,000. A great majority of young children and babies are sufficiently vaccinated.
Lawmakers in OR and Washington are considering bills to end non-medical exemptions for childhood vaccines due to a Pacific Northwest measles outbreak. Uninsured or underinsured children may be eligible to receive vaccines at no cost through the Vaccines For Children program.
Facebook itself announced Thursday that it is using vaccine hoaxes identified by the World Health Organization, the CDC and other global organizations to address inaccurate information plaguing the site. More serious side effects, like allergic reactions or seizures, are much less common.