IMMUNITY AGAINST TETANUS IN ADULTS OVER T HE AGE OF 49 YEARS

BACKGROUND: Despite the existence of an effective, cheap vaccine with few side effects, tetanus remains present in Spain with most of the ca ses being observed in subjects over the age of 49 years. The present s eroepidemiologic study was performed to detect the degree of protectio n of this population. METHODS: The presence of antitetanic antibodies were determined in 324 subjects over the age of 49 (range: 50-88 years , mean 65.5 +/- 9.8 years) in Guipuzcoa. A passive hemagglutination te chnique (Tetan test(R); Istituto Sieroterapico Milanese) was used to d etect tetanic antitoxoid antibodies following validation of the techni que with a neutralizing test of the toxin in white mouse. RESULTS: Onl y 12.3% (40/324) of the subjects were considered as immune versus teta nus. The older subjects were the least protected: 7.7% (8/104) of thos e over 70 years of age versus 17.3% (17/98) of those from 50-59 years of age (chi(2) = 4.34, p = 0.037). The women were globally less protec ted: 5.4% versus 17% (33/194) males (chi(2) = 9.72; p = 0.002). CONCLU SIONS: Most of the adult population over the age of 49 years in Guipuz coa is not protected against tetanus. This is in contrast with the sit uation observed in the infant and adolescent population. Specific prev entive measures directed at the adult and elderly population should be undertaken.