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May 13, 1968


Author Affiliations

From the Department of Surgery, Harvard Medical School, and the Fifth (Harvard) Surgical Service and the Sears Surgical Laboratory, Boston City Hospital.

JAMA. 1968;204(7):614-616. doi:10.1001/jama.1968.03140200054017

Tetanus is a dread infection written about since ancient times. It is known and described chiefly because of the severe toxic effect of the exotoxin of the causative anaerobic organism, Clostridium tetani.

Onset of Symptoms  Infection may follow a trivial, forgotten injury. More often it follows a severe, contaminated, crushing type of wound. The incubation period is usually stated as 7 to 21 days, but the infection frequently occurs in less time. Prognosis becomes less favorable as incubation time shortens and mortality rises sharply when it is less than 10 days. Formerly, the outlook for younger patients with tetanus infection was better than for older patients, but this may no longer be true. In an earlier series from the Boston City Hospital from 1930 to 1947, ten of 17 tetanus patients under 12 years of age recovered, whereas all the ten patients over 12 years of age died (Table 1).