To the pediatrician the problem of prophylaxis against tetanus is of particular importance. One half of the deaths from tetanus occur among children under 15 years of age. Tetanus may develop after receipt of a superficial scratch and even in persons lacking objective evidence of an injury for which no medical attention was sought. The routine injection of antitoxin in all cases of injury, a procedure carried out in the accident rooms of many hospitals and elsewhere, is obviously a dangerous practice when applied to allergic persons, especially those hypersensitive to horse dander, horse serum or both. The frequency of anaphylactic (allergic, hyperergic) shock among hypersensitive persons following the injection of serum is much higher than the reported incidence of 1 instance per 50,000 injections of serum in unselected cases. Numerous examples illustrating the inadequacy of passive immunization of soldiers against tetanus were furnished during the World War of 1914-1918.
PESHKIN MM. IMMUNITY TO TETANUS INDUCED BY COMBINED ALUM-PRECIPITATED DIPHTHERIA AND TETANUS TOXOIDS: BASED ON A STUDY OF ONE HUNDRED AND EIGHTY-SIX ALLERGIC CHILDREN. Am J Dis Child. 1941;62(1):9–25. doi:10.1001/archpedi.1941.02000130018002
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