A six-year-old boy in Oregon nearly lost his life to a tetanus infection, and it's all because he was not vaccinated. A new CDC report explains that the young child was playing outdoors on a farm in 2017 when he accidentally cut his forehead. The wound was cleaned and stitched up at home, but six days later, the boy's jaw began to clench and his muscles started spasming uncontrollably. It was only when his breathing became more difficult later that day that his parents contacted emergency services, and he was air-transported to the nearest paediatric hospital. The diagnosis was childhood tetanus, the first documented case in Oregon in over 30 years. Tetanus is an uncommon but very serious neuromuscular disease caused by the bacterium Clostridium tetani. This bacteria produces spores that can be found just about anywhere, including soil, dust and faeces, and which can cause serious medical complications if they enter an open wound. The only way to protect yourself is through five doses of a vaccination. In fact, since the 1940s and the advent of the tetanus vaccine and wound management techniques, the United States has experienced a 95 percent decline in the number of tetanus cases and a 99 percent decrease in tetanus-related deaths. In this particular case, however, the boy had not received his tetanus vaccine, or any other recommended vaccinations for that matter. The result was eight weeks in inpatient care - 47 days of which were spent in intensive care - followed by several weeks of rehabilitation. When the child first got to the hospital, he was unable to open his mouth, and spasms in his diaphragm and larynx meant that doctors had to put him on a ventilator so he could breathe properly. To control his spasms, the child was set up in darkened room with ear plugs and minimal stimulation. At the same time, he was given the tetanus vaccine and antibodies to fight off the bacteria. Nevertheless, the spasms causing his back and neck to arch worsened, and he developed hypertension, a speeding heart rate and a fever. It wasn't until a month after rehabilitation that the child was once again able to walk and run without assistance. All in all, the medical care cost more than $800,000, and that's not even including the air transport, ambulance costs or the inpatient care. But the tragedy does not end there. Even after receiving extensive advice on the risks and benefits of the tetanus vaccination, his parents declined a second dose and any other recommended immunisations. In the state of Oregon, parents are generally required to have their kindergartners vaccinated against diphtheria, measles, mumps, rubella, polio, chickenpox, Hepatitis A and B, and tetanus. However, exemptions can be made for philosophical and religious reasons, and at 7.5 percent, Oregon currently has the highest percentage of these in the entire country. What's worse, that number is continuing to grow. "While more nonmedical exemptions mean fewer children are being immunised, the vast majority of Oregon parents and guardians still choose to fully immunise their children," says Stacy de Assis Matthews, an immunisation school law coordinator with the Oregon Immunisation Program. "Most parents and guardians know that immunisation is still the best way to protect children against vaccine-preventable diseases such as whooping cough and measles." The case was published by the CDC in its MMWR and Morbidity and Mortality Weekly Report.<doc-sep>A report showed that a 6-year-old unvaccinated boy from Oregon was with tetanus, the state's first case of its kind in nearly 30 years. The young boy contracted the disease after he cut his forehead while playing outside on a farm, according to a report released by U.S. Centers for Disease Control and Prevention (CDC) on Thursday that details the 2017 case. ADVERTISEMENT The boy’s parents reportedly cleaned and stitched his cut at home. Roughly a week later, the boy began to cry as his limbs involuntarily spasmed and his jaw began to clench tight. After his neck and back began to arch and he started to experience spasms across his entire body, his parents then sought medical help for the child. He was later reportedly airlifted to a medical center nearby, where physicians diagnosed him with tetanus. The young boy was alert and requested water upon his arrival to the hospital, but he was unable to open his mouth. A tube had to be placed in the boy’s windpipe. He was later administrated the tetanus and pertussis vaccine along with tetanus immune globulin. After he was given the medication, doctors placed the boy “in a darkened room with ear plugs and minimal stimulation” as loud noise and light seemed to worsen his condition. In total, the boy required nearly “8 weeks of inpatient care, followed by rehabilitation care, before he was able to resume normal activities,” the CDC said in the report. Excluding the costs of air transportation, inpatient rehabilitation and ambulatory follow-ups, inpatient charges for the boy totaled $811,929. But despite “extensive review of the risks and benefits of tetanus vaccination by physicians,” the boy’s parents declined a second dose of the tetanus-fighting medication and “any other recommended immunizations.” The report about the case was part of the center’s Morbidity and Mortality Weekly Report, which aggregates discussions and field studies about contagious outbreaks across the globe. The report comes as lawmakers in the United States attempt to tackle what has been considered "a growing public health threat” as measles outbreaks continue to grow across the nation.<doc-sep>In all, the boy’s medical charges in the hospital amounted to $811,929 — which did not include the cost of being airlifted to the hospital or of inpatient rehabilitation, according to the CDC. It’s unclear from the report who covered his hospital expenses. It took about a month after his rehab for the boy to return to “normal activities” such as running and bicycling, the report added.<doc-sep>The young son of anti-vaccine parents endured excruciating pain and spent 47 days in pediatric intensive care after contracting tetanus, a devastating bacterial infection easily prevented by vaccines. Despite the nightmarish ordeal, his parents still refused to have him vaccinated, according to health officials in Oregon who helped treat the boy. They reported the boy’s harrowing case Friday, March 8, in Morbidity and Mortality Weekly Report, an online publication from the Centers for Disease Control and Prevention. The six-year-old Oregon boy contracted tetanus—also called lockjaw—innocently enough. He got a cut on his forehead while playing on his family’s farm in 2017. The boy’s wound was treated and sutured at home. Six days later, he showed signs of tetanus. Tetanus is caused by the bacterium Clostridium tetani, which is found in soil and produces a toxin that causes painful muscle contractions. The boy’s symptoms started as crying fits, jaw clenching, muscle spasms, and neck and back arching. The same day, he started having trouble breathing, at which point his parents contacted emergency medical services, who quickly air-lifted him to a pediatric medical center. When he arrived at the hospital he was suffering jaw muscle spasms. He indicated he wanted some water but couldn’t open his mouth enough to drink it. Some of his muscles necessary for breathing also started spasming, throwing the boy into respiratory distress. He had to be sedated, intubated, and placed on mechanical ventilation. At this point, doctors admitted him to the intensive care unit, where they kept him in a dark room with ear plugs to avoid stimulating him, which can exacerbate the muscle spasms. They treated him with antibiotics and gave him a shot of a tetanus vaccine (DTaP). Still, his condition worsened. His heart raced, his blood pressure went up, and his body temperature spiked to nearly 105 degrees Fahrenheit. Doctors gave him multiple intravenous drugs to control his blood pressure, pain, and muscle spasms. They also performed a tracheostomy, cutting a hole in his neck for prolonged ventilator support. Advertisement The boy stayed like this for 35 days. At that point, the doctors were able to wean him off the drugs for muscle spasms over five days. On day 44 of his hospital stay, he came off the ventilator and tolerated drinking clear liquids. On day 47, he was moved out of the ICU and into an intermediate care unit at the hospital. Three days later he was able to walk 20 feet—but he needed assistance. On day 57, he was released from the hospital and transferred to a rehabilitation center. He spent another 17 days there. And it took another month after his rehab before he was back to his old activities, including running and riding a bike. Despite the heart-wrenching saga and “extensive review of the risks and benefits of tetanus vaccination by physicians,” his parents refused another DTaP vaccination—and all other recommended vaccines. That means he’s still vulnerable to a whole slew of vaccine-preventable illnesses and could one day get tetanus again. The doctors noted that his hospital bill totaled $811,929, which is about 72 times the average hospital bill for children. And that bill does not include air-transport and rehab costs. They also noted that the boy was the first case of pediatric tetanus in Oregon in more than 30 years. This lack of tetanus cases is attributed to widespread tetanus vaccination. Nationwide, between 2009 and 2015, there were only 197 cases of tetanus, which resulted in 16 deaths. The recommended schedule for tetanus vaccines for children is a five-dose course at 2, 4, and 6 months, then 15-18 months, and 4-6 years. Health experts recommend a booster shot every 10 years.<doc-sep>
An unvaccinated Oregon boy almost died from tetanus, the first case of the bacterial infection in the state in 30 years. The 6-year-old's harrowing illness and painful, two-month treatment — which cost close to a million dollars — were detailed by doctors in a case report published Friday by the Centers for Disease Control and Prevention. The boy became infected in 2017 after cutting his head while playing outdoors on the family's farm. His wound was cleaned and stitched by his family at home, according to the Oregon doctors who treated the child and wrote the CDC report. All seemed fine, until six days later when he started crying and experiencing involuntary muscle spasms and clenching his jaw. Soon he was arching his neck and suffering back and muscle contractions throughout his body. When he began to have trouble breathing, his parents called for emergency services and the child was airlifted to a pediatric medical center. Upon arrival at the hospital, the child was alert but unable to open his mouth due to lockjaw and severe muscle spasms, critical care pediatrician Dr. Carl Eriksson of the Oregon Health and Science University and the OHSU Doernbecher Children’s Hospital told NBC News via email. "He required mechanical ventilation (a respirator) through a breathing tube in his mouth, and multiple medications to control severe muscle spasms, pain and agitation," Eriksson said. In the pediatric intensive care unit, the boy was cared for in a darkened room and fitted with earplugs because stimulation of any kind seemed to intensify the spasms. When doctors learned the boy had received no immunizations, he was given a medication that contained tetanus toxin antibodies, along with the standard vaccine against tetanus, diphtheria and pertussis, DTaP. As the arching of his neck and back worsened, the boy started to experience “dramatic swings in his heart rate, blood pressure and temperature,” Eriksson said, adding that this condition “can be very dangerous and is often difficult to treat.” He was given medications to help control his muscle spasms, blood pressure and pain, and he remained in the ICU for another 35 days. “Because tetanus causes such severe muscle spasms, it also causes severe pain,” Eriksson said. “It can also be frightening to have uncontrolled muscle spasm, especially when it is so severe.” It wasn’t until the 44th day that the boy was disconnected from the ventilator and able to take a few sips of clear liquid. After 57 days in the hospital, the boy was transferred to a rehabilitation center where he would spend the next 17 days. The hospital bill for the boy’s care totaled $811,929, excluding the cost of air transportation, inpatient rehab and follow-up costs. 'Entirely preventable' After the boy was finally released, he returned to normal activities, including running and bicycling, the CDC report stated. His parents chose not to have him vaccinated further. "Despite extensive review of the risks and benefits of tetanus vaccination by physicians, the family declined the second dose of DTaP and any other recommended immunizations," the doctors wrote. Tetanus, also known as lockjaw, is a vaccine-preventable infection caused by the bacteria Clostridium tetani. When the bacteria enters the body through a scrape or cut, it produces a poisonous toxin that causes painful muscle contractions, including in the neck and jaw, making it hard for the patient to swallow. Children are immunized against tetanus with the DTaP vaccine, designed to protect against diphtheria, tetanus and acellular pertussis. It's usually given in five doses: at 2, 4 and 6 months of age and between 4-6 years. Booster doses of diphtheria and tetanus vaccines are recommended every 10 years for everyone. Ericksson declined comment on the patient’s insurance status due to privacy concerns. “But what I can say is that this hospitalization would almost certainly have been prevented if the patient had been vaccinated against tetanus,” he said via email. “Most school-aged children have received five doses of tetanus vaccine, with each dose costing approximately $30.” There are so many things wrong with what happened to this boy, “it’s hard to know where to start,” said Dr. Albert Wu, an internist and professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health. “This was entirely preventable — an unnecessary episode of torture for this poor child," Wu said. "Tetanus is a truly deadly disease.