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Two cases of severe tetanus in women aged 61 years with histories of incomplete vaccination were notified in April 2002, the first cases reported sofar this year (1). The first case from West Yorkshire developed symptoms eight days after sustaining a head injury from a fall down stairs. Neither tetanus toxoid nor immunoglobulin was given at the time of her injury, which required stitches. She was admitted to intensive care four days later with respiratory and cardiac arrest, and severe trismus, and died two and a half weeks later. Only one dose of tetanus toxoid given eight years ago was shown in her medical records.


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