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Tetanus in Injecting Drug Users

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Tetanus is an acute illness caused by the toxin of Clostridium tetani. It is a vaccine preventable disease for which there is a national immunisation programme in the UK.

Information on the tetanus vaccine and the national immunisation programme is available from the Public Health Observatory website and from the Immunisation pages of the Health Protection Scotland website.

Before 2003, occasional cases, usually in unvaccinated people over 65 years of age, were recorded in the UK. This pattern changed in 2003, when a cluster of tetanus in injecting drug users (IDUs) occurred.

Since IDUs are at risk for Clostridium infections, professionals working with injectors and voluntary organizations should ensure that IDUs are vaccinated against tetanus and educated about signs and symptoms of soft tissue infections that require prompt medical intervention.

Tetanus (local and generalized) is a notifiable disease by law and all suspected cases should be notified to the proper officer, normally the local Consultant in Public Health Medicine (CPHM).

Enhanced surveillance of tetanus in IDUs for Scotland is carried out by the Health Protection Scotland (HPS), and CPHMs are requested to inform HPS (0141 300 1173 or NSS.HPSBBVSTI@nhs.net) of all cases using the enhanced surveillance questionnaire available below.

Information for injecting drug users and health professionals is available from the links below