Many Unprotected Against Tetanus Risks From Home, Garden and Yard Activities


WASHINGTON -- As the arrival of spring ushers in

this year's gardening season, a new survey shows that many gardeners are

unaware of their increased risk for tetanus, a potentially fatal infectious

disease caused by bacteria found in dirt, potting soil and manure. The

National Foundation for Infectious Diseases (NFID)/National Coalition for

Adult Immunization (NCAI) and the National Gardening Association (NGA) are

working together to spread the news about outdoor tetanus risks and encourage

routine tetanus and diphtheria (Td) immunization during the NGA's National

Garden Month in April.

Results of a national consumer survey conducted by the NGA point to a

general lack of preparedness among people working around their home, garden or

yard, with at least 40 percent of respondents reporting that they are unprotected

against tetanus. This is despite the fact that more than twice as many

respondents admit receiving injuries in the last year that put them at direct

risk for contracting the disease.

"The bacteria that cause tetanus are widespread in the environment and can

potentially prove fatal," says home improvement expert Bob Vila, who has

joined NFID/NCAI to encourage routine tetanus immunization. "Even I run the

risk of tetanus exposure from everyday gardening and landscaping activities,

just like the folks in 84 million households across America who participate in

do-it-yourself lawn and garden activities. Fortunately, I've had my Td

booster shot, which protects against two diseases, tetanus and diphtheria."

According to NFID/NCAI, many people may not realize that their childhood

vaccine series for tetanus and diphtheria doesn't protect them throughout

their entire life. For adolescents and adults, one vaccine protects against

both infections since both require a booster every 10 years. Tetanus is

widely present in the environment and can enter the body through any simple

wound -- not just from stepping on a rusty nail. Diphtheria is a contagious

disease that is still common in 87 countries and can have a devastating effect

if it were to spread among a population with a waning level of immunity. The

Centers for Disease Control and Prevention (CDC) recommends that all adults

and adolescents protect themselves before exposure occurs by keeping their

tetanus and diphtheria immunization up to date.

"Tetanus is rare in the U.S. today, but it's difficult to tell when you

may be exposed and the potential consequences can be devastating," says NFID

president Susan Rehm, MD. "Because you can never tell when you might be

exposed to tetanus, it is important for all healthy adolescents and adults to

protect themselves against the disease with a booster shot, every 10 years."

Other key findings about the public's knowledge of risk and protection

against tetanus raised by the 2004 National Gardening Association survey


Most respondents don't know where tetanus comes from:

* 57 percent of respondents did not know tetanus bacteria are commonly found in

soil, dirt and manure. According to the CDC, 31 percent of tetanus injuries

occur in the yard/garden/farm and an additional 23 percent occur around other

outdoor locations.(1)

* Only 35 percent of respondents recognize that wounds caused by animal or

insect bites are potential sources of tetanus infection, despite the

commonality of these injuries.

A majority of gardeners report tetanus-prone injuries:

* 80 percent of survey respondents reported some type of tetanus-prone injury

while working around the home, garden or yard; but 40% report they have

not had a tetanus shot in the last 10 years.

Few recognize increased tetanus risk for those over 60 years of age:

* 86 percent of respondents did not know that seniors are at an increased risk

for tetanus infection compared to children. According to the CDC, 70 percent

of adults 70 years of age and older lack protection against tetanus and

diphtheria. Further, at least 40 percent of those aged 60 years or older

remain unprotected against both diseases,(2) and many may never have

received a childhood vaccination, which was introduced in the late


In the survey, gardening fans report somewhat higher tetanus immunization

rates (60 percent) than the general public; CDC's analysis of more than 18,000 blood

samples from the U.S. public show that 53 percent of people aged 20 years and older

are not adequately protected against tetanus and diphtheria.

Now in its second year, the NFID/NCAI's public education campaign about

tetanus and diphtheria risks and prevention uses the theme "Power of 10" to

focus on the importance of staying up to date with the booster immunization

for both diseases required every 10 years. This year's efforts include TV and

radio public service announcements featuring campaign spokesperson Bob Vila,

information on gardening-related tetanus risks, a self-quiz on the NFID Web

site and a pamphlet to help people assess their own risk and immunization

status. For more information about the Power of 10 campaign, tetanus and

diphtheria, or to take the Power of 10 quiz, visit the NFID Web site at

Both tetanus and diphtheria can be very difficult to diagnose, are

especially complicated to treat and can be fatal. Contracting a tetanus or

diphtheria infection does not provide immunity against future infections,

underscoring the importance of routine boosters.

The CDC recommends that everyone have a primary vaccination series against

tetanus and diphtheria, and maintain life-long protection. Vaccine protection

for tetanus and diphtheria must be "boosted" every 10 years, which is done

with a combined vaccine known as "Td." Since the late 1940s, U.S. children

have received initial protection with a combined vaccine against tetanus,

diphtheria, and pertussis (whooping cough). Some adults over 60 years of age

may never have had this series. In such cases, the Td vaccine can also be

used to provide primary immunization as a three-shot series for adults.

Maintaining up-to-date immunity with a Td booster keeps the disease from

recurring among the general domestic population and protects people who travel

to countries where the risk of tetanus and diphtheria exposure can be high.

Founded in 1973, the NFID is a non-profit organization dedicated to public and

professional educational programs about and in support of research into the

causes, treatment and prevention of infectious diseases. NCAI is a network of

more than 140 organizations dedicated to promoting adult immunization

primarily through educational and motivational activities. The coalition was

formed in 1988 to make the most efficient use of public and private resources

to achieve national goals in adult immunization. The Power of 10 campaign was

made possible through an unrestricted educational grant to NFID from Aventis



(1) Centers for Disease Control and Prevention. Tetanus Surveillance,

United States, 1998-2000. MMWR; 2003:52 (No. SS-3): 1-12

(2) Centers for Disease Control and Prevention. Diphtheria, Tetanus and

Pertussis: Recommendations for Vaccine Use and Other Preventive

Measures: Recommendations of the Immunizations Practices Advisory

Committee (ACIP). MMWR; 1991:40 (No. RR-10): 1-28.

Source: National Foundation for Infectious Diseases (NFID)

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