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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
* 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)