Clinical Study of Neonatal Tetanus (1967~1977)

Author reviewed the experience with 50 cases seen at the Ewha Womans University Hospital in Seoul between January 1967 and December 1977, with an overal mortality of 50.0% from the disease. The average number of patients in the annual incidence was 4~5 cases, which was 0.8% of the total admitted patients of pediatrics in our hospital. Monthly distribution revealed as the highest in summer (42.0%) and the male to female ratio was 3.2:1. Compared with Seoul and the rural area of its outbreak, there was a significantly higher in Seoul (82.0%) than in the rural area(18.0%). Neonatal tetanus was a serious problem in some areas of our country where modern aseptic techniques were not employed. And the umbilical contamination by the dirty scissor was the highest source of infection (66.0%). Seventy-two percent of 50 cases was delivered in the contaminated environment. The incubation period was extremely variable but the usual range was 5 to 7 days(36cases). A short incubation (less than 10 days) was associated with a higher mortality rate (55.6%) than the incubation period over than 10 days with a mortality of 14.3%. The most common chief complaint on admission was the stop sucking (86.0%). The others were convulsion(62.0%), trismus (32.0%), fever (30.0%), irritability(18.0%), spasticity(16.0%) in orders. There was a significant correlation between fever and the outcome. The cases who were mild degree in the temperature(37°~37°9'C) had a better chance of recovery (62.5%). The mean hospital day in the improved cases was 21 days. The percentage of the beginning of the sucking ability within 1 to 2 weeks after the onset of the disease was high as 56.0%. The sucking power was normalized within the 4 weeks after the onset of the desease in all of the improved cases.