The prevalence of Tetanus in Canada and India

The prevalence of Tetanus in Canada and India A critical comparison of the vaccination and hygienic influences on the prevalence of Tetanus in Canada and India. Tetanus is caused by a toxin, tetanaspasmin, produced by the bacterium Clostridium tetani (Guifoile 2008, p. 10). This toxin affects the inhibiting motor neurons within the body, causing muscle contractions to become erratic and violent. These contractions are extremely painful for the individual suffering them, the contractions being violent enough to cause the strongest of bones in the body to fracture. In the last century, around 1940, the likelihood of death if you contracted tetanus was approximately 90% (Guifoile 2008, p. 10). Over time, however, vaccines and effective treatment options were developed, decreasing the mortality rate of tetanus. The vaccination programs of two countries, Canada and India, are both considerably thorough for the protection against tetanus. Furthermore, Canada has a high standard of hygiene and sanitation, further lowering the risk of tetanus in the country. India, however, does not have as high sanitation or hygiene standards, which may have an eff ect on the protection of tetanus. Both India and Canada follow vaccination procedures in order to prevent tetanus infection. Because of this, tetanus in Canada is quite rare; the PHAC (2014) states that through the years of 1990 and 2010 there were approximately 4 cases per year of tetanus in Canada. In India, though the prevalence of tetanus has declined, it is still a major health problem [] with significant morbidity and mortality due to [] incomplete vaccination (Kole et al. 2013). Skowronksi et al. (2004) reports that in New Delhi, India, 53% of adults were reported to have no protection against tetanus. This is comparable to Canada, in which a study reported that roughly 55% of adults do not have protection against tetanus. Whilst less have gotten vaccinated in Canada compared to the number of adults vaccinated in India, Tetanus is still a threatening disease in India. Considering this, both Indian and Canadian infants are given the tDap/DTap vaccinations. In Canada, routine vaccinations for newborns are given at 2 months of age, then again at 4, 6, 8, and 12-23 months. The Canadian vaccination schedule suggests that children under the age of 6 should be vaccinated more than 20 times (Public Health Agency of Canada (PHAC) 2014). Furthermore, Skowkronski et al. (2004) states that Canadian immunization programs are publicly-funded in all provinces. This is similar to in India, as the National Immunization Schedule ensures all children in the country under the Expanded Program of Immunization (EPI) are immunized free of charge. Moreover, the newborn vaccinations are not done as frequently in India. Newborn children are not vaccinated until 8 weeks of age, then they are again vaccinated at 16 weeks. Another vaccination is given at 15-18 months (Viswanathan 2005). Whilst both Canada and India provide vaccinations against tetanus to newborn children and infants, this may not have any relation to the prevalence of tetanus in India, however, due to the tetanus bacterium being spread only by wound s or fecal-oral transmission (Ji, cited by Mercola 2012). The majority of fields and roads are contaminated with animal feces in India. Because of this, Kole et al. (2013) suggests that the farming population in India should be targeted for complete tetanus immunization as they may be exposed more often to animal feces and contaminated soil. Contrastingly in Canada, there is a largely higher level of hygiene and sanitation; unlike India, human or animal fecal matter does not sit in the streets. As such, the risk of the soil or environment having been contaminated by the tetanus bacteria is low. This may link back to Canadas low prevalence of tetanus despite the lack of vaccinated individuals. As tetanus spreads through fecal matter and the bacterium can reside in the soil, Ji (cited by Mercola 2012) suggests that hygiene, sanitation and proper nutrition should be focused on in order to prevent the transmission of tetanus and other fecal-oral route viruses. This may also reduce the morbidity of tetanus if a person is infected. Ji states: You simply cant vaccinate people out of [unhealthy] conditions, and as Indias new epidemic of vaccine-induced polio cases clearly demonstrates, the cure may be far worse than the disease itself (cited by Mercola 2012). Whilst Ji is discussing the affects of the 2011 polio epidemic in India caused by vaccinations, this statement can still be applied to tetanus as the process of infection is the same: fecal-oral route. However, tetanus can also be transmitted through punctures or wounds (Guilfoile 2008) which strengthens the link between Indias poor sanitation and hygiene and the prevalence of tetanus: many Indian people walk with bare feet, increasing the likelihood of stepping on a stick/nail/other such thing that is contaminated with the tetanus bacterium. Furthermore, according to Guilfoile (2008), has been found [] in the fecal matter of humans and other animals thus leading to the tetanus bacterium being common in the soil in rural areas in the country. Both India and Canada both provide free and routine vaccinations again tetanus (TDap/dTap vaccine), and both countries ensure newborns are vaccinated and are given booster shots. It has been established that both countries have fairly thorough vaccination schedules, though Canadas schedule includes more frequent vaccinations for infants. However, it can be thought that the number of immunizations against tetanus do little to protect against the bacterium that cause tetanus, as these bacteria are transferred via the mouth through fecal matter (Ji, cited by Mercola 2012). It can be concluded that India, due to fecal matter amongst the streets and the generally low standard of hygiene within the country, is an area of which tetanus infection is much more likely, with or without vaccination. Due to Canadas higher sanitation and hygiene levels, despite the lower vaccination rate, tetanus is much less prevalent there and has a lower mortality rate. Word count 968 References Mercola, J 2012, Confirmed: India’s Polio Eradication Campaign in 2011 Caused 47,500 Cases of Vaccine-Induced Polio Paralysis, Mercola, viewed 12 April 2015, http://articles.mercola.com/sites/articles/archive/2012/08/28/polio-eradication-campaign.aspx> Kole, A, Roy, R Kole, D 2013, Tetanus: still a public health problem in India — observations in an infectious diseases hospital in Kolkata, South-East Asia Journal of Public Health, pp. 184-186 Public Health Agency of Canada 2014, Canadian Immunization Guide, Public Health Agency of Canada, viewed 9 April 2015, http://www.phac-aspc.gc.ca/publicat/cig-gci/p04-tet-eng.php> Vijayalakshmi, M 2014, Resources, All For Kids India, viewed 9 April 2015, http://www.allforkidsindia.com/Resources/VaccineOptions.aspx> Vashishtha, V 2011, FAQs on Vaccines and Immunization Practices, Jaypee Brothers Medical Publishers, New Delhi, India, p. 37. Viswanathan, R 2005, Get Your Tetanus Shot Today!, Rediff, viewed 9 April 2015, http://www.rediff.com/getahead/2005/jun/13tetanus.htm> Skowronski, D, Pielak, K, Remple, V, Halperin, B, Patrick, D, Naus, M McIntyre, C 2004, Adult tetanus, diphtheria and pertussis immunization: knowledge, beliefs, behaviour and anticipated uptake, Vaccine, vol. 23, no. 3, pp. 353-361. Guifoile, P 2008, Deadly Diseases and Epidemics: Tetanus, Infobase Publishing, New York, New York, pp. 10-16. This form meets the 2006 requirements of UniSA’s Code of Good Practice: Student Assessment 1