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TETANUS

D Norbaizura Saidin,

Cawangan Kawalan Penyakit Berjangkit

JKWPKL&P

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Painful muscle contraction

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KES TETANUS DI JKWPKL&P

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Kes Tetanus di JKWPKL&P

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Wabak diisytiharkan pada 2019 melibatkan 2 kes neonatal tetanus (PKC dan PKK)

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Kes Other Tetanus di JKWPKL&P (4 kes)

  • 1 kes mati, 3 intubated
  • History of contaminated wound post MVA/ accident (fall down from staircase).
  • Onset of symptoms: 7 – 11 days.
  • Presenting symptoms:
    1. SOB with generalised muscle spasm 🡪 pt died.
    2. Painful jaw and unable to open mouth 🡪 intubated
    3. Fitting and jerky movement 🡪 intubated
    4. Lock jaw, stiffening bilateral limbs 🡪 intubated

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Kes neonatal tetanus di JKWPKL&P (2 kes)

  • Both are foreigners
  • 1 involve non-sterile birth (traditional midwife)
  • 1 case contaminated umbilical cord (non-sterile cleaning)
  • Both case intubated in neonatal ICU 🡪 survived.

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TETANUS

  • No human to human transmission.
  • Diagnosis does not require laboratory or bacteriological confirmation.
  • Incubation period: 3 – 21 days (average 8 days).
  • Tetanus can lead to death.
  • Types:
    1. Neonatal tetanus
    2. Other tetanus

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NEONATAL TETANUS

CONFIRMED CASE

  1. Normal ability to suck and cry during the first two days of life
  2. Could not suck properly between 3 and 28 days of age
  3. Developed muscle stiffness and/or spasm (jerking)

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Sumber: WHO

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opisthotonus

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Risk factor specific to neonatal tetanus

  • Non-sterile birth
  • Birth using traditional midwife
  • Foreigners (low income status)

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Other tetanus

  • Case definition:

Acute onset of hypertonia and/or painful muscular contractions (usually the muscle of the jaw and neck) and generalised muscle spasm without other apparent medical cause.

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Treatment

  1. Immediate treatment with human tetanus immune globulin (TIG)
  2. Aggressive wound care
  3. Drugs to control muscle spasm
  4. Tetanus vaccination
  5. Intubation maybe needed depending on the severity of infection

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