Question for Pupuce

[Jimjams]

Pupuce- folowing on from the conversation under "hib"- can I just pick your brains.

The only vaccinations I'm not 100% happy with ds2 missing are tetanus and strangely enough diptheria. Mainly because I haven't been able to track down much in the way of information- either about the effectiveness of the vaccinations, or the incidence of the diseases. Do you know of anything? I do know that there is a question as to whether tetanus works at all, and I did read that diptheria had declined by 90% before the introduction of vaccinations. I also heard it was making a comeback in the war torn old eastern block. Not that we're thinking of going there!. Anyway if you do have any information I'd really like to know more.

Many thanks!

I know that I am not pupuce, Jimjam, but I do know a bit about the anti tetanus jabs, as I used to work on the toxin many years ago. I know that in the 1980's the highest incidence of tetanus was in female OAPs. The men had all been given the jabs during service in the war/national service, but the women, who had not served in the same numbers had never been given the jabs. Consequently they were the largest group to get the condition, often following deep puncture wounds (the bacteria is anaerobic).
I understand your reticence about the jabs, but the toxin's effects are truly horrific. The patient's muscles go into spasm and the person ends up bow shaped, with only their heels and shoulders on the bed. They need ventilation as they lose the ability to breathe independently. Survival is not assured, even with first rate care. I don't know what the incidence is running at, but I do know that the jab did reduce the numbers of cases, based on the epidemiological data of the male/female distribution.

Thanks hmb- hmm I've had a picture of someone with tetanus described to me a few years ago and it sounded pretty horrific! (I actually thought it was aproaching 100% death rate- for cases that weren't caught very early) I thought the highest incidence was in OAP's, although I thought that was becuase protection wore off - don't they only last 10 years? (and also from umbilical stump infections- which funnily enough ds2 had- he was quite ill for a while- they didn't tell me whether tetanus was invoved though). The thing that is confusing me is that apparently getting tetanus once (and having antibodies) is no guarantee to not getting it again (so how on earth does the vaccine work). Also there is the problem with repeated booster doses giving more severe reations- so you're only allowed a certain number in your life??? I thought that was partly why the OAPS were affected. I've never got to the bottom of this- read loads of conflicting stuff.

If I was going to give tetanus to ds2 I would probably do it around pre-school booster age - Until then I figured I would have a pretty good idea if he had a tetanus type wound (and could then be given the horse antibody things). Also I have a feeling all single tetanus jabs countain thimerosil, so he's not getting that early.

Does tetanus work better when conjoined to diptheria (or is it diptheria that works better when joined to tetanus). it's all veyr confusing. I know I don't want ds2 to have pertussis vaccination for all sorts of reasons I won't bother listing here.

Thanks for your help though hmb- this is exactly the sort of information I'm trying to track down. I've only ever "dealyed" tetanus and diptheria- never decided totally against them (meningitis C as well- but that's delayed until teenage years so not really thinking about that one at the moment). Now ds2 is mobile and inquisitve I'm trying to get more to grips with all the pros and cons,

Thanks hmb- hmm I've had a picture of someone with tetanus described to me a few years ago and it sounded pretty horrific! (I actually thought it was aproaching 100% death rate- for cases that weren't caught very early) I thought the highest incidence was in OAP's, although I thought that was becuase protection wore off - don't they only last 10 years? (and also from umbilical stump infections- which funnily enough ds2 had- he was quite ill for a while- they didn't tell me whether tetanus was invoved though). The thing that is confusing me is that apparently getting tetanus once (and having antibodies) is no guarantee to not getting it again (so how on earth does the vaccine work). Also there is the problem with repeated booster doses giving more severe reations- so you're only allowed a certain number in your life??? I thought that was partly why the OAPS were affected. I've never got to the bottom of this- read loads of conflicting stuff.

If I was going to give tetanus to ds2 I would probably do it around pre-school booster age - Until then I figured I would have a pretty good idea if he had a tetanus type wound (and could then be given the horse antibody things). Also I have a feeling all single tetanus jabs countain thimerosil, so he's not getting that early.

Does tetanus work better when conjoined to diptheria (or is it diptheria that works better when joined to tetanus). it's all veyr confusing. I know I don't want ds2 to have pertussis vaccination for all sorts of reasons I won't bother listing here.

Thanks for your help though hmb- this is exactly the sort of information I'm trying to track down. I've only ever "dealyed" tetanus and diptheria- never decided totally against them (meningitis C as well- but that's delayed until teenage years so not really thinking about that one at the moment). Now ds2 is mobile and inquisitve I'm trying to get more to grips with all the pros and cons,

aagghh I keep doing that!

I don't know if it works best if conjoined. I've just had a quick google for incidence rates in the UK and found this www.dhsspsni.gov.uk/publichealth/hib/dtwp_factsheet.pdf

I know that it is 'pro' jabs site, but it does give the incidence rates in the UK. For a very quick read it would seem that all the deaths that occur do so in patients with no immunisation, or incomplete imunisation. The jab gives 10 years protection once given, and can also give protection if given shortly after a tetanus prone injury.

Re the bit about having tetanus not giving you immunity.....a good question, which I have not found the answer to, at the moment. The only comment I have been about to find is that it is because the toxin is so potent...not sure how that would work. I didn't work in the immunology of tetanus, just the neurotoxicity. I'll do some more googling and see if I can find the answer.

Babies are protected if their mother is given the anti-tetanus shot. Neonatal tetanus is almost unheared of in the UK, but happens with heart breaking regularity in the developing world. I went to a conference about this in 1987, and some of the stats were truly horrific. Basically the toxin causes the muscles to go into spasm. The US quote a 16% death rate in infected patients, death rates are highest in the elderly.

Hi Jimjams.... I am a bad one to ask !
I am very unlike most people, including people who believe in alternative methods.... I don't even do homeopathy or other alternative therapies for US.

We chose not to vaccinate our children because we do not think they would benefit from the vaccine, i.e. it would harm their immune system (I don't mean MMR and autism) - generally I think our bodies, our mind, our surroundings are strong enough to get us through (I know this will sound like complete lunacy to some and to be honest I don't care as I am not trying to convince anyone).
My children (2 and nearly 4) have never been ill (except a runny nose and to me that is not illness), they have never taken any drug - including Calpol (I don't even have any).

My son has had mouth ulcers when he was younger - again to me that was not an illness (and even dentist said it wasn't) - it was a sign of his system being a bit run down... the way we tackle this is through rest, proper food, lots of TLC.

So I am not a classic "anti-vaccination people" - nothing wrong with those but my reasoning and view of health is different.

I am not worried that my children will catch any of the diseases you can get a vaccine for either. And I am not running to measles parties....

Generally I steer clear of the whole vaccination debate (after attempts at it some 1 or 2 years ago!) - I have my beliefs and I am not expecting anyone to understand or believe me. All that matters to me is that my kids are healthy and happy - like every other mum I am sure.

Curious to hear the reaction I'm going to get on this thread !

so we will vaccinate our children to stop everyone else gaetting measles?!

Had a swift look about and found this

'Immunity
Unlike other diseases, such as diphtheria, recovery from the natural disease usually does not confer immunity, since even a lethal dose of tetanospasmin is insufficient to provoke an immune response.
Prophylactic immunization is accomplished with tetanus toxoid, as part of the DPT (DTP) vaccine or the DT (TD) vaccine. Three injections are given in the first year of life, and a booster is given about a year later, and again on the entrance into elementary school.

Whenever a previously-immunized individual sustains a potentially dangerous wound, a booster of toxoid should be injected. Wherever employed, intensive programs of immunization with toxoid have led to a striking reduction in the incidence of the disease. ' at www.bact.wisc.edu/Bact330/lecturetetbot

From what I have read of the Tetanus toxoid the toxoid is adsorbed onto aluminium phosphate or aluminum potassium sulfate. This prolongs and enhances the antigenic properties by retarding the rate of absorption into the body. So I suppose that the 'natural' toxin is absorbed too fast for the body to generate sufficient antibodies. I do know that it is taken up by the nervous system very quickly and that this is part if the reason that it is second only to botulinum toxin in it's level of leathal effect. And like botulinum when it binds to nervous tissue, it binds for good.

From one of the sites it would seen that the US and canadian TT contains thimerosil. Not sure about the UK supplies

Are any of the links from Healthhub any use?

Also when we were in Australia, I found the Public Health site for Victoria had some excellent information although some of the publications within the site run to hundreds of pages....

Vaccination agains tetanus is not done to give herd immunity, as tetanus is not passed from person to person. It is only caught from puncture wounds that become infected with the causal agent, Clostridium tetani (often found in animal feces) I am pro immunisation myself, but the rational behind tetanus is rather different to the arguments given for MMR. Chosing not to vaccinate your child against tetanus has no effect on any other child.

Thanks hmb- and pupuce.

You sound pretty sane to me pupuce- I agree with everything you have written. I do use Calpol but only when temperatures go above 40..... I get mouth ulcers when I'm run down, and I have to say that unvaccinated ds2 has (touch wood) been far healthier than his vaccinated elder brother. 4 years ago I would have thought you were mad (lol), but having seen the effect vaccinations had on ds1's immune system I wish I had been as sane as you when ds1 was a baby.

Tetanus is the only one I really can't get my head round. hmb - the description you gave of head and shouders on the bed was given to me about 10 years ago (actually it was of someone lying on a bed with their feet touching their head- yuk yuk yuk!) and it's something that always stayed with me! I know tetanus is horrific- I just can't get a grip on how likely ds2 is to get it (or ds1- I suppose since he has now missed pre-school boosters). I didn't think about it until recently as he's only been walking for a couple of months. There's the often quoted statistic about there only being 12 cases during WW1 in the trenches- but I'm, not sure I would trust their record keeping . Just can't bear the thought of vaccinating the boys either....... hmmmmm

thanks hmb- that does make sense..... I thought it contained thimerosil - so that agrees (and looks as if it comes with diptheria).

If either of the boys (ds1 now part-immunised, ds2 not at all) had a tetanus type wound they could still have the horse antibody thingies couldn't they (you know the short term one)? The extract there suggests its given to already vaccinated people as well.

Thanks everyone else as well- your posts crossed with mine!

I sympathise Jimjams. And I know what you mean when you say that the picture stays with you, it has stayed with me as well

The awful fact that lives with me is that women and babies in India (in rural areas) often had tetanus because the woman was 'purified' post delivery by having her vagina packed with dried cow manure. Cows are sacred as it was thought to be beneficial to the mother. The umbilical stump would also be dressed in this way. Horrible, horrible, horrible to think that there can't be a much better was of making sure that they got tetanus.

The risk thing will be difficult for you to address, since immunisation is so wide spread. Up to now your ds2 would have been OK, since he was less mobile. The problem comes when they are independent. I know how much my ds loves playing in the dirt, and he seems to always have a cut or a graze, just the sort of thing that could become a lethal problem. True it isn't common, and you can give the jab if an accident happens. But also true is that there is no treatment and you just have to ventilate the patient until they get better, or die.

hey hmb- re-reading your stuff- the americans have an extra booster than us. (a year after first set)

One other thing- why is it that as an adult you can only get boosters every 10 years. I remember something about residual immunity causing an allergic reaction? See I really know nothing about tetanus vaccinations. Aha found some figures- which are even more confusing. Apparently of 430 randomly selected adults over 49 in Aus, only half had antibdy levels high enough to be considered protected- and yet tetanus remains rare. 1993 6 cases in england and wales- all women over 75- (ties in with your figures hmb) - 3 deaths, 1994 3 cases no deaths.

Even a lot of anti vaccination types are fairly relaxed about tetanus vaccination as the toxin is entering the body via its normal route iyswim (for the same reason theyre usually relaxed about oral polio). I'm just scared of losing another little boy. DS2 is so obvioulsy NT and helathy atm. Mind you if the vaccine contains thimerosil then that makes my mind up because I'm more scared of that than his tetanus risk (assuming he could get treatment for a likely looking wound).

Right I'm off to bed- for bad dreams no doubt!

And just before I also go to bed Passive immunisation was used during WW1 which might explain the rates you quoted....but they sound a bit low to me.

hmb- Am I right in thinking that in an open wound the clostridium bacteria will be out-competed by aerobes anyway.

I've aways figured that if ds2 (or ds2 for that matter) was say bitten by a mammal, or trod on the proverbia rusty nail, I could take them to A and E and get some ready made antibodies anyway.

Right bed now.....

Codswallop.... I don't mind my kids getting measles
And considering the society we live in, if they did catch it I would keep them in to ensure no one else gets it - wouldn't want to be considered "unconsiderate" by other mothers

Now I am sure that someone will write to say that measles is contagious before you know your child actually has it. For what it's worth my friend's daughter caught measles at nursery - she is not vaccinated but she got it from a vaccinated child and so did 3 others... so 4 were vaccinated and 1 was not - all 4 got it ! She says taht her DD was the one who has better the fastest.... doesn't necessarily prove anything....

Yes they sound quite low to me as well.... Given the mud and shrapnel wounds etc.

Passive immunisation is an option then...... Hmm in that case not so worried about delaying whilst he's always with me then (so I can see what type of wounds he gets iyswim)

I had measles- and the most fantastic thing is it means I'v had lots of lovely antibodies to give to both ds's when they were babies. I've always been pleased I had measles for that reason.

Actually measles wasn't so bad- I remember it as a golden time from childhood. My friend was off school with whooping cough and we played togther...... She didn't get meales and I didn't get whooping cough.

I had measles too...

Oh no I have a horrible feeling I've started a vaccination debate........ Sorry all.

Thanks for all your help though everyone. I have loads more articles to read now. SueW - I've only had time for a quick browse- but that's great- the most I've ever seen on diptheria- very interesting- thanks!

The problen with the open wound thing is that it is puncture wounds that cause the biggest problem. Keeping them open will help, but you can't guarentee that the very bottom of the would will get enough oxygen to prevent the anaerobes from taking over. The classic tetanus injuries would be the foot in the nail, or a jab from a thorn bush. The top most part will have lots of O2, but the problem is down at the bottom, which might contain the spore (also hard to wash out that bit well enough). The problem gets worse when the wound heals up.

I don't know if passive immunisation is still an option, just hat it was intoduced during ww1.

And you hid the topic so well Jimjams in an innocuous sounding title Only we nosy types found it at first!

Oh I thought they gave you passive immunisation if you hadn't had shot within the last 10 years- I'm sure that's what I used to teach my A level students. The majority of them have gone off to be dr's a well- so hope whatever I taught was right

Everyone will wonder why such an innocent sounding title has so many messages