Unvaccinated US boy almost dies from tetanus in rare case that cost $1m

Parents refuse to let child receive immunisation injections even after surviving Oregon's first case of disease in 30 years

An unvaccinated boy almost died after falling seriously ill with the first case of tetanus in one US state for more than 30 years.

The six-year-old spent two months in hospital with the bacterial illness after suffering a deep cut while playing in a farm in Oregon, according to a case study published by the Centres for Disease Control and Prevention (CDC).

His care cost nearly $1m (£770,000), about 72 times the average for a paediatric hospitalisation in the US, noted the paper, in a case that has alarmed preventative medicine experts.

The unidentified child received an emergency dose of the tetanus vaccine in the hospital, but his parents declined to give him a second dose – or any other childhood immunisation injections – after he recovered.

"When I read that, my jaw dropped. I could not believe it,” said William Schaffner, a professor of infectious diseases at Vanderbilt University School of Medicine in Tennessee. “That's a tragedy and a misunderstanding, and I'm just flabbergasted.”

He added: “This is an awful disease, but ... we have had a mechanism to completely prevent it, and the reason that we have virtually no cases anymore in the United States is because we vaccinate, literally, everyone."

Cases of tetanus have dropped by 95 per cent since widespread vaccination began in the US in the 1940s.

Judith Guzman-Cottrill, the paediatrician who treated the Oregon child, said she had never seen tetanus in a patient before the 2017 case, details of which were made public on Friday.

The boy was rushed to Doernbecher Children's Hospital in Portland with muscle spasms so severe he could not talk, could not open his mouth and was struggling to breathe.

He was unable to drink liquids for 44 days and subsequently required weeks of rehabilitation before he was able to walk, run and ride a bike.

"We had a hard time taking care of this child – watching him suffer – and it is a preventable disease," Dr Guzman-Cottrill said.

Doctors who treated the boy declined to provide any further information about his family, citing medical privacy laws.

Details of the case emerged as politicians in Oregon and Washington consider bills that would end non-medical exemptions for routine childhood vaccines.

The debate comes as the northwest states weather their third month of a measles outbreak. Seventy people, most of them unvaccinated children, have been diagnosed with the highly contagious viral illness in southwest Washington this year. There have also been a handful of cases in Portland.

Unlike measles, which is a virus, a patient who has survived a case of tetanus is not immune and can get the illness again if they remain unvaccinated.

Tetanus is transmitted by bacterial spores found in soil, household dust and human or animal faeces, rather than person-to-person through sneezing or coughing.

Symptoms including muscle spasms, lockjaw, breathing difficulties and seizures typically begin within three to 21 days. The disease can cause severe disability or death.

About 30 people contract tetanus in the US each year, according to the CDC, and 16 people died of the disease between 2009 and 2015. It is rare among children, with those over 65 the most vulnerable.

The CDC recommends a five-dose series of tetanus shots for children between the ages of two months and 6 years, and a booster shot every 10 years for adults.

Health bodies around the globe have voiced concerns about parents refusing to get their children immunised, as well as about myths peddled on social media about the supposed risks of vaccinations.

In January, the World Health Organisation listed the anti-vaccine movement one of the worst threats facing humanity in 2019.

Additional reporting by agencies