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Presentation
Single vials containing 250 IU human tetanus antitoxin.
Contraindications
Individuals with:
• IgA deficiency – unless they have no circulating anti IgA antibodies.
• Severe thrombycytopenia or coagulation disorder that would contraindicate IM injections.
Precautions
Administer by intramuscular injection. MUST NOT be administered intravenously.
Care should be taken to draw back plunger of syringe before injection to be certain needle is not in a
vessel.
Give with caution to patients with a history of prior systemic allergic reactions to human
immunoglobulin preparations.
Availability
Requests to ARCBS.
What is tetanus?
Tetanus is a painful disease that affects the muscles and can cause breathing problems. In
some situations, it can cause death. It is caused when germs that are found in soil and manure
get into the body through open cuts or burns.
Tetanus immunoglobulin may also be recommended for individuals who are fully vaccinated but who
have a tetanus prone wound which is also heavily contaminated i.e. a wound contaminated with
manure/soil or an abscess in an injection site. In a highly contaminated wound, toxin production can
outpace the capacity of the individual to produce their own antibodies to neutralise the toxins, thus
additional ‘immediate’ antibodies are required.
What should hospitals do for non-emergency cases during the shortage and is this
treatment as effective?
The Department of Health recommends the use of combined tetanus, low dose diphtheria and
polio vaccine (Revaxis), (or the equivalent age appropriate vaccine for young children). This should
be used where tetanus immunoglobulin would normally have been indicated, although this may not
generate a response quickly enough to prevent tetanus at the beginning of the incubation period.
If preferred, hospitals can import tetanus immunoglobulin on the basis of a Clinical Emergency
after the approval by the Medicines and Healthcare products Regulatory Agency.
Before 2003 tetanus generally occurred in older unvaccinated people. Since July 2003 however
cases of tetanus have been occurring in injecting drug users, either due to contaminated drugs or to
contaminated sites of injection and abscesses. Eight cases were officially notified in 2003, 12 in
2004 and 3 in 2005; some additional cases are known to have occurred but were not reported to the
relevant authorities.