Data
The tetanus surveillance system established by Santé publique France makes it possible to study the epidemiological trends of this vaccine-preventable disease.
Surveillance data on tetanus cases reveal the following epidemiological characteristics:
This disease continues to affect the oldest age groups in the population (between 2012 and 2021, 71% of the 48 reported cases were aged 70 and older)
This disease primarily affects women (66%), who are less well protected than men
In the majority of cases (around 75%), the entry point is a minor wound contaminated with soil or plant debris, but the proportion of cases involving chronic wounds is not negligible (10–20%)
In approximately 10 to 20% of cases, the entry point may go completely unnoticed.
A Decline in the Number of Tetanus Cases in France
There has been a marked decrease in tetanus cases since 1960. In fact, between 1 and 10 cases have been reported each year over the past 10 years, representing an average annual incidence of 0.07 cases per million inhabitants during this period (ranging from 0.02 to 0.15 cases per million inhabitants).
Figure - Tetanus in France from 1960 to 2021: Annual reported cases and deaths
An increase in the number of cases and the mortality rate with age
The average annual incidence rate (per million people) of tetanus increases with age. It is 0.75 among those aged 80 and older, compared to 0.14 among those aged 70 to 79. This incidence rate is also higher among women (0.09) than among men (0.05).
Table - Number of reported tetanus cases* and incidence rate, France as a whole, 2012–2021
| Women | Men | Total | ||||
|---|---|---|---|---|---|---|
| Age groups | Number of cases | Average annual incidence rate (per million) | Number of cases | Average annual incidence rate (per million) | Number of cases | Average annual incidence rate (per million) |
| 0–49 years | 0 | 0 | 3 | 0.01 | 3 | 0.01 |
| 50–59 years | 3 | 0.07 | 3 | 0.07 | 6 | 0.07 |
| 60–69 years | 1 | 0.03 | 3 | 0.09 | 3 | 0.06 |
| 70–79 years | 4 | 0.14 | 3 | 0.13 | 10 | 0.14 |
| 80 years or older | 24 | 0.99 | 4 | 0.31 | 30 | 0.75 |
| TOTAL | 32 | 0.09 | 16 | 0.05 | 52 | 0.07 |
Source: DO, Santé publique France. * Five additional cases (not included in the table) were reported in Mayotte among Comorian nationals. These cases involved four children aged 3 to 8 and a 20-year-old man, all unvaccinated, who had recently arrived in Mayotte or were transferred to the Mamoudzou Hospital after symptoms appeared. All recovered without complications.
Between 2012 and 2021, the overall case-fatality rate was 29% over the period, with a higher rate among those aged 70 and older (35%) compared to those under 70 (14%).
Tetanus Case Fatality Rate by Age, France, 2012–2021
| Individuals under 70 years of age | Individuals aged 70 and older | Total | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Years | Number of cases | Number of deaths | Case fatality rate (%) | Number of cases | Number of deaths | Case fatality rate (%) | Number of cases | Number of deaths | Case fatality rate (%) |
| 2012–2021 | 14 | 2 | 14% | 34 | 12 | 35% | 48 | 14 | 29% |
Source: mandatory reporting, Santé publique France
In relation to
Vaccination
thematic dossier
Contagious diseases most often affect children at a very young age. Because children are particularly vulnerable, they are a priority target for vaccination programs.
