Reporting & Investigation of Tetanus

Table of Contents

A. Purpose of Surveillance and Reporting

To assure early evaluation and, where appropriate, treatment with tetanus-diphtheria toxoid (Td) and/or tetanus immune globulin (TIG) and hospitalization.
To identify groups and areas in which risk of disease is highest (due to under-immunization, occupation, other practices, etc.) to initiate prevention efforts, such as catch-up vaccination.

B. Laboratory and Healthcare Provider Reporting Requirements

Iowa Administrative Code 641-1.3(139) stipulates that the laboratory and the healthcare provider must report. The preferred method of reporting is by utilizing the Iowa Disease Surveillance System (IDSS).  However, if IDSS is not available to your facility the reporting number for IDPH Center for Acute Disease Epidemiology (CADE) is (800) 362-2736; fax number (515) 281-5698, mailing address:

Iowa Department of Public Health, CADE
Lucas State Office Building, 5th Floor
321 E. 12th Street
Des Moines, IA 50319-0075

Postage-paid disease reporting forms are available free of charge from the IDPH clearinghouse. Call (319) 398-5133 or visit the website: healthclrhouse.drugfreeinfo.org/cart.php?target=category&category_id=295  to request a supply.

C. Local Public Health Agency Follow-up Responsibilities

With assistance from the hospital infection preventionist, complete an investigation using the Iowa Disease Surveillance System (IDSS).  The following data are epidemiologically important and should be collected in the course of case investigation. Additional information may be collected at the direction of IDPH.

  • Demographic information: Name, Address, State of residence, Date of birth, Age, Sex, Ethnicity, Race, Occupation
  • Reporting Source: County, Earliest date reported
  • Clinical: Hospitalization and duration of stay, Date of onset of symptoms, Type of tetanus disease, Wound location and management, Complications, Pre-existing conditions (e.g., diabetes, chronic otitis media), Outcome (case survived or died), Date of death
  • Treatment: Prophylaxis with Td and TIG, Date started,
  • Vaccine Information: Dates of vaccination (prior tetanus toxoid history including Td, Tdap, etc), Time since last dose of tetanus-containing vaccine, Manufacturer of vaccine, Lot number, If not vaccinated, reason
  • Epidemiological: Risk factors for disease such as history of a wound or injury, recent injection drug use, tattooing, or body piercing

For neonatal cases, maternal country or origin and number of years of residence in the U.S.