Infectious Disease · Public Health · 46 min ago
Rural US Counties Had Higher Tetanus Incidence From 2009 to 2023
A US surveillance analysis examined tetanus incidence across jurisdictions and county characteristics from 2009 through 2023. Incidence was higher in rural areas, including when analyses accounted for social vulnerability; the authors suggest differences in vaccination access, exposure, or post-wound care may contribute.
- Tetanus incidence varied by jurisdiction, reaching 0.20 per million person-years.
- Rural areas had higher incidence than urban areas.
- Health-insurance vulnerability remained associated with incidence after urbanicity stratification.
Researchers analyzed tetanus cases reported to the US National Notifiable Diseases Surveillance System from 2009–2023, combining case data with population estimates, rural–urban classifications, and county-level social vulnerability indices. They assessed incidence by jurisdiction and across measures related to socioeconomic status, insurance, housing, and medical comorbidities.
Jurisdiction-specific incidence ranged from 0 to 0.20 cases per million person-years. Rural areas had higher incidence, including after accounting for social vulnerability. In crude analyses, several vulnerability measures were associated with higher incidence, but most of these trends largely disappeared after stratification by urbanicity. Higher health-insurance vulnerability remained associated with higher incidence within urbanicity strata.
The findings identify geographic associations, not their causes. Differences in vaccination access, environmental exposure, and timely wound care are possible explanations, but were not established by this analysis. The authors call for further work on barriers to vaccination and post-wound care, particularly in rural areas.
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Clinical Infectious Diseases: Geographic Differences Among Tetanus Cases—United States, 2009–2023 ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.