Tetanus in refugee patients: Two cases and review of the literature

Tetanus is a rare but potentially fatal disease, caused by Clostridium Tetani. This microorganism is very common in the environment and may be transmitted through open wounds.1 Immunization and proper wound care are the best ways of prevention of tetanus.2 Mortality caused by tetanus can vary between 10 and 80% in non-immunized individuals, especially in both extremes of age.2 Full immunity against the disease may not be achieved in all hosts even if the primary vaccination is completed.1 Having said that studies confirm the non-immunized individuals who have got infected with tetanus have a more severe disease compared to immunized population and they have a higher rate of mortality.1,3 Tetanus represents a great risk for unregistered refugees, populations who implement anti-vaccination, and people who live in areas which are not covered by a vaccination program. In this case series, we aim to highlight the increasing frequency of tetanus by discussing two fatal cases seen in unvaccinated, unregistered refugees whose numbers are recently growing.