欧洲疾控中心2024年度破伤风流行病学报告

Tetanus Annual Epidemiological Report for 2024 Key facts •In 2024, 73 tetanus cases were reported in the European Union/European Economic Area (EU/EEA),15 of which (21%) were confirmed cases.•The number of cases reported has been increasing since 2020, with 32 cases in 2021, 50 cases in2022, 53 cases in 2022, and 73 cases each in 2023 and 2024.•A higher number of cases were reported among men than women, and adults 65 years and abovewere the most affected age group.•In 2024, 19 fatal tetanus cases were reported (representing 28% of the 67 cases with a knownoutcome), mostly in men over 70 years.•The current epidemiology in the EU/EEA may be explained by lower vaccination coverage and/orwaning immunity among older populations.•Although the EU/EEA population-weighted average vaccination coverage for diphtheria tetanus toxoid andpertussis (DTP3) among one-year-olds remained high for 2024 (92.6%), there was a slight declinecompared with previous years (93.4% in 2020, 93.6% in 2021, 93.4% in 2022, 92.8% in 2023).•Due to the severity of tetanus, there is a need to maintain high vaccination rates in all age groupsand to continue developing and implementing strategies to protect specific groups – particularly theelderly – in countries with higher rates of disease. Introduction Tetanus is a severe disease caused by the neurotoxin of the bacteriumClostridium tetani, which infects throughwounds and thrives in low-oxygen conditions. Unlike other vaccine-preventable diseases, tetanus is not contagiousand can only be contracted through direct contamination with spores found in soil, dust and faeces. The neurotoxinaffects the nervous system, leading to muscle rigidity and spasms. The disease presents in three forms:generalised, localised, and cephalic, with generalised being the most common. Vaccination is the primary prevention method, significantly reducing incidence in regions with comprehensiveimmunisation programmes. Tetanus remains a concern in areas with inadequate vaccination, especially affectingnew-borns and mothers. Treatment involves immunoglobulin, antibiotics and wound care, but once the toxin bindsto neurons it cannot be neutralised. Despite the decline in cases in Europe, maintaining high vaccination coverage,especially among the elderly and high-risk groups, is essential. Methods This report is based on data for 2024 retrieved from EpiPulse Cases on 18 March 2026. EpiPulse Cases is a systemfor the collection, analysis and dissemination of data on communicable diseases that replaced The EuropeanSurveillance System (TESSy) in October 2024. For a detailed description of the methods used to produce this report, refer to the Methods chapter of the ‘ECDCAnnual Epidemiological Report’ [1]. An overview of the national surveillance systems is available online [2]. A subset of the data used for this report is available and downloadable through ECDC’s online ‘Surveillance Atlas ofInfectious Diseases’ [3]. For 2024, 27 EU/EEA countries reported data on tetanus cases to EpiPulse Cases. All countries except Belgium,Denmark, France, Italy and Romania reported data on cases of tetanus in accordance with the 2008, 2012 or 2018EU case definitions. Denmark, France, Italy and Romania used other cases definitions and Belgium did not specifythe case definition [2,4]. Most countries reported case-based data from comprehensive and passive surveillance systems with nationalcoverage; Bulgaria reported aggregated data. Tetanus is not under surveillance in Finland. Germany has neverreported tetanus data to ECDC, and Austria last reported tetanus data to ECDC in 2011. Vaccination coverage estimates presented in this report were obtained from the World Health Organization (WHO)Immunization Data Portal/United Nations Children’s Fund (UNICEF) Estimates of National Immunization Coverage(WUENIC) [5]. Vaccination coverage is defined as the percentage of one-year-olds who have received three dosesof the combined diphtheria, tetanus toxoid, and pertussis vaccine in a given year. The method for calculating thisindicator is outlined in the metadata, which is available online [5]. Epidemiology In 2024, 27 EU/EEA countries reported 73 tetanus cases, which is the same number as in 2023 but higher than the53 cases reported in 2022. Of these, 15 cases (21%) were classified as confirmed and 58 (79%) as probable. Italyreported the highest number, accounting for 38% of all cases (Table 1, Figure 1). Spain, Poland and Romaniaaccounted for a further 38% of all notified cases. Sixteen countries reported zero cases (Table 1, Figure 1). Since2020, an upward trend has been observed in number of reported cases. In 2023 and 2024, case numbersremained stable, at levels higher than those observed in the previous three years (2022: 53 cases; 2021: 50; 2020:32) which had probably been affected by the COVID-19 pandemic. The crude EU/EEA notification rate was 0.03 cases per 100 000 population, which is within the range that has beenreported since 20