The Region of the Americas has eliminated maternal and neonatal tetanus (MNT), a disease that used to be responsible for the deaths of more than 10,000 newborns every year in the Americas.

Neonatal tetanus occurs in infants born without protective passive immunity, because the mother is not immune. It usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with an unsterile instrument. Credits: CDC
Neonatal tetanus occurs in infants born without protective passive immunity, because the mother is not immune. It usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with an unsterile instrument.
Credits: CDC

The elimination of the disease was declared this year in Haiti, which made it possible to reach the regional goal. MNT is the sixth vaccine-preventable disease to be eliminated from the Americas, following the regional eradication of smallpox in 1971, poliomyelitis in 1994, rubella and congenital rubella syndrome in 2015, and measles in 2016.

“The elimination of maternal and neonatal tetanus is proof again that vaccines work to save the lives of countless mothers and babies,” said Carissa F. Etienne, director of the Pan American Health Organization/World Health Organization (PAHO/WHO). “Let us continue to protect the people of our Region by investing in strong national immunization programs that are capable of vaccinating all individuals and quickly identifying vaccine-preventable diseases.”

Unlike other vaccine-preventable diseases, MNT is considered eliminated when there is an annual rate of less than one case of neonatal tetanus per 1,000 live births at the district level. Tetanus cannot be fully eradicated because the bacterium that causes the disease, Clostridium tetani, exists throughout the environment in soil and the feces of many different animals.

Before widespread modern vaccination against MNT began in the 1970s, neonatal tetanus was responsible for the deaths of more than 10,000 newborns every year in the Americas – a number considered low by experts due to severe underreporting of cases. According to data from WHO, neonatal tetanus killed about 34,000 newborn children in 2015, a 96% reduction from 1988, when an estimated 787,000 newborn babies died of tetanus within their first month of life.

Neonatal tetanus generally occurs when a newborn’s unhealed umbilical stump is infected with the C. tetani bacterium, particularly when the instrument used to cut the umbilical cord is unsterile, when the surface the baby is born on is unclean, when the hands used to deliver the baby are unclean, or when harmful traditional substances are applied to the umbilical stump. It is often fatal because paralysis prohibits breathing and breastfeeding. It is prevented by immunizing pregnant women against tetanus using the dT or TT vaccine and ensuring clean delivery and post-delivery practices.

Recent progress in global elimination has led to 43 countries, including Haiti, eliminating MNT between 2000 and June 2017. There are 16 countries worldwide that have yet to eliminate the disease.

“Children and their mothers are the most precious treasure that the Americas have. Nurturing their health and their perspective to thrive is the best bet that we as organizations, and we as human community have to building a bright future,” emphasized Maria Cristina Perceval, UNICEF Regional Director for Latin America and the Caribbean.

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