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JAMA. 2002;288:1710-1711.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

MMWR. 2002;51:613-615

During February-May 2002, the Puerto Rico Department of Health (PRDOH) received reports of three tetanus cases, two of which were fatal. The last reported case of tetanus in Puerto Rico had occurred in 1999. This report summarizes the investigations of these three cases, which underscore that health-care providers should ensure that all patients have been vaccinated fully against tetanus.^1-2

Case Reports

Case 1

On December 19, 2001, a man aged 86 years with a history of hypertension and coronary artery disease (CAD) sustained a splinter in his right hand while gardening. On December 22, the patient saw a physician for wound care. At that time, he was not treated with either a tetanus toxoid vaccine or prophylactic tetanus immune globulin (TIG). His tetanus vaccination history was not documented in the medical record; he had no history of military service.

On December 26, the patient received treatment for pharyngitis from a . . . [Full Text of this Article]

Case 2

Case 3