<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>mamakay</strong> <a href="/community/forum/post/10342585"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">But you can extrapolate this one increased risk of poor circulation in diabetics to poor circulation in the elderly.</div>
</td>
</tr></table></div>
Sure. You can treat "poor circulation" as a gradient, with the most severe vascular complications of diabetes at the far end. But starting from "normal circulation" and moving toward that far end, you cross a binary threshold: the point at which it begins to result in open sores. Whatever decrease in circulation exists below that threshold can be ignored as far as tetanus incidence is concerned, because it isn't going to impact that directly. If you want to talk about <i>indirectly</i>, then fine, but it's going to get hairy. You're going to be talking about increased risk for accidents, and diabetes (as well as plain old age itself) can impact that in lots of ways: poorer vision, poorer sense of balance...<br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Yes, lots of elderly people and diabetics don't develop tetanus.</td>
</tr></table></div>
Right. They don't develop open sores or get poked with anything.<br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">That the incidence in children was higher than it was in the elderly?</td>
</tr></table></div>
Demography is a science in itself. In considering the risk factors for tetanus, you might begin with vax status, or you might begin by considering the risk factors for certain types of injury -- but you can't ignore either one, no matter where you start. Are children and the elderly equally at risk for puncture wounds or deep lacerations? I don't feel qualified to answer that, but I'd be willing to guess that they're not.<br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">But I think poor circulation adds an additional risk (along with declining immune system functioning) to that age group.</td>
</tr></table></div>
Immune function as it relates to tetanus infection is a bit of a special case. As with any infectious disease, immune response does not take place until the pathogen has proliferated enough to become visible to the immune system. With tetanus, the problem is that one of the toxins produced by the bacterium is lethal to humans in doses as small as 2.5 nanograms per kilogram of body weight, and is produced (in vitro) in amounts up to 5 to 10% of the bacterial weight. For this reason, previous infection is not associated with immunity to the disease; if the illness progresses far enough to trigger an immune response, it kills you.<br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">How many is it that don't (practically or otherwise) exist?</td>
</tr></table></div>
Okay, OKAY. Sheesh. I noticed your math error when you first put it up, and roughly calculated that I had used "practically nonexistent" to refer to maybe several million kids. That goes beyond what I'd accept as hyperbole, but rather than retract, I chose to let your math error stand. I might be able to justify a thing like that if it were somebody else, but you deserve better (after all, you have dutifully pointed out <i>every single error</i> you've ever caught me making, as far as I can tell, and I owe it to you to reciprocate). I wish I had a more dignified way out of it, but I don't see any choice but to apologize for my crime of omission and retract my "<i>practically nonexistent</i>". It was a poor choice of words, and I give up on trying to defend it. I don't know precisely how many U.S. children are unvaccinated against tetanus. I think there's about eighty million kids altogether, so if it's five percent, that would be roughly four million. I can't stretch "practically nonexistent" to fit around that.