the population-based background incidence reported by Beghi et al. of 1.64 per 100,000 per year, or 0.14 per 100,000 per month, the one-month attributable incidence (excess risk) can be estimated as 0.5 to 1 case per 100,000 tetanus toxoid recipients.

Conclusion

The evidence is inadequate to accept or reject a causal relation between tetanus toxoid, DT, or Td and peripheral mononeuropathy (other than those caused by direct intraneural injection).

The evidence favors acceptance of a causal relation between tetanus toxoid and brachial neuritis.

If the evidence favors acceptance of a causal relation between tetanus toxoid and brachial neuritis, then in the committee's judgment the evidence favors acceptance of a causal relation between DT and Td and brachial neuritis. The relative risk for brachial neuritis following vaccination with tetanus toxoid-containing vaccines can be estimated as on the order of 5 to 10 and the one-month attributable incidence (excess risk) on the order of 0.5 to 1 case per 100,000 tetanus toxoid recipients.

Risk-Modifying Factors

None.

ARTHRITIS

Clinical Description

Arthritis is inflammation of one or more joints detectable as swelling, redness, and tenderness. Arthralgia is pain in a joint or joints. According to the 1988 National Health Interview Survey, approximately 13 percent of respondents surveyed reported currently having "arthritis of any kind or rheumatism." Prevalence rates increased with age, with approximately 0.2 percent of persons under age 18 years reporting arthritis of any kind or arthralgia.

History of Suspected Association

None.



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