Abstract：
Horses are exquisitely sensitive to tetanus neurotoxin and are exposed to the risk of infection with Clostridium tetani throughout life. The vaccine against tetanus is highly effective at preventing disease, whereas tetanus in unvaccinated populations is associated with high mortality rates. Current guidelines in New Zealand and Australia for the available vaccine contain contradictions and limitations surrounding the optimal tetanus immunisation protocols for both adult horses and foals. This review critically evaluates the scientific literature on tetanus prophylaxis in horses within the context of equine practice and available products in New Zealand and Australia. The review was conducted by a panel of industry and specialist veterinarians to obtain agreement on nine equine tetanus prophylaxis guidelines for practising veterinarians. The primary protocol for tetanus toxoid (TT) immunisation consists of a three-dose series IM for all horses ≥ 6 months of age, and a four-dose series IM is proposed if commencing vaccination in foals between 3 and 6 months of age. Tetanus prophylaxis in foals < 3 months of age relies on passive immunity strategies. Following the completion of the primary protocol, a TT booster dose IM should be administered within 5 years, and every 5 years thereafter. When followed, these protocols should provide adequate protection against tetanus in horses. Additional tetanus prophylaxis guidelines are provided for veterinarians attending a horse experiencing a known \"risk event\" (e.g. wound, hoof abscess, surgery, umbilical infection). When a correctly vaccinated horse experiences a risk event, pre-existing immunity provides protection against tetanus. When an unvaccinated horse or one with unknown vaccination status, or a foal born to an unvaccinated dam, experiences a risk event, TT IM and tetanus antitoxin (TAT) 1,500 IU SC should be administered simultaneously at separate sites, and the TT primary immunisation protocol should subsequently be completed for the horse\'s respective age. In previously immunised pregnant broodmares, a TT booster dose administered 4-8 weeks prior to parturition optimises the transfer of passive immunity against tetanus to the newborn foal via colostrum; provided that post-natal IgG concentration in serum is > 800 mg/dL (8 g/L), such foals should be passively protected against tetanus up to 6 months of age. Survivors of clinical tetanus must still receive the primary protocol for vaccination against tetanus. In summary, all horses in New Zealand and Australia should be vaccinated against tetanus with protection maintained throughout life via TT booster doses, facilitated by accurate medical record keeping and client education.
摘要：
马对破伤风神经毒素非常敏感，并且一生都有感染破伤风梭菌的风险。破伤风疫苗在预防疾病方面非常有效，而未接种疫苗人群中的破伤风与高死亡率相关。新西兰和澳大利亚目前关于可用疫苗的指南包含围绕成年马和马驹的最佳破伤风免疫方案的矛盾和限制。这篇评论在新西兰和澳大利亚的马实践和可用产品的背景下，严格评估了有关马匹破伤风预防的科学文献。这项审查是由一个行业和专业兽医小组进行的，目的是就执业兽医的九种马破伤风预防指南达成协议。破伤风类毒素（TT）免疫的主要方案包括所有≥6月龄马的三剂量系列IM，如果在3至6个月大的小马驹中开始接种疫苗，则建议进行四剂量系列IM。<3月龄小马驹的破伤风预防依赖于被动免疫策略。主协议完成后,应在5年内施用TT加强剂量IM，此后每5年。当跟随时，这些方案应提供足够的保护，防止马的破伤风。为参加经历已知“风险事件”的马的兽医提供了额外的破伤风预防指南(例如，蹄脓肿,手术,脐带感染）。当正确接种疫苗的马经历风险事件时，预先存在的免疫力可以预防破伤风。当未接种疫苗的马或接种疫苗状态未知的马，或者出生在未接种疫苗的大坝上的小马驹，经历风险事件，TTIM和破伤风抗毒素（TAT）1,500IUSC应在不同的地点同时施用，随后应完成马各自年龄的TT初次免疫方案。在以前免疫的怀孕的育母中，分娩前4-8周给予的TT加强剂量优化了对破伤风的被动免疫通过初乳转移到新生马驹;前提是出生后血清中的IgG浓度>800mg/dL（8g/L），这种小马驹应该在6个月大的时候被动地预防破伤风。临床破伤风的幸存者仍必须接受针对破伤风的疫苗接种的主要方案。总之,新西兰和澳大利亚的所有马匹都应接种破伤风疫苗，并通过TT加强剂量在整个生命中保持保护，通过准确的医疗记录保存和客户教育。
