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Herpes Zoster — SCE Infectious Diseases MCQ

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HardHIV MedicineHerpes ZosterSCE Infectious Diseases

A farm worker completed an adequate tetanus primary course, but the last dose was 14 years ago. A manure-contaminated puncture wound contains devitalised tissue and is judged high-risk tetanus-prone. What prophylaxis is indicated?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Immediate reinforcing tetanus vaccine plus human tetanus immunoglobulin and wound care

Explanation lettering: E = shown as A · D = shown as B · A = shown as D · B = shown as E

E is correct. For an adequately primed person whose last tetanus dose was more than ten years ago, a high-risk tetanus-prone wound requires an immediate reinforcing vaccine dose and human tetanus immunoglobulin, alongside debridement and appropriate wound management. Priming is not lifelong without schedule completion and boosters. Vaccine alone is insufficient for this high-risk category, immunoglobulin alone does not provide durable immunity, and restarting a full primary series is unnecessary.

Reference: UKHSA Green Book chapter 30: tetanus: https://www.gov.uk/government/publications/tetanus-the-green-book-chapter-30