It was the first instance of the life-threatening neuromuscular disease in a child in OR in more than three decades. He had to wear earplugs and the medical staff had to keep his room as dark and as quiet as possible to prevent any stimulation, which may trigger spasms.
Doctors diagnosed the six-year-old boy with tetanus and administered a dose of the vaccine, but it took 57 days in a hospital, including 47 days in intensive care, to restore his health.
He also suffered "arching of the neck and back" and "generalized spasticity", according to the report.
OR is one of 17 states that allow personal and philosophical exemptions from vaccines, which permit individuals who hold conscientious objections to one or more shots not to get them or let their children get them.
Amid outbreaks of preventable childhood illnesses, one unvaccinated OR boy's nightmarish encounter with tetanus should serve as a cautionary tale for "anti-vaxxer" parents, doctors say. His scalp wound was cleaned by medical professionals.
It was the first time that Dr. Judith Guzman-Cottrill, the pediatric infectious disease expert who treated the child, had ever seen tetanus because of widespread vaccination against it in the U.S.
On day 54, his tracheostomy was removed.
The child's 57-day hospital stay cost the family US$811,929 but it excluded air transportation, inpatient rehabilitation and ambulatory follow-up costs.
"It was hard to take care of him, to watch him suffer", says Judith Guzman-Cottrill, a pediatric infectious-disease physician who co-authored the article in the CDC's online journal Morbidity and Mortality Weekly Report.
Case study co-author Dr. Carl Eriksson, an assistant professor of pediatric critical care at Oregon Health & Science University, who was involved in the boy's treatment, wrote in an email to TIME that severe tetanus cases are very rare in the US, where vaccination effectively prevents such conditions.
An image taken in 1995 and released by the Centers for Disease Control shows a group of Clostridium tetani bacteria, responsible for causing tetanus in humans.
"Despite extensive review of the risks and benefits of tetanus vaccination by physicians, the family declined the second dose of DTaP and any other recommended immunizations", the CDC report stated. Throughout history, the disease was sometimes referred to as "lockjaw" because of the cramping of the jaw muscles that occur with its onset.
Doctors gave the child a diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) during the course of his eight-weeks of treatment, which the CDC estimated to cost over $800,000. Other symptoms include stiff neck and abdominal muscles, difficulty swallowing, and painful, involuntary muscle spasms.
"The CDC report says tetanus vaccines have contributed to a" 95 percent decline in the number of tetanus cases and a 99 percent decrease in the number of tetanus-related deaths since the 1940s".
But with tetanus, that's not the case. Children aged four through six years old should receive a booster shot. According to the World Health Organisation, "vaccine hesitancy" is one of the top 10 threats to global health this year.
The good news: The boy survived his vaccine-preventable ordeal and seems to have fully recovered, running and bicycling again as might any child his age. "Vaccination is one of the most cost-effective ways of avoiding disease - it now prevents 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved".