A woman died from tetanus after she tripped in the garden and severely cut her face.

Sheila Creighton died from the disease which is so rare that there are only a handful of cases every year in the UK.

An inquest heard yesterday that in 1999 there were only three cases - and only one fatality.

Mrs Creighton had to have 22 stitches when she was taken to hospital by her husband Ronald after tripping in the garden, the inquest was told.

Mrs Creighton, 61, told hospital doctors that she had a tetanus booster in 1995, but prior to that she had had nothing for 20 years to protect her against the rare disease.

Doctors at Dewsbury District Hospital believed she was fully immune from the disease.

But just a week later Mrs Creighton, of Liversedge, returned to hospital complaining of numbness in her face and suffering pain when opening her mouth.

Doctors sent her to Pinderfields Hospital in Wakefield for treatment after believing she may have cut her face on a rose bush, but once there she began having spasms and suffered facial paralysis.

On April 10 last year, Mrs Creighton collapsed in a toilet at the hospital and was transferred to the intensive care unit with major breathing problems.

The Huddersfield inquest heard how doctors diagnosed her as suffering from tetanus, but Mrs Creighton, of Milton Road, died just a month after the fall.

A post mortem revealed she died from bronchial pneumonia and brain damage, caused by lack of oxygen to the brain, due to a tetanus infection following wound contamination.

"Tetanus is a very widespread organism in any country," said pathologist, Dr Patricia Gudgeon. "It's a contaminant in soil and it's very likely for a wound to be contaminated. The effect of tetanus isn't infection - it's a toxin organism produced which has an effect on the nervous system causing rigidity and spasm. It also causes difficulty in swallowing, spasms of the larynx and the possibility of respiratory arrest. It is a very rare disease - there are less than 30 cases a year and fatality is extremely rare in this country. I haven't seen a case before in my 20-plus years experience."

Mrs Creighton's GP's records later revealed that she had not had a booster from her doctor's surgery in 1995, but was tetanus immune in 1991.

Dr Edward Walker, who examined Mrs Creighton, said he knew she had fallen in the garden but not in soil. Her wound did not display any signs of a tetanus-prone injury and he never considered it.

He said Department of Health guidelines stated that anyone with an up-to-date course of immunisation and a booster in the last ten years was regarded as tetanus immune.

A number of doctors who examined Mrs Creighton at both Dewsbury and Pinderfields hospitals also failed to diagnose tetanus because it was felt her symptoms could have been caused by the cut becoming infected. None of them had ever encountered a case of the disease in England before.

In recording a verdict of accidental death, Coroner Roger Whittaker said he did not criticise doctors who had treated Mrs Creighton.

He said he would recommend to the Department of Health the introduction of a medical card - to be carried by a patient - on which all their immunisation details could be recorded by electronic chip.

Speaking after the inquest, Mrs Creighton's daughter Janet, 40, said: "This is still a complete shock. Mum was very well liked - about 150 to 200 people attended her funeral last May. She was a very sociable person who loved her bingo and worked locally all her life.

"It was a complete shock to find she had tetanus and we want everyone to now be aware that it can happen and to check that their immunisation is up-to-date. We never thought it would happen to our family and it has, so people need to be aware of how up-to-date their injections are."

Mr Creighton said: "The verdict of the inquest was satisfactory and they did what they had to do at the hearing."