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Tetanus

Tetanus

Tetanus is serious ailment of the nervous system caused by a toxin producing bacteria known as Clostridium tetani. Commonly known as lockjaw, tetanus causes contraction of muscles, particularly of the jaw and neck. Since there is no cure for tetanus, it can be life-threatening, and treatment is focused on symptom management.

However, because of widespread use of vaccines, it is a forgotten disease in the developed countries. But in developing countries like India, the prevalence of tetanus and resulting mortality remains to be high.

Tetanus does not spread from person to person.

What are the symptoms of tetanus?

Average time for the symptoms to appear from infection is approximately 10 days.

The most common type of tetanus is generalized tetanus where symptoms begun gradually and worsen over weeks . Tetanus is suspected if a cut or a wound is followed by one or more symptoms:

  • Difficulty in swallowing
  • Fever
  • Sweating
  • Stiffness of the neck or jaw accompanied by a sneering or grinning expression.
  • Uncontrollable contractions of the jaw, called lockjaw, and of the neck muscles
  • Contraction of other muscles that are painful

The other symptoms that might develop as diseases progresses are:

  • High blood pressure
  • Low blood pressure
  • Rapid heart rate
  • Fever

The other form of tetanus is localized and cephalic tetanus.Localized tetanus is generally at the site of infection and is less severe while cephalic is due to a head wound.

What are the causes of tetanus?

Tetanus causing bacterium is called Clostridium tetani. This bacteria survives in a dormant state in soil until it discovers a place to multiple and live. This dormant bacteria, upon entering a wound, grows and divides and release a toxin that impairs the nerves that control muscles in the body.

What are the risk factors of tetanus?

The biggest risk factor is not getting vaccinated or not keeping up with booster shots.

Factors that increase the risk of tetanus infection are:

  • Cuts or wounds that are exposed to soil
  • Getting hurt by a foreign body such as rusty nail, needle injection sites, burns, splinters
  • Previous history of Immune-suppressing medical conditions
  • Skin lesions diabetic patients that are infected
  • An infected umbilical cord in a mother who wasn’t fully vaccinated

How can tetanus be prevented?

Tetanus can be prevented by vaccination and a good wound care.

Vaccination in children:

Tetanus vaccine is given a part of a combination with diphtheria and pertussis (DPT). Generally five vaccines are given to children over course of time in arm or thight. These are at ages – 2 months, 4 months, 6 months, 15 to 18 months and 4 to 6 years.

Booster shots is given to children at age 11 or 12. Adults may be given the booster shot once in every 10 years and it is recommended in the third trimester of pregnant women irrespective of their vaccination schedule.

Good wound care:

Immediate and good wound care may also help prevent infection. Remember these tips:

  • Apply first aid to any blisters, cuts, scrapes or break in skin, even if minor.
  • Wash hands soap and water as often as possible or sanitize your hand if washing is not possible at the time.
  • Don’t hesitate to consult the doctor and take advice in case of doubts.

References

  1. Marulappa VG, Manjunath R, Mahesh Babu N, Maligegowda L. A Ten Year Retrospective Study on Adult Tetanus at the Epidemic Disease (ED) Hospital, Mysore in Southern India: A Review of 512 Cases. J Clin Diagn Res. 2012 Oct;6(8):1377-80.
  2. Tetanus. January 2024. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/tetanus/symptoms-causes/syc-20351625
  3. Tetanus. January 2024. Centers for Disease Control and Prevention. https://www.cdc.gov/tetanus/about/prevention.html
  4. Tetanus. January 2024. WebMD. https://www.webmd.com/children/vaccines/understanding-tetanus-basics

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