Tetanus
Introduction
Tetanus is a serious bacterial disease that leads to stiffness of your jaw muscles and other muscles. It can cause severe muscle spasms, make breathing difficult and, ultimately, threaten your life.
A cut, puncture wound, laceration or other wound can lead to a tetanus infection and toxin production if you don't have immunity. Spores of the tetanus bacteria, Clostridium tetani, usually are found in the soil, but can occur virtually anywhere. If deposited in a wound, the bacteria can produce a toxin that interferes with the nerves controlling your muscles.
Treatment for tetanus is available, but the process is lengthy and not uniformly effective. Tetanus may be fatal despite treatment. The disease is rare in the United States, with less than 100 cases of tetanus reported annually. The best defense against tetanus is prevention.
Signs and symptoms
Signs and symptoms of tetanus may include:
- Stiffness of your jaw, neck and other muscles
- Muscular irritability
- Spasms of your jaw, neck and other muscles
- Fever
Signs and symptoms of tetanus may appear anytime from a few days to several weeks after an injury. The incubation period for the disease is usually between three days and three weeks, with an average of eight days.
Causes
The bacteria that cause tetanus, Clostridium tetani, are found in soil, dust and animal feces. When they enter a deep flesh wound, spores of the bacteria may produce a powerful toxin, tetanospasmin, which acts on various areas of your nervous system. The effect of the toxin on your nerves can cause muscle stiffness and spasms — the major signs of tetanus.
Treatment
Treatment may include use of a tetanus antitoxin, such as tetanus immune globulin (TIG). However, the antitoxin can neutralize only toxin that hasn't yet combined with nerve tissue. Your doctor may also give you antibiotics, either orally or by injection, to fight tetanus bacteria. You'll also need to receive a tetanus vaccine in order to prevent future tetanus infection.
Tetanus infection often requires a long period of treatment in an intensive care setting. You may need drugs to sedate you and to paralyze your muscles, and that may result in shallow breathing that needs to be supported temporarily by a ventilator.
In most cases of tetanus, the illness is severe and widespread, and there's a risk of death despite treatment. Death may result from constriction of airways, pneumonia or instability in the autonomic nervous system. The autonomic nervous system is the part of your nervous system that controls your heart muscles, other involuntary muscles and glands.
People who've had tetanus often recover completely. However, some people have lasting effects, such as brain damage caused by a lack of oxygen when muscle spasms in the throat cut off the airway.
Prevention
You can easily prevent tetanus by being immunized against the toxin. Almost all cases of tetanus occur in people who've never been immunized or who haven't had a tetanus booster shot within the preceding 10 years.
The vaccine
The tetanus vaccine usually is given to children as part of the diphtheria and tetanus toxoids and pertussis (DTP) shot. This vaccination provides protection against three diseases: diphtheria (a throat and respiratory infection), pertussis (whooping cough) and tetanus. The latest version of this immunization is known as the diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine.
The DTaP vaccine consists of a series of five shots, typically administered in the arm or thigh and given to children at ages:
- 2 months
- 4 months
- 6 months
- 15 to 18 months
- 4 to 6 years
It's recommended that adolescents get a booster shot between the ages of 11 and 18, and that adults receive a routine tetanus booster shot every 10 years. If you're traveling internationally, it's a good idea to have up-to-date immunity against tetanus because tetanus may be more common where you're visiting, especially if you're traveling to a developing country. If you receive a deep or dirty wound and it has been more than five years since your last booster shot, get another booster shot.
A booster of the tetanus vaccine is typically given in combination with a booster of diphtheria vaccine. Recently, pertussis vaccine has been added to this routine combination immunization to ensure that adults and adolescents are fully protected against pertussis. This combination vaccine is referred to as Tdap, and it's approved for use in teens and adults. In order to stay up-to-date with all of your vaccinations, request that your doctor review your vaccination status on a regular basis.
Having had a tetanus infection doesn't provide immunity. Following recommendations for vaccinations is necessary to prevent recurrence of tetanus. If you were never vaccinated against tetanus as a child, see your doctor about getting the Tdap vaccine. You can't get a tetanus infection from the vaccine.
Taking care of a wound
If you have a wound, these steps will help prevent you from contracting tetanus:
- Keep the wound clean. Rinse thoroughly with clean water. Clean the wound and the area around it with soap and a washcloth. If debris is embedded in a wound, see your doctor.
- Consider the source. Puncture wounds or other deep cuts, animal bites or particularly dirty wounds may put you at increased risk of tetanus infection. Call your doctor if the wound is deep and dirty, and particularly if you're unsure of your immunization status. Your doctor may need to clean the wound, prescribe an antibiotic and give you a booster shot of the tetanus toxoid vaccine. If you've previously been immunized, your body should quickly make the needed antibodies to protect you against tetanus.
- Use an antibiotic. After you clean the wound, apply a thin layer of an antibiotic cream or ointment, such as the multi-ingredient antibiotics Neosporin or Polysporin. These antibiotics won't make the wound heal faster, but they can discourage bacterial growth and infection and may allow your body to close the wound more efficiently. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment.
- Cover the wound. Exposure to the air may speed healing, but bandages can help keep the wound clean and keep harmful bacteria out. Blisters that are draining are vulnerable; keep them covered until a scab forms.
- Change the dressing. Applying a new dressing at least once a day or whenever the dressing becomes wet or dirty may help prevent infection. If you're allergic to the adhesive used in most bandages, switch to adhesive-free dressings or sterile gauze and paper tape
Informations obtained from National Institute of Health.