Tetanus

Tetanus is a rare but serious condition which is caused by a type of bacteria that gets into wounds. It can become fatal if treatment is not taken on time. It primarily affects your nervous system leading to muscle contractions that are painful. In India, it is estimated that fewer than one million people are affected by tetanus.

Tetanus is a medical emergency and requires aggressive treatment. Thankfully, tetanus can be prevented by the use of vaccine called tetanus toxoid. However, the effect of vaccine does not last permanently, you may require booster shots for every 10 years.

Tetanus symptoms usually occur within 4 to 21 days (an average of 10 days) after infection. The main symptoms of tetanus include:

  • stiffness in jaw and neck muscles which makes it difficult to open your mouth
  • painful muscle spasms that cause difficulty in swallowing and breathing
  • unusual sweating
  • a rapid heartbeat (tachycardia)
  • a high body temperature of 38oC (100.4oF) or above

The bacterium which causes tetanus is Clostridium tetani. It is commonly found in soil and the fecal excreta of cows and horses. It can stay alive for a long time outside the body. If you’re infected, the bacteria enter your bloodstream through the wound and multiply quickly. The toxins released by these bacteria affect the nerves, producing symptoms such as muscle stiffness and spasms.

Tetanus infection can occur when there are

  • burns
  • cuts and scrapes
  • tears or splits in the skin
  • eye injuries
  • injection of contaminated drugs
  • insect or animal bites

Tetanus is not contagious, i.e. it does not spread from person to person.

Most of the cases of tetanus are recorded in people who do not get vaccinated. Missing either an initial immunization or a booster dose can increase the risk.

You are also more likely to have tetanus if you have an injury that paves the way for the entry of the bacterial spores. Use of illegal drugs is another risk factor for tetanus infection.

Based on your symptoms, your physician will ask about your medical history and performs a physical examination. A laboratory test may not help to diagnose tetanus. But to rule out the other conditions with similar symptoms, lab tests may be performed.

If you are at risk of developing tetanus but do not have any associated symptoms, then your doctor will clean the wounds and give you tetanus immunoglobulin injection. Also, a dose of tetanus vaccine will be given if you haven’t taken one in the past.

If your doctor suspects tetanus, then you will be admitted to the intensive care unit (ICU) and the following tetanus treatment is provided:

  • antibiotics such as penicillin to kill the bacteria
  • tetanus injection containing immune globulin to neutralize the bacterial toxins
  • muscle relaxants to relieve muscle spasms and stiffness
  • a ventilator to support breathing

The serious health complications that can result due to severe muscle spasms associated with tetanus are:

  • breathing problems as a result of spasms of the vocal cords
  • abnormal heart rhythms
  • brain damage due to poor oxygen supply
  • secondary infections due to extended stay in the hospital
  • pneumonia (an infection of the lungs)
  • bone fractures

You may take some steps for the prevention of tetanus infection when you have a wound, such as:

  • Applying pressure to control bleeding
  • Keeping the wound clean
  • Using antibiotics
  • Covering the wound
  • Regularly changing the dressing

Vaccination is the only way to prevent tetanus infection. The tetanus vaccine in children is administered along with diphtheria and acellular pertussis (DTaP) vaccine. It is administered at the ages of two months, four months, six months, 15 to 18 months, and four to six years.

The booster shots of tetanus vaccine are given in combination with diphtheria vaccine (Td). It is administered at the ages of 11 and 12, and then a TD booster after 10 years.