Tetanus is a serious and possibly fatal disease caused by spores of Clostridium tetani bacteria. Muscle spasm and rigidity (muscles becoming stiff) is the characteristic feature of tetanus. Currently there is no cure for tetanus. Treatment o
Tetanus is a serious and possibly fatal disease caused by spores of Clostridium tetani bacteria.
People of all ages can get tetanus, right from newborn to elderly. The disease is often more serious in newborn babies and most infants with the disease die. When tetanus affects a newborn, it is called neonatal tetanus.
How is tetanus spread?
Tetanus is not contagious, i.e. it is not transmitted from person to person. A person usually becomes infected with tetanus when a wound is contaminated with dirt. Clostridium tetani spores are present ubiquitously, but are found most commonly in soil, dust and manure. The spores can survive for a long time outside of the body. If deposited in a wound, the spores multiply rapidly and produce a neurotoxin that interferes with nerves that control muscle movement.
When tetanospasmin produced at the site of injury enters the bloodstream, it rapidly spreads around the body and causes tetanus symptoms. The toxin tetanospasmin affects the signals sent from the brain to the nerves in the spinal cord, and then on to the muscles. It causes muscle spasms and stiffness.
Wounds at risk of getting infected with tetanus germs are:
- Deep puncture wounds caused by dirty nails, knives, tools, wood splinters (especially if contaminated with that manure or soil) and animal bites.
- Any wound that needs surgical intervention and that is delayed for more than six hours.
- Any burn wound that needs surgical intervention and that is delayed for more than six hours.
- A wound or burn with significant amount of dead tissues which have to be removed.
- Open bone fractures (fracture in which bone comes out of skin). In these wounds the bone is exposed to infection.
- Wounds/burns in patients with systemic sepsis.
Women are at risk of infection if contaminated instruments are used during delivery or during an abortion. A newborn baby is at risk of tetanus if contaminated knife, razor, or other instrument is used to cut its umbilical cord, or if dirty material is used to dress the cord.
Symptoms of tetanus usually start about 10 days after initial infection. Symptoms tend to be more severe in patients with shorter incubation periods.
Muscle spasm and rigidity (muscles becoming stiff) is the hallmark feature of tetanus. Spasm usually starts in chewing muscles, hence the disease is also known as lockjaw. With progression of disease, muscle spasms spread to the neck and throat, causing dysphagia (difficulty in swallowing) and to other muscles. Involvement of the trunk muscle causes characteristic arching of the back known as opisthotonus. In some cases the muscle spasms may be intense enough to cause fracture of bones and dislocation of joints. Breathing difficulties may be caused because of spasm of vocal cords, or neck and chest muscle.
Other symptoms which occur in tetanus include:
- bloody in stools (feces)
- sensitivity to touch
- sore throat
- tachycardia (rapid heartbeat).
Currently there is no cure for tetanus. Treatment of tetanus involves:
- wound care (includes removing dirt, foreign objects and dead tissue from the wound)
- antibiotics (such as penicillin and metronidazole to kill the bacteria),
- TIG (tetanus immunoglobulin) to neutralise tetanospasmin toxin
- sedative and muscle relaxants to control muscle spasms
- supportive treatment such as ventilation and nutritional support.
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