Tetanus is a condition that is directly caused by a nerve toxin produced by the bacterium Clostridium tetani, which belongs to the same family as the bacteria that causes botulism and gangrene. It is a worldwide health problem that takes the lives of more than 500,000 people annually. However, because of the introduction of a vaccine in the 1950s, it is almost eradicated in developed countries. Cases of tetanus usually involve individuals who have not been vaccinated or those who don’t have up to date immunizations.
Signs and Symptoms
The signs and symptoms of tetanus can start to appear a few days to several weeks after the tetanus bacteria have entered the body through a wound. On average, the incubation period is about 7 to 8 days.
The signs and symptoms in order of appearance are as follows:
- Spasms and stiffness of the jaw muscles.
- Stiffness in the neck area.
- Having a difficult time swallowing.
- Stiffness in the abdominal area.
- Body spasms accompanied by pain which can last several minutes.
- The other signs and symptoms include sweating, fever, rapid heart rate and elevated blood pressure.
Causes and Risk Factors
Tetanus is caused by the bacterial Clostridium tetani which can be found in dust, soil and animal feces. They typically enter the body through a deep flesh wound. The spores of the bacteria produce tetanospasmin which is a potent toxin that impairs the motor neurons which are nerves that control the muscles. The result is spasms and muscle stiffness which are the primary signs of tetanus.
Here are the risk factors for tetanus bacteria to proliferate in the body:
- Lack or inadequate immunization.
- A deep wound that introduces tetanus spores to the site.
- Having injured tissue.
- A foreign body stuck in the skin like a splinter or nail.
- Swelling around an injury.
- The presence of any infective bacteria.
- Generalized Tetanus – It is the most common form of tetanus making up about 80% of all cases. It usually presents with a descending pattern starting from the jaw area and facial spasms down to the neck and then the chest muscles.
- Neonatal Tetanus – This occurs in newly born children, which is usually caused by an infection of the umbilical stump. The incubation period is only about 4 days, but immunization of the mother gives her child what is called passive immunity.
- Local Tetanus –In this type of tetanus, he contractions and spasms are only limited to the site of injury. It usually lasts for a few weeks, then subsides to a milder and less threatening form of tetanus. Proper treatment is required in order to avoid its development into generalized tetanus.
- Cephalic Tetanus – This is the rarest type of tetanus and in some cases occurs alongside an ear infection.
Tests and Diagnosis
Doctors generally diagnose tetanus based on physical examination, immunization history and the signs and symptoms of the patient. There are no laboratory tests that are useful in diagnosing tetanus.
Treatment and Medications
There is still no cure* for tetanus, but the treatment includes wound care, medications for alleviating symptoms and supportive care. Cleaning the wound is very important because it prevents the growth of tetanus spores. It includes the removal of dirt, foreign objects and dead tissue on the wound.
- Antitoxin – Tetanus antitoxin like tetanus immune globulin can be administered by the doctor. However, this only neutralizes toxins that still haven’t bonded to nerve tissue.
- Antibiotics – This helps fight tetanus bacteria and it is either taken by injection or orally.
- Vaccine – Having tetanus will not make a person immune to the bacteria, so a tetanus vaccine is needed to avoid future infection.
- Sedatives – These are used for controlling muscle spasms.
- Other Drugs – There are medication like magnesium sulfate and specific beta blockers that helps regulate involuntary muscle activity like breathing and the beating of the heart.
Must Watch – Tetanus: Treatment and Symptoms
Precaution and Self Care
If you have any puncture wound, other deep cuts, animal bites or a severely inflamed wound, you have an increased risk of tetanus infection. If the wound is deep and dirty, it is important to get medical attention, especially if you are not sure of your immunization status. Leave the unclean wounds open to prevent trapping bacteria in the wound. The doctor usually cleans the wound, prescribes an antibiotic and administers a booster tetanus toxoid vaccine shot. Here are steps to prevent getting tetanus if you have a minor wound:
- Apply pressure to control the bleeding.
- Keep the wound clean by rinsing thoroughly with clean water or saline solution. For debris in the wound, go to your doctor.
- Apply an antibiotic solution or any topical medication prescribed by your doctor.
- Cover the wound after thoroughly cleaning it.
- Change the dressing regularly to prevent infection.