Watch out for any open wound that occurs in a dirty environment, as it can be a potential site for tetanus infection. Caused by a deadly bacterium, clostridium tetani, tetanus can be prevented by timely vaccination.
What is tetanus?
Tetanus is the infection of the nervous system caused by the deadly bacterium, Clostridium tetani. It is also called as lockjaw.
Neonatal tetanus is a type of generalised tetanus, occurring in newborns. It usually occurs through infection of the unhealed umbilical stump. Infants who have not acquired passive immunity because the mother has never been immunised are at risk of developing this type of tetanus.
Causes of tetanus
Spores of Clostridium tetani remain in the soil and are inactive, but have the potential to cause infection for about 40 years.
Infection begins when spores enter the body through injury or wound. The spores release bacteria that spread and make a poison called tetanospasmin. This poison blocks nerve signals from the spinal cord to the muscles, causing severe muscle spasms. The spasms can be so powerful that they tear the muscle or cause fracture of the spine.
The time between the infection and first appearance of the symptoms is approximately 7 to 21 days.
Symptoms of tetanus
Tetanus begins with mild spasms in the jaw muscles known as lockjaw. The spasm can also affect the chest, back, neck and abdominal muscles.
Generalised tetanus can affect all skeletal muscles. Local tetanus affects the muscles at or near the wound. Cephalic tetanus affects one or several muscles in the face rapidly after a head injury or ear infection.
Sometimes spasm can affect the muscles related to respiration, leading to breathing problem.
Prolonged muscular action can cause sudden, powerful and painful contractions of muscle groups. This is known as tetany. These episodes can cause fracture or muscle tear.
Other symptoms of tetanus include:
- Saliva dripping from the mouth
- Excessive sweating
- Hand or foot spasms
- Difficulty in swallowing and
- Uncontrolled urination or defecation
No specific lab test can be performed. Doctor can do a physical examination and can ask medical history like incomplete tetanus immunisation.
Treatment for tetanus
- Antibiotics like penicillin can be given
- Bed-rest in dim light, reduced noise and stable temperature are advised.
- Tetanus immunoglobulin should be given
- Muscle relaxant like diazepam should be given.
- Surgery to clean the wound and remove the source of poison.
- Breathing support with breathing tube and oxygen if symptoms are there.
Prognosis for a tetanus infection
Untreated cases have a poor prognosis. Death rate is high in the case of newborn infants with untreated tetanus.
Wounds on head and face have a poor prognosis than wounds on other parts of body. Uncorrected episodes of hypoxia caused by muscle spasm in the throat may lead to irreversible brain damage.
Complications seen in tetanus infection
- Airway obstruction
- Respiratory arrest
- Heart failure
- Brain damage due to lack of oxygen during spasms.
Tetanus is completely preventable by active tetanus immunisation. Immunisation provides protection for 10 years. If it’s your first tetanus shot, then you must take it within 24 hours of injury. In case of a booster dose, take a tetanus shot within 48 hours after injury.
Thorough cleaning of all injuries and wounds and the removal of dead or severely injured tissue may reduce the risk of developing tetanus.
Photograph via sxc.hu