TETANUS

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 Tetanus is a serious disease caused by a bacterial toxin that affects
your nervous system, leading to painful muscle contractions,
particularly of your jaw and neck muscles. Tetanus can interfere with
your ability to breathe and can threaten your life. Tetanus is
commonly known as "lockjaw."

Thanks to the tetanus vaccine, cases of tetanus are rare now. But the
disease remains a threat to those who aren't up to date on their
vaccinations. It's more common in developing countries.

There's no cure for tetanus. Treatment focuses on managing

complications until the effects of the tetanus toxin resolve.
 Signs and symptoms of tetanus appear anytime
from a few days to several weeks after tetanus
bacteria enter your body through a wound. The
average incubation period is seven to 10 days.

Common signs and symptoms of tetanus include:

•Spasms and stiffness in your jaw muscles (trismus)
•Stiffness of your neck muscles
•Dif iculty swallowing
•Stiffness of your abdominal muscles
•Painful body spasms lasting for several minutes,
typically triggered by minor occurrences, such as a
draft, loud noise, physical touch or light
Possible other signs and symptoms include:
•Fever
•Sweating
•Elevated blood pressure
•Rapid heart rate
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CAUSES
• a toxin made by spores of bacteria, Clostridium tetani, found in soil,
dust and animal feces. When the spores enter a deep lesh wound,
they grow into bacteria that can produce a powerful toxin,
tetanospasmin. The toxin impairs the nerves that control your
muscles (motor neurons). The toxin can cause muscle stiffness and
spasms — the major signs and symptoms of tetanus.

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RISK FACTORS
• The following increase your likelihood of getting tetanus:
• Failure to get vaccinated or to keep up to date with
booster shots against tetanus
• An injury that lets tetanus spores into the wound
• A foreign body, such as a nail or splinter

Tetanus cases have developed from the following:

• Puncture wounds — including from splinters, body
piercings, tattoos and injection drugs
• Gunshot wounds
• Compound fractures
• Burns
• Surgical wounds
• Injection drug use
• Animal or insect bites
• Infected foot ulcers
• Dental infections
• Infected umbilical stumps in newborns born of
inadequately vaccinated mothers
COMPLICATIONS
Once tetanus toxin has bonded to your nerve endings it is impossible to
remove. Complete recovery from a tetanus infection requires new nerve
endings to grow, which can take up to several months.

• Broken bones. The severity of spasms may cause the spine and other
bones to break.

• Blockage of a lung artery (pulmonary embolism). A blood clot that has

traveled from elsewhere in your body can block the main artery of the lung
or one of its branches.

• Death. Severe tetanus-induced (tetanic) muscle spasms can interfere with

or stop your breathing. Respiratory failure is the most common cause of
death. Lack of oxygen may also induce cardiac arrest and death. Pneumonia
is another cause of death.
PREVENTION - Get vaccinated!!!
• (DTaP) vaccine -This vaccination provides protection against three
diseases: a throat and respiratory infection (diphtheria), whooping
cough (pertussis) and tetanus.
The DTaP vaccine is a series of ive shots, typically given in the arm or
thigh to children at ages
• 2 months
• 4 months
• 6 months
• 15 to 18 months
• 4 to 6 years
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The BOOSTER
A booster of the tetanus vaccine is typically given in combination with a booster of diphtheria vaccine (Td).

In 2005, a tetanus, diphtheria and pertussis (Tdap) vaccine was approved for use in
teens and adults under age 65 to ensure continuing protection against pertussis, too.

It's recommended that adolescents get a dose of Tdap, preferably between the ages
of 11 and 12, and a Td booster every 10 years thereafter. If you've never received a
dose of Tdap, substitute it for your next Td booster dose and then continue with Td
boosters.

To stay up to date with all of your vaccinations, ask your doctor to review your
vaccination status regularly.
If you weren't vaccinated against tetanus as a child, see your doctor about getting the
Tdap vaccine.
DIAGNOSIS
Doctors diagnose tetanus based on a physical exam, medical and
immunization history, and the signs and symptoms of muscle
spasms, sti ness and pain. Laboratory tests generally aren't helpful
for diagnosing tetanus.
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TREATMENT
There's no cure for tetanus. Treatment consists of wound care,
medications to ease symptoms and supportive care.
WOUND CARE
• It's essential to clean the wound to prevent the growth of tetanus
spores. This involves removing dirt, foreign objects and dead tissue
from the wound.

Puncture wounds or other deep cuts, animal bites, or particularly dirty

wounds put you at increased risk of tetanus infection. Get medical
attention if the wound is deep and dirty, particularly if you're unsure of
when you were last vaccinated. Leave unclean wounds open to avoid
trapping bacteria in the wound with a bandage.

If your wound is small and clean but you're concerned about infection
or whether you're immune from tetanus, start by seeing your primary
care provider.
• Control bleeding. Apply direct pressure to control bleeding.
• Keep the wound clean. After the bleeding stops, rinse the wound thoroughly
with clean running water. Clean the area around the wound with soap and a
washcloth. If something is embedded in a wound, see your doctor.
• After you clean the wound, apply a thin layer of an antibiotic cream or
ointment. These antibiotics won't make the wound heal faster, but they can
discourage bacterial growth and infection.
• Cover the wound. Exposure to the air might speed healing, but bandages
can 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. Apply a new dressing at least once a day or whenever
the dressing becomes wet or dirty to 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.
 MEDICATIONS
• Antitoxin. Your doctor may give you a tetanus antitoxin, such as tetanus immune
globulin. However, the antitoxin can neutralize only toxin that hasn't yet bonded to
nerve tissue.

• Antibiotics. Your doctor may also give you antibiotics, either orally or by injection, to
ight tetanus bacteria.

• Vaccine. All people with tetanus should receive the tetanus vaccine as soon as
they're diagnosed with the condition.

• Sedatives. Doctors generally use powerful sedatives to control muscle spasms.

• Other drugs. Other medications, such as magnesium sulfate and certain beta
blockers, might be used to regulate involuntary muscle activity, such as your
heartbeat and breathing. Morphine might be used for this purpose as well as
sedation.
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What you can do?
If possible, let your doctor know the following information:
• When, where and how you were injured
• Your immunization status, including when you
received your last tetanus booster shot
• How you've been caring for the wound
• Any chronic illness or condition you have, such as diabetes,
heart disease or pregnancy

If you have a severe tetanus infection, you'll often need to stay in an intensive care
setting. Since sedatives can inhibit breathing, you might temporarily need a
ventilator.