By John Smith
What is Tetanus?
Tetanus is a severe infection of the nervous system caused by the bacterium Clostridium tetani, which is commonly found in soil, household dust and animal feces. The bacteria contaminates the body normally through a deep cut or puncture wound, and can also result from injuries such as burns, frostbite and gangrene, where the skin's natural resistance is compromised.
Tetanus cannot be passed by person-to-person contact, only by direct contamination of the blood stream, and it cannot be passed on via the tetanus vaccine.
Symptoms of Tetanus
The presenting symptom is usually the characteristic muscular spasm and rigidity of the jaw and neck (known as trismus or 'lockjaw'). Over a 24-48 hour period following this, muscle rigidity spreads down the body to the limbs, and can decrease the ability to swallow and breathe. Patients can be over-sensitive to light, noise and touch during the early stages of tetanus, and stimulus can cause painful muscular spasms that cause fractures or dislocations. For this reason, patients are usually treated in dark, quiet areas in order to reduce these risks.
How common is it?
Due to widespread immunisation in childhood, tetanus is now extremely rare in developed countries. In the US, only 130 cases were reported in the period 1998-2000 (Dire 2005); most occurring among unvaccinated or inadequately vaccinated individuals following an acute injury.
How is it treated?
Treatment is by administration of the antitoxin in patients who are not adequately immunised, cleansing of the wound, and medical control of the symptoms. Patients may require invasive medical treatment in intensive care to assist with breathing and nutritional support.
Most patients recover from tetanus and return to their full health over a period of 2-4 months.