Tetanus – a Killer Infection

Tetanus is an infectious disease caused by the toxin produced by the bacteria Clostridium Tetani (C. Tetani). These gram positive anaerobic bacteria produce the neurotoxin tetanospamin that results in severe uncontrollable muscular spasms.

The disease is associated with the term lock jaw because the spasms usually develop first in the jaw. This disease is infectious but not contagious. Although it is the only known vaccine-preventable disease that is not contagious, Tetanus infection is so deadly that it can cause the life of an individual in days.

Causes
Tetanus is often related to rust. This association is somewhat misleading because the rust itself does not cause the infection. The rusty metal surfaces only provide the habitat for the bacterial endospore to reside. When skin is punctured by rusty metal surfaces, endospores in those surfaces are released into the wound. After the punctures, lacerations and abrasions cause dead tissues. This environment with lack of oxygen will be the perfect place for endospores to become active and cause infection. Clostridium tetani is an anaerobic bacterium. This means that it survives and multiplies when there is lack of oxygen in the environment. Any kind of wound will be the right environment for these bacteria.

Rust is not the only medium for bacteria to reside. Clostridium tetani can also be found in the soil, dust, intestines, and feces of many animals such as horses, pigs, cows and chicken. These places enable the spores to survive for many years and become resistant to extreme temperatures.

Symptoms
People often take for granted their wounds especially when they are not deeply punctured. But what people do not know is that no matter how shallow or deep wounds are, those wounds can still cause tetanus.

The main characteristic of tetanus is muscle rigidity and spasms. Muscle rigidity and spasms usually happen in a descending pattern. The first sign of infection is trismus or lock jaw followed by facial spasms, stiff neck, difficulty of swallowing, and stiffness of the pectoral muscles and abdominal muscles. Fever, rapid heart rate, elevated blood pressure and sweating also occur. Spasms last up to several minutes with the body shaping into an arch called opisthotonus.

The high fatality rate of tetanus is caused by the complications of the symptoms presented above. Laryngospasm or spasm of the vocal cords can happen that will impede breathing. The spine and long bones can break because of severe convulsions. Secondary infections from prolonged hospital stay such as pneumonia can occur. Oftentimes complications from acquiring tetanus infections cause death among victims. If the individual with severe tetanus infection survived, there is a high chance of disability because of nerve damage.

Treatment
Wounds should be washed first with soap and running water upon acquiring the wound. Visit your doctor or the nearest hospital for further management of wounds. The antibiotic metronidazole is the main choice of medication for tetanus. It decreases the number of bacteria but it does not kill the bacterial toxin. If metronidazole is not available, the next drug of choice is penicillin. Immunization of human anti-tetanospasmin immunoglobulin or tetanus immunoglobulin is very important for treatment of tetanus. Victims are required to be vaccinated by one of these vaccines or be given a booster shot.

Tetanus immunoglobin, metronidazole IV, Diazepam and tetanus vaccination are the treatment of choice for mild cases of Tetanus. Severe cases will be treated in the intensive care department. Tracheostomy, ventilator, magnesium, human tetanus immunoglobulin given intrathecally and other types of muscle relaxants are needed for treatment of severe cases along with the four mentioned treatment of choice for mild cases earlier. Maintenance of the patent's airway and proper nutrition are needed in order to survive tetanus.

Prevention
Most of the victims of tetanus are people who are unvaccinated or with incomplete immunization. Tetanus can be prevented with vaccination of tetanus toxoid. For adults, it is recommended that a booster shot should be administered every ten years or if an individual is uncertain of his or her latest vaccination. For children under the age of seven, a combined vaccine of diphtheria, pertussis and tetanus known as DTP/DTaP is given. For children over seven, the Td vaccine (tetanus and diphtheria) or Tdap (tetanus, diphtheria, and acellular pertussis) is used.

 


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