Tetanus: Symptoms, Causes, Treatment & Prevention

 

A toxin-producing bacteria is the source of the serious nervous system disease tetanus. The contraction of muscles is caused by the condition, especially in the jaw and neck muscles. Lockjaw is the common name for tetanus.

The neurotoxic produced by Clostridium tetani spores disrupts the neurons that regulate muscular action in a wound.

Severe muscle spasms, severe breathing difficulties, and even death may result from the infection. There is tetanus treatment available, but it's not always successful. Getting the vaccination is the most effective method of tetanus protection.

What is Tetanus?

A serious bacterial infection is tetanus.

Soil, manure, and other environmental substances contain the bacterium. An infection that affects the entire body might occur in someone who gets a puncture wound from a contaminated object. It might be fatal.

Every year, there are roughly thirty cases of in the United States. Most of these individuals have not received their yearly booster injections or have not received their tetanus vaccination.

Symptoms:

The incubation period, or the time it takes for symptoms to appear, is typically 10 days. There is a range of 3 to 21 days during the incubation period.

General tetanus is the most common type of tetanus. Over two weeks, the signs and symptoms rapidly intensify after a cautious start. Usually, they begin at the jaw and move down the body.

Generalized tetanus symptoms and signs include:

• Your jaw's painful muscle spasms and inflexible, unyielding muscles (muscle rigidity)

• Your lips' surrounding muscles tense up sometimes, giving you a constant smile

• Stiffness and excruciating spasms in your neck muscles

• Having difficulties with swallowing

• Rigid muscles of the abdomen

Generalized spasms are painful, seizure-like spasms that occur repeatedly and last for many minutes as tetanus progresses. Typically, the fists are clinched, the legs stiffen, the arms are brought up to the body, and the neck and back arch. Breathing problems could be brought on by stiff neck and abdominal muscles.

Minor stimuli that arouse the senses, such as a draft, light, loud sound, or physical touch, can cause these intense spasms.

Other indications and symptoms that may appear as the illness worsens include:

• High blood pressure

• Low BP

• Rapid heart rate

• Fever

• Extreme sweating

Causes:

Clostridium tetani is the name of the bacteria that causes tetanus. In the latent condition, the bacteria can be found in soil and animal feces. It's effectively shut down until it finds a home where it may thrive.

The germs enter a wound, which is favorable for growth, and the cells are "awakened." Tetanospasmin is a toxin that they emit during growth and division. The poison damages the body's neurons that regulate muscular contraction.

Factors at risk:

The biggest risk factor for contracting tetanus is not getting vaccinated or failing to receive booster doses every ten years.

The following additional variables raise the chance of contracting tetanus:

• Cuts or wounds from contact with manure or dirt

• A foreign object in a wound, such as a splinter or nail

• A medical history of immune-suppressive disorders

• Skin lesions that are infected in diabetics

• An unvaccinated mother who has an infected umbilical chord

• Shared, filthy needles used for illegal drug use

Also Read: 19 Food to Boost the Immune System

Complications

Tetanus infection complications can include:

• Problems with breathing. Strictness of the vocal cords and rigidity of the muscles in the neck and abdomen can cause life-threatening breathing difficulties, particularly when there is a widespread spasm.

• Lung artery blockage (pulmonary embolism). One of the lung's branches or the main artery may become blocked by a blood clot that has spread from another part of your body.

• Pneumonia. One consequence of generalized spasms could be aspiration pneumonia, an infection of the lungs brought on by anything mistakenly inhaled into the airways.

• Broken bones. Spinal or other bone fractures can result from generalized spasms.

• Death. A clogged airway during spasms or injury to the nerves controlling breathing, heart rate, or other organ functions are common causes of tetanus-related deaths.

Diagnosis:

there are no blood tests available yet to diagnose tetanus. The diagnosis is made based merely on the presentation of tetanus symptoms; it is not dependent on the bacterium being isolated, which can be separated from individuals who do not have tetanus but is only retrieved from wounds in 30% of cases. The only way to identify C. tetani in a lab setting is to have mice produce tetanospasmin. If no other diagnosis has been made, having recently had a head trauma may imply cephalic tetanus.

The "spatula test" is a clinical tetanus test that entails using a soft-tipped device to touch the posterior pharyngeal wall and monitor the reaction. A negative test result would often be a gag reaction trying to remove the foreign object, whereas a positive test result would be an involuntary contraction of the jaw (biting down on the "spatula"). According to a brief paper published in The American Journal of Tropical Medicine and Hygiene, the spatula test demonstrated good sensitivity (94% of infected individuals produced a positive test) and high specificity (zero false-positive test results) in an affected person research study.

Treatment:

A tetanus infection requires immediate medical attention as well as ongoing supportive care, frequently in an intensive care unit, while the illness progresses. The medical staff will take care of any wounds and ensure that breathing is protected. Medicines are administered to treat symptoms, kill germs, target the toxin produced by the bacterium, and strengthen the immune system.

The goal of antitoxin therapy is to eliminate toxins that haven't yet damaged nerve tissue. Passive immunization is a therapy that uses a human antibody against the poison.

Muscle spasms can be lessened with the use of sedatives, which slow down nervous system activity.

Receiving a normal tetanus vaccination boosts your immune system's ability to combat the toxins.
Antibiotics used intravenously or orally may aid in the battle against tetanus germs.
Other medications. To control involuntary muscle activity, such as your breathing and heartbeat, you may need to take additional drugs. Both sedation and this usage of morphine are possible

A medical emergency involving tetanus necessitates:

• Hospital care 

• Includes immunization against tetanus,

• Vigorous wound care,

• Human tetanus immune globulin (TIG) medication,

• And antibiotics to decrease muscle spasms.

• Individuals who recover from tetanus require vaccination because they lack natural immunity and are susceptible to infection again.

Prevention:

By getting a vaccination, tetanus can be avoided.


Vaccinations for children

Children receive the tetanus vaccination as part of the acellular pertussis vaccine (DTaP), which also includes diphtheria and tetanus toxoids. A dangerous bacterial infection of the nose and throat is diphtheria. Whooping cough, commonly known as acellular pertussis, is a very contagious respiratory ailment.

Youngsters who cannot handle the pertussis vaccination may be given the DT vaccine instead.

The DTaP consists of five injections that are usually administered to children between the ages of:

• 2 months

•  4 months

• 6 months.

• 15 to 18 months

• 4 to 6 years of age

Childhood vaccinations (ages 7 to 18)

Children who turn 11 or 12 years old should get a booster vaccination. We refer to this booster as the Tdap vaccination. Consult your doctor about the best course of action if your child has not received a booster shot at this age.

Adults aged 19 and up should get vaccinated

Adults should get a booster shot every ten years. Tdap or Td may be the vaccine in question. See your doctor about receiving the Tdap vaccination if you were not vaccinated against tetanus as a kid or if you are not sure if you have had any vaccinations.

vaccinations are given before becoming pregnant

In the third trimester of pregnancy, a booster is advised regardless of the mother's immunization schedule.


More recommendations

Ask your physician to check your immunization history regularly.
If you are traveling abroad, be sure you are up to date on your immunization regimen.

References:

• Havers FP, et al. Use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccines: Updated recommendations of the advisory committee on immunization practices — United States, 2019. MMWR Morbidity and Mortality Weekly Report, 2020; doi:10.15585/mmwr.mm6903a5.

• Bennett JE, et al. Tetanus (Clostridium tetani). In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed March 4, 2021.

• Fowler GC, et al., eds. Wound dressing. In: Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed March 4, 2021.

• Emergency wound care after a natural disaster. Centers for Disease Control and Prevention. https://www.cdc.gov/disasters/woundcare.html. Accessed March 8, 2021.

• AskMayoExpert. Tetanus, diphtheria, and pertussis (Tdap) vaccination. Mayo Clinic; 2020.

• Fowler GC, et al., eds. Wound dressing. In: Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed March 4, 2021.

• Tetanus (lockjaw). U.S. Department of Health and Human Services. https://www.vaccines.gov/diseases/tetanus. Accessed March 4, 2021.

• Emergency wound management for healthcare professionals. Centers for Disease Control and Prevention. https://www.cdc.gov/disasters/emergwoundhcp.html. Accessed March 8, 2021.