TETANUS
Last Updated : 3/4/2005
Dr. Ira Shah
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What is tetanus ?
Tetanus is an infection caused by the bacteria called clostridium tetani. It is called "Dhanur" in Hindi and both "tetanus" and "Dhanur" mean arching of the body. Tetanus infection leads to severe stiffness and spasm of the muscles leading to arching of the body.

How does tetanus spread ?
Tetanus occurs worldwide. Tetanus spores are present in soil and dust and can survive for years. Contamination of a wound, improper and unhygienic method of cutting the umbilical cord in the babies and lack of hygienic habits can lead to entry of tetanus spores into the wound. These spores germinate to form the tetanus bacteria. These bacteria form toxins that spread into the body especially the spinal cord causing paralysis, stiffness and spasms of various muscles of the body.

What are the symptoms of tetanus ?
After contamination of a wound, the symptoms of tetanus appear after 10-15 days. Muscles around the site of injury become painful and cause spasms. The disease may spread and lead to involvement of all muscles of the body. A condition called as "Lockjaw" may occur whereby the patient is unable to move the jaw and open the mouth due to spasms of muscles of the jaw. These spasms occur on even a minute stimulus such as bright light, noise or even touch. There is difficulty in swallowing too. Muscles of the face become rigid giving the face a constant grinning appearance called as " Risus sardonicus ". The muscles of back and abdomen become rigid leading to arching of the body. With severe infection, complications of tetanus such as constipation, retention of urine, fever, high blood pressure, irregular heart beats and difficulty in breathing may occur.

How is the diagnosis of tetanus made ?
Diagnosis of tetanus is made by clinically.

What is the treatment of tetanus ?
Tetanus requires meticulous nursing care. The patient should be kept in a quiet room with minimal sound and minimal lights. Immediate administration of tetanus immunoglobulin is required to neutralize the toxins. Penicillin antibiotic for 10 days is required to kill the tetanus bacteria. All wounds should be cleaned properly. For severe spasm in the muscles, muscle relaxants are required. Feeding by tube or intravenous feeding may be required. Patients with difficulty in breathing should be kept in intensive care units.

How is tetanus prevented ?
The death rate after tetanus infection is very high-about 45 to 55% and for small babies around 70%. Thus prevention of tetanus is the best treatment for tetanus. Immunization with DPT vaccine or tetanus toxoid (TT vaccine) helps to prevent infection. As per universal immunization, all children should receive DPT at 6, 10 and 14 weeks of life followed by booster shots at 1½ and 4½ years of age. TT should be then given at 10 years and 16 years of age and then every 10 years. All pregnant women should receive 2 doses of tetanus toxoid during pregnancy to prevent infection in the newborn babies.

If I get an injury, do I need to take tetanus toxoid ?
If you have taken all the shots of DPT and TT vaccine as per the universal schedule, there is no need to take tetanus toxoid at the time of injury. However, if you have missed any shots as per the immunization schedule, you will need to take tetanus toxoid if there is an unclean injury and preferably take a second shot after 1 month of the first shot and a 3rd shot after 6 months to ensure that you maintain good immunity against tetanus.



Contributor Information and Disclosures

Dr. Ira Shah
Consultant Pediatrician, B.J.Wadia Hospital for Children, Mumbai, India


First Created : 3/5/2001

References

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