Tetanus

I was looking at some of the categories on the site and found it amazing to find that no one had written a review on Tetanus. As this is potentially a very serious condition and owing to my interest in most things medical, I thought that it would be pertinent to highlight its main features and inform people of the possible consequences of contracting this infection.

What is Tetanus?

Tetanus also commonly referred to as Lockjaw. Is an infection which is caused by a bacterium called "Clostridium Tetani". It can affect the brain, muscles and nervous system within the body resulting in unpleasant spasms and convulsions. Be aware that Tetanus is an extremely serious condition which can be fatal. Pneumonia, breathing difficulties, muscle problems and possible coma can be associated with Tetanus. Furthermore the spasms and convulsions can stop breathing and ultimately cause heart failure. Although tetanus is now rare in this country mainly due to successful vaccination uptake, the bacteria that causes the infection is still very much present today and cannot be eradicated from the environment. Therefore anyone who is not fully protected against the virus is still at risk from developing it.

What Causes Tetanus?

The actual bacteria which causes Tetanus lives in the soil and dirt and possibly more unpleasantly in animal and human faeces. The spores of this bacteria may get into the body via a cut or other open wound, or a burn in the skins surface. Often as a result of touching something dirty like a rusty nail or through sustaining an animal bite. This bacteria then makes a toxin which causes the infection.


Types of Tetanus?

Generalised

This is the most common type of the tetanus infection and is ultimately life-threatening. Incredibly this kind can be in the body for several weeks before an infected person is even aware of its existence. Normally however symptoms start appearing around the seven day mark. These can include: Jaw and muscle spasms or stiffness-commonly referred to as lock-jaw. Muscle stiffness and muscle pain which usually starts in the neck shoulder and back. Spasms or convulsions of the body which may be painful and which can affect breathing and digestion. Seizures can also occur. Fever and sweating are also common. Symptoms can last for around four to six weeks, they then gradually subside. Death may occur though the rate is affected by age and immunisation status.

Localised Tetanus.

This causes muscle spasms in a site close to the original injury. It may persist for several weeks or months before eventually subsiding. Death is extremely rare in these cases.

Cephalic tetanus

This type is associated with head injury, and can lead to different areas of paralysis within the body. Jaw spasm may also be present. It may progress to generalised tetanus with similar risks outlined above.

Treatment

Hospital treatment is required quickly if tetanus is suspected. Initially the wound will be thoroughly cleaned. Drug therapy will be commenced. This will consist of Immunoglobulins (they attach to the Tetanus bacteria and assist in destroying it). The heart will be monitored and breathing continually assessed. Antibiotics will also be administered, and muscle relaxants will also be given to try and combat spasms and stiffness.

Tetanus Vaccination Programme

The immunisation programme is provided as a course of five doses, and in the UK and starts in early childhood. It is normally given as a combination vaccine of Diphtheria, Tetanus and Pertussis. Administered in the arm or the thigh. The first three doses are given to babies when they are two, three and four months old. They then receive a booster at three to four years and then ten years later. This should provide tetanus protection for life. A booster however may be required if travelling abroad. If older you can get the first three doses at any age followed by a booster 10 years later. For further information on the immunisation programme either for children or adults then consult your GP or for research purposes there are several websites which will provide up-to-date information on the subject.

Side-effects of Immunisation?

It is common to get a little redness, and swelling around the injection site which goes after a few days. Some people feel slightly unwell for a day or so with a mild headache, slight aching of the muscles and a mild fever. Severe reactions are extremely rare.


Who should not receive Tetanus Vaccination?

If unwell with an illness causing a fever, it is wise to postpone an injection until the illness has gone (except if the dose is needed after a cut or wound). Also you should not have another injection of vaccine if a previous injection caused a severe reaction. The tetanus vaccine is safe if you are pregnant or breast feeding.


Those Who May Be Most At Risk?

Be advised that some adults have NOT been immunised against tetanus because routine immunisations for children were not introduced until 1961. Men serving in the armed forces from 1938 onwards were offered tetanus immunisation. So some older people may still be at risk particularly women. If in doubt about your immunisation status consult your GP or practice nurse. Don't leave injury to chance check out your immunisation status.

The following websites may be of interest if you require further information on this subject.

www.nice.ac.uk
www.neli.org.uk
www.immunize.org