Tetanus, also known as Lockjaw

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What is Tetanus?

Heard of TT injection? Tetanus is one of the serious bacterial infection caused by the toxin of Clostridium tetani. The neurotoxin affects the central nervous system and muscles causing spasms and contractions all over the body.

Tetanus toxin affects jaw and neck muscles resulting in difficulty in breathing. Hence, tetanus is also known as lockjaw. Tetanus is life-threatening in the absence of immediate treatment. The toxin released by tetani bacteria gets deposited in the wound. Tetanus bacteria are widely distributed in soil and intestine of man and animals. After the invention of the tetanus vaccine, the number of mortality rates due to tetanus has shown flattening of the curve.

Tetanus can result in a fatality in approximately 10-20% of cases. It is one of the medical emergencies. Any wound caused by the sharp object may result in tetanus infection if not hospitalized immediately. Strong immunization programs are needed to keep the infection in check. Most of us have heard about TT injection. This is the vaccine given to avoid the infection. Regular introduction of a booster dose in every 10 years will confer the immunity against tetanus.

Need to know the causes, symptoms and treatment? If yes, scroll down for brief note on tetanus recommended by 3MEDS-best healthcare service provider in India.
 

Causes of Tetanus:

Clostridium tetani are the bacteria responsible for the tetanus infection. It is a slender bacillus, flagellated with characteristic drumstick appearance histologically.

Clostridium tetani produce two distinct toxins: tetanolysin (haemolysin) and tetanospasmin (neurotoxin). Tetanospasmin is a powerful neurotoxin which is responsible for clinical manifestations of tetanus. The spores of these bacteria have less penetrative power in intact skin. However, on the presence of a wound, these bacteria easily get access into the body and in the process contaminate the wound.

The potential source of infection may be soil, dust, faeces, etc. the bacteria don’t release toxin until favourable environment exists. The spore releases toxin which enters the central nervous system and blocks the nerve signal thereby, causing spasm of the body.

Common injuries which may lead to tetanus infection are:

· Road traffic accidents

· Crush injuries

· Injury caused by a sharp object like metal, piercing of tattoos, injection drug abuse

· Burn injuries

· Contamination of wound with dirt, saliva and faeces

· Bites of animals, insects

· Chronic infections, dental infections, sores.

· Injuries involving dead tissue
 

Symptoms:

The incubation period of tetanus bacteria is 3-21 days. It may take 4 days to 3 weeks to produce symptoms, sometimes, for months.

The distance between the injury site and the central nervous system determines the incubation period. Farther the distance, the longer is the incubation. Shorter the distance, more severity of the infection.

· Spasm of the muscles is the first symptom. It usually affects facial muscles and masticatory muscles causing difficulty in chewing and making facial expressions. Hence, the name lockjaw. The face appears taut without the display of expressions. Further, the infection spreads to the muscles of a neck and throat causing difficulty in breathing. Muscles of the chest, and back are also affected in few individuals causing chest stiffness and arching of the back. It is more pronounced in children.

Other symptoms include:

· Diarrhoea and bloody stools

· Headache, fever

· Sore throat

· Excessive sweating

· Increased (rapid) heartbeat

· Sensitivity to touch

Prevention and Treatment:

Surgical:

It aims at the removal of foreign body, blood clots, etc., in order to prevent anaerobic conditions favourable for the bacillus. Depending on the type of wound, a surgical procedure may vary from simple cleansing to radical excision.

Antibiotics:

· Antibiotics destroy or inhibit tetanus bacilli and other pyogenic bacteria in wounds and thus, the production of toxin is prevented. Long-acting penicillin injection or erythromycin may be given.

· Muscle relaxants to relieve muscle spasm.

· Ventilator in serious breathing problems.

These medications can be accessed from 3MEDS-best pharmacy app in India.

Immunisation:

Tetanus is a preventable disease if paid immediate attention. Two types of immunisation is available to prevent acquiring the infection.

Active immunisation:

Tetanus toxoid (TT), which is available either as ‘plain toxoid’, or adsorbed on aluminium hydroxide or phosphate (APT), is commonly used for active immunisation. Three doses of 0.5 ml tetanus toxoid (APT) each are introduced intramuscularly, with an interval of 4 to 6 weeks between the first two doses and 6-12 months between the second & third dose. A complete course of three doses provides immunity for a period of at least 10 years. A ‘booster dose’ is suggested after every 10 years.

Tetanus toxoid is given along with diphtheria toxoid and pertussis vaccine (DPT) in children.

Passive immunisation:

Homologous serum prepared from humans, human antitetanus immunoglobulins (HTIG), is given with a dose of 125 units.

Outlook:

Tetanus can be prevented by regular vaccination. People without vaccine are at higher risk for acquiring the disease. It immediate attention is not paid, it may either result in fatality or complications. Laryngospasm, brain damage, pneumonia, fractures of bone are some complications. Children and older adults have higher mortality.