Your parents used to refer to tetanus as “lockjaw”, as this is the name that was popularly given to one of tetanus’s more recognizable symptoms. Tetanus is a bacterial disease of the nervous system that has the ability to stiffen up the muscles of your body, your jaw included, hence the strange and somewhat scary name that your mom and dad knew it by. There are only about one hundred cases of tetanus reported annually in the United States, with perhaps five of those fatal, but worldwide, tetanus has a far greater impact, especially in developing countries where citizens lack proper vaccination against it.
Tetanus is the result of the introduction of the spores from the bacterium known as clostridium tetani into an open wound or puncture. These bacteria live in the soil, animal feces, and dust and are found across the globe. Laying dormant, tetanus bacteria can stay infectious for as long as forty years. Once the spores find a way into an injured area, they germinate, releasing active bacteria that rapidly reproduce and release a neurotoxin called tetanospasmin. This toxin will then block nerve transmissions from the spinal cord to the muscles, causing the muscles to experience violent and severe spasms, some powerful enough to tear the muscles or cause compression fractures to vertebrae.
The initial stages of tetanus are signaled by mild spasms in the muscles of the jaw, neck, and face. This stiffness will then spread into the regions of the chest, back, and abdomen. Breathing can be impaired when the rigidity makes it way to the laryngeal muscles that control the function. Muscular seizures known as tetany then arise; strong and painful contractions that can cause the extensive damage to muscles and vertebrae. Additional symptoms of tetanus can include a fever, drooling, excessive sweating, the inability to control urinating and your bowel movements, hand and foot spasms, and having a hard time swallowing. These symptoms can develop anywhere from a couple days to several weeks after you have been infected through the injured site, with the average incubation period of the disease being about eight days.
There are over one million cases of tetanus reported each year worldwide, and who knows how many that are never reported or diagnosed. Tetanus infections in newborns and infants account for well over half of all deaths from the disease. Left untreated, tetanus will be fatal one third of the time, two out of three when the victim is a newborn. If medical care is received, only one in ten will succumb to the effects of tetanus. The treatment for tetanus often includes the use of a tetanus antitoxin, usually one known as tetanus immune globulin. But these antitoxins only affect those toxins in the body that have not yet damaged nerve tissue. This means that you will need additional antibiotics, taken orally or by injections, to battle the remaining tetanus bacteria at work in your system. Advanced tetanus infections require hospitalization and intensive treatment, which can include sedation to paralyze muscles to avoid the spasms that can further injure you. In severe tetanus cases, the treatment is not always successful, and death can be brought about by the inability of air to make it through airways because of the muscle constriction, and from pneumonia as well. The nervous system in charge of your heart muscles can shut down, with death a certain consequence.
Immunization from tetanus can provide protection from the disease for up to an estimated ten years. The DTaP shot now given infants in the United States provides protection against diphtheria, an infectious bacterial disease; pertussis, which is a hugely contagious bacterial disease that causes uncontrollable coughing also known as whooping cough, and tetanus. This three-in-one vaccine is required for all children, and is given in a series of five shots, starting at two months old and ending at age six. There are tetanus boosters available so that immunization stays constant in teens and adults, and anyone who has sustained an injury that could result in tetanus should get a booster shot if it has been more than five years since the last one was given. If you receive a wound, make sure the area is thoroughly cleaned and all dead skin and tissue is carefully removed from the area. Any injury that could allow contact with soil into the open wound is potentially an opportunity for tetanus to take hold. It is the dirt that contains the tetanus bacteria, as opposed to say rust on a barbed wire fence, which is the culprit.
Puncture wounds, deep cuts, bites from animals, and very dirty wounds are the ones that will most likely cause tetanus if you are unvaccinated for it or have not had a booster shot within the past ten years. Clean the wound with soap and warm water and then apply an antibiotic cream such as Neosporin. This can stop bacteria from flourishing in the tissue. Cover the wound to insure that it stays clean and keeps bacteria from gaining access to it. Be sure to change the dressing daily, or if it becomes wet or dirty during the course of the day. Get to a doctor if you are not current with your tetanus boosters. It’s a good idea to always know when you had your last one, since this will be the first question you are asked in the emergency room. Tetanus can be as scary as the “lockjaw” name implies, and it is not something to be trifled with under any circumstances.
