A Vaccine Preventable Illness; commonly known as "Lockjaw"

What is Tetanus?

Tetanus is a serious and sometimes fatal disease of the central nervous system. When a wound is exposed to the spores of the Clostridium tetani bacteria, tetanus can enter a poorly oxygenated tissue where it thrives. Clostridium tetani does not favor a specific age of human hosts. Tetanus can affect anyone at anytime. Vaccine for this is recommended to be bundled in a multi-use vaccine titled DTap many different times in a child's life and then once every ten years as an adult.

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History of Tetanus

The discovery of tetanus was in 1884 by Carle and Rattone. Although there is evidence of tetanus tracing back to 5th century BC, Carle and Rattone produced tetanus by injecting animals with pus from a fatal case of human tetanus. Don't let these guys take all of the credit; during the same year, Nicolaier produced tetanus by injecting bits of soil into animals also. In 1889, Kitaso isolated the bacterium and proved that it was the cause of this fatal disease.

The discovery of tetanus lead to the understanding of the protective effect that it possessed as well. In 1897, Nocard showed the world that passive immunizations of this was used for prophalaxis during WWI. Considering the gunshots that many men experienced in the dirt ridden land, this was a milestone for the world.

The Clostridium tetani bacterial spore has not been eradicated since it's discovery. Tetanus is still a highly regarded disease that can be incredibly painful and detrimental to one's health.


How does someone know they have tetanus?

If a person experiences a laceration, puncture wound, or deep abrasion, it is policy nowadays to be aware that they could have potentially contracted tetanus. Clostridium tetani spores mostly thrive in soil; however, spores with good motility could end up virtually anywhere, including onto something that could have caused a laceration. The tell tale sign of a developed tetanus is trismus, or a locked jaw that makes the mouth hard to open and close. A person may develop a sore back, abdominal muscles, facial muscles and oddly enough, a permanent smirk of their mouth. While these are the main symptoms, a person could show signs of multiple small fractures (caused by intense muscle spasms), hypertension, tachycardia and dyspnea.

The list from the CDC is as follows:

- Headache

- Jaw cramping

- Sudden, involuntary muscle cramping

- Painful muscle stiffness

- Dysphagia

- Jerking or staring

- Febrility and diaphoresis

- Hypertension

How is it transmitted?

The CDC suggests that there are specific and rare ways of getting the disease into your body:

- Wounds contaminated with feces, soil or saliva.

- Puncture wounds.

- Burns.

- Crush Injuries.

- Injuries which involve dead or stagnant tissues.

The more rare ways include:

- superficial abrasions

- surgical procedures

- insect bites

- dental infections

- compound fractures

- IV drug use

- Open sores or lesions.


- For the above photo: http://www.podiatrytoday.com/how-treat-puncture-wounds

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Complications of Tetanus?

Tetanus can affect anyone and everyone. People who are at most risk are people who are not immunized, most of them being over the age of 50. The tetanus shot is administered once around the age of 7 and then a booster shot is needed every 10 years. If a person is not up to date with a tetanus shot at the time of injury, a booster can be given by a physician without complication.

Complications include:

- Uncontrolled muscle contraction of the vocal cords.

- Fractures of the bones from uncontrolled muscle spasms.

- Hospital acquired infections.

- Pulmonary embolism, or stroke.

- Pneumonia

- SOB, which can lead to death (10-20%)


Recommended Prevention and Control of Tetanus

Tetanus can be prevented by being vaccinated with the DTaP vaccination. The DTaP vaccination provides the child immunity to three deadly bacterial diseases; diptheria, tetanus and pertussis.

- The CDC recommends that a patient begin a DTaP vaccination at the age of two months. The infant than should receive another 4 rounds of the vaccine. Once at four months, once at six months, once at 15-18 months and then once again between the ages of four and six. After receiving these shots in adolescence and childhood, they will need to be administered a Booster shot every ten years to continue immunity.

- Proper wound care is another critical component of preventing tetanus. If a clean is washed out properly, dressed with clean dressings and evaluated by a physician; the likelihood of a person contracting the disease can be minimized. Physicians are required to ask a person with a wound if their tetanus is up to date. If it is not, a simple booster can be given immediately and contraction of tetanus is less likely.