What is tetanus? : Tetanus is a very serious disease caused by a toxin coming from a bacteria called
Clostridium tetani. The toxin affects the central nervous system and the muscles of the body become rigid usually starting with the neck and jaw which is why the disease is commonly called lockjaw.
C. tetani is found in soil and manure as well as on the surface of human skin and heroin contaminated with the bacteria. Only 175 nanograms of toxin, less than a pinhead, are needed to cause disease in a 154 pound person. Today, only 50 to 100 people get tetanus every year in the United States since most people receive tetanus shots.
How could I get tetanus?: The
Clostridium tetani bacteria enters the bloodstream through wounds or other entrances to the body. It is not spread from one person to another.
Tetanus infection may follow:
- Any kind of wound, including those from stepping on a nail, barbed wire, piercings, IV drug use and surgery.
- Animal or human bites.
- Ear infections and dental infections.
- Pregnancy, miscarriage or abortion.
In addition, infants born to a mother without tetanus immunity may get tetanus through the umbilical cord stump, especially if the cord was cut with a contaminated instrument.
What are the typical symptoms of tetanus?: Symptoms may begin after as few as three days and as many as 21 days after exposure to
C. tetani, but eight days after initial exposure to the bacteria is the average time before symptoms develop.
- Muscle rigidity and spasms start at the neck and jaw. Spasms can last a few minutes and come back often.
- Difficulty swallowing is noticed.
- Abdominal muscles are rigid.
- Elevated temperature, sweating, high blood pressure, and a high heart rate every now and then.
Recovery can take three to four weeks, but complete recovery may even take months.
What types of tetanus are there?: In 80 per cent of tetanus cases, muscle spasms of the vocal cords and muscles used to breathe make breathing difficult and many complications follow, especially pneumonia. Aspiration pneumonia is found in 50-70 per cent of cases upon autopsy. Bones may break from the intense muscle spasms and high blood pressure and an increased heart rate do not help matters.
Of those who get tetanus, 18 per cent are older than 60 years old and 22 per cent are unvaccinated.
Only 20 per cent of tetanus cases are cephalic, localized to the head, or local. In these cases, muscle spasms may be limited to a specific part of the body.
How is tetanus diagnosed and treated?: Tetanus is diagnosed purely on signs and symptoms. The actual cause of tetanus,
C. tetani is isolated in the laboratory only 30 per cent of the cases. So blood tests are not used to diagnose tetanus.
Once tetanus is diagnosed, tetanus immune globulin (TIG) can be given as a shot in a large muscle to deactivate any tetanus toxin that has not yet caused damage to the nerves. If the wound where tetanus entered can be found, it should be cleaned and TIG applied. Intravenous tetanus antitoxin can also be given if tetanus immune globulin cannot be found. Antibiotics do not help prevent disease caused by tetanus.
How can I prevent tetanus?: Updated tetanus shots will prevent tetanus disease just about 100 per cent. People who are immunized against tetanus getting the disease are extremely rare. If a person who has had three or more tetanus shots is wounded with suspected tetanus, the wound should be cleaned, but neither TIG nor tetanus antitoxin need to be administered. The tetanus shot is made from tetanus toxoid and is combined with the diphtheria vaccine and in children, with the diphtheria and whooping cough (pertussis) vaccine.
How often do I need a tetanus shot?: If you were immunized as a child, you will only need a booster shot every 10 years. The tetanus vaccine is not available alone and is always found as a combined vaccine with diphtheria or with diphtheria and whooping cough (pertussis), two diseases doctors recommend being immunized against anyway.
If you are an adult or a child over seven years-old being immunized for the first time against tetanus, you will need three tetanus shots within about a year:
- First tetanus shot
- 4 weeks later, second tetanus shot
- 6-12 months after the second shot, another tetanus shot
- Every 10 years, you will need a booster tetanus shot.
What if it’s been more than 10 years since my last shot?: If you are an adult who was immunized against tetanus as a child, just go get a booster shot now. You don’t need to get the three shot series to get you immunized again. Your booster shot will set you up against tetanus for another ten years, although if you get a wound before the ten years is up, a doctor may recommend that you go for an additional booster shot.
Are there any reasons I shouldn’t get the tetanus shot?: The thorough CDC site I used to reference this tetanus and tetanus shot information did not specify any reasons pregnant women should not receive a tetanus shot, but consult with your doctor before going for a booster shot if you are pregnant. The only reason for not getting a tetanus shot according to the CDC is an allergy to any of the components of the tetanus vaccine or in case a person already has a serious illness. In the case of allergy, a skin test can be performed with the vaccine if allergies are suspected.
When should babies and kids get a tetanus shot?: Children should receive either a Diptheria-Tetanus and Pertussis (DtaP) or a Diptheria-Tetanus (DT) shot in this routine:
- 2 months: First DtaP
- 4 months: Second DtaP (not less than 4 weeks after the previous shot)
- 6 months: Third DtaP (not less than 4 weeks after the previous shot)
- 15-18 months old: Fourth DtaP (not less than 6 months after the previous shot)
Brand names of tetanus vaccines are Boostrix (for children 10-18 years-old) and Adacel (for people from 10-64 years old) and neither the DtaP nor the TDaP vaccines contain thimerosol as a preservative. Thimerosol is an additive that contains mercury that has come under fire in recent years, although it has shown to be safe in peer-reviewed research by scientists and physicians.
Children should have four tetanus shots if the first one was given when the child was younger than one year old. A fifth tetanus shot is needed between four and six years old for children who received all four shots before they were four years-old. Another booster may also be given at 11-12 years old.
Sources
CDC. Tetanus. PDF.
