by Sarah Staples

Created on: June 09, 2008   Last Updated: May 16, 2010

Although rare, tetanus is still responsible for human deaths. The majority of these fatalities occur in developing countries, but can also inflict residents of Western developed nations. Most people in the Western world have heard of tetanus bacteria, but are probably unaware of the symptoms of this disease and the treatment needed.

The tetanus bacteria is called Clostridium tetani. Spores of these bacteria are found in soil, dirt, feces and dust. These spores are able to germinate under the right conditions to produce a toxin called tetanospasmin. It is this toxin which attacks the nervous system of victims and is responsible for tetanus symptoms.

The tetanus bacteria can enter the human body through contaminated cuts and wounds. Puncture wounds, heavily contaminated wounds and wounds left unattended are particularly susceptible. For this reason, prompt treatment and adequate cleansing of wounds is essential for tetanus prevention.

Tetanus symptoms can appear at any time from a day to months after the initial injury; in many cases the wound that caused entry of the tetanus bacteria may well have been forgotten by the victim by the time symptoms occur. Initial tetanus symptoms are generalized tiredness, accompanied by a fever and headache. As the disease develops more classic symptoms appear.

Signs and symptoms include:

1. Lockjaw.
This is difficulty opening the mouth due to muscle spasms. Tetanus disease has often previously been referred to by the term lockjaw.

2. Abnormal body posture.
The victim may arch their back and over extend their neck.

3. Spasms.
These spasms can cause swallowing and breathing problems.

4. Heart and blood pressure problems.
These occur due to interference with the nerves that control heart rate and blood pressure.

Treatment of established tetanus requires expert help. Anyone suspected of having tetanus should be taken to their nearest hospital. Diagnosis of tetanus is based on the clinical picture; laboratory tests are seldom useful.

Victims of tetanus need to be nursed in intensive care. Treatment involves meticulous cleaning of the wound responsible. Any dead tissue will need to be cut away. Antibiotics are given and a shot of human tetanus immune globulin is administered. The victim may need medications to control seizures and will probably need to be on a ventilator. Even with expert care death rates from established tetanus are high.

The majority of people in developed countries have been immunized against tetanus with a vaccine. The tetanus vaccine is called tetanus toxoid. Children are routinely given the tetanus vaccine as part of the triple primary immunizations as a baby. A further tetanus shot is given before starting school and again in early adulthood. It is now recommended that once these five shots have been given further shots are only needed if significant injury occurs.

Luckily, tetanus shot side effects are generally limited to mild local reactions at the injection site.

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