Tetanus is also known as lockjaw and the bacterium responsible for the disease has been identified as Clostridium Tetani, which is found in the soil. It releases a toxins that primarily stimulates the muscles of the head, face, jaw and neck, but can also extend to the arms and legs.
Tetanus is not transmitted directly from person to person but introduced into the body via cuts, grazes, abrasions, puncture wounds and areas of unnoticed broken skin. The transmission medium is contaminated soil, dust, animal and human feces and contaminated shared injection needles.
Tingling pains at the site of the injury with spasticity of the surrounding muscle are all considered important symptoms. As the symptoms progress, spasms of the respiratory muscle takes place causing asphyxiation, airway obstruction, irritability and the inability to sleep.
One in ten cases end in fatality, the main cause of which can be attributed to respiratory failure or disturbance in the heart rhythm. Prompt and immediate treatment is essential and the groups most susceptible to the infection are the very young and the very old who are attacked most severely. The Td (tetanus and diphtheria) vaccine is the immunisation drug currently being used to prevent tetanus in adults, whilst the Tdap (tetanus, diphtheria and pertussis) are combined and used to vaccinate the very young.
The incubation period is between 3-21 days, however 8 days is seen as average and research had indicated that the further away the injury site is from the nervous system the longer the incubation period.
The disease is wholly preventable if the right precautions are taken in a timely manner. An immunisation vaccine has been available since the 1920’s developed by using Tetanus Toxoid that has been heat treated only long enough to decrease the toxic effect, but still retain it antigenic profile. Tetanus Toxoid can be given as a stand alone vaccination or as previously mentioned it can be combined with the whooping cough (pertussis) and diphtheria vaccine which is the form it is commonly given to children.
For the primary immunisation in adults Tetanus Toxoid is given in two doses 4 to 6 weeks apart, with a follow-up 6 to 12 weeks later. This is again followed up 10 year later with a booster dose in an effort to maintain the correct level of immunity. This is particularly important for those who are 50 years old and over, farm workers and those working within the agricultural industry, whilst travellers abroad are advised to ensure that they are protected.
Tetanus is an on-going international health problem. In 2008 the World Health Organisation (WHO) reported that 59,000 newborn babies died from the tetanus bacterium, mainly due to being born in conditions that were less than sanitary.
An attack and recovery from tetanus does not result in immunity, which in effect means that attacks can reoccur and peculiarly it is also the only vaccine-preventable disease that is not contagious.