Tetanus or Lockjaw

Tetanus is a serious but preventable bacterial infection which affects the nerves. It is commonly known as lockjaw. Tetanus is spread by contact with an object or surface that has been contaminated with Clostridium tetani. Transmission is most often the result of a puncture wound that provides the bacterium easy access into the body. Tetanus can cause body spasms ranging from mild to powerful entire body contractions, suffocations and heart attacks.There are currently no blood tests available to diagnose tetanus. There is no cure for tetanus. link

Thanks to the tetanus vaccine, cases of tetanus are rare in the developed world. But the disease remains a threat to those who aren’t up to date on their vaccinations. Treatment focuses on managing complications until the effects of the tetanus toxin resolve.

Types

Local tetanus is an unusual form of the disease consisting of muscle spasms in a confined area close to the site of the injury. Although local tetanus often occurs in people with partial immunity and is usually mild, progression to generalised tetanus can occur.

Cephalic tetanus is uncommon and usually occurs after head trauma or otitis media. Patients with this form present with cranial nerve (CN) palsies. The infection may be localised or may become generalised. link

Neonatal tetanus is caused by the action of a potent neurotoxin produced during the growth of the bacteria in dead tissues, e.g. in dirty wounds or in the umbilicus following non-sterile delivery. The disease is common and serious in newborn babies. It is particularly commonplace in rural areas where deliveries are at home without adequate sterile procedures. Unfortunately, most infants who contract the disease die.

Symptoms

The incubation period of tetanus varies between 3 to 21 days after infection. Most cases occur within 14 days.

Symptoms can include:

• jaw cramping or the inability to open the mouth
• muscle spasms often in the back, abdomen and extremities
• sudden painful muscle spasms often triggered by sudden noises
• trouble swallowing
• seizures
• headache
• fever and sweating
• changes in blood pressure or fast heart rate.

In neonatal tetanus, symptoms include muscle spasms, which are often preceded by the newborn’s inability to suck or breastfeed, and excessive crying.

Tetanus is diagnosed on the basis of clinical features and does not require laboratory confirmation. The WHO definition of a confirmed neonatal tetanus case is an illness occurring in an infant who has the normal ability to suck and cry in the first 2 days of life, but who loses this ability between days 3 and 28 of life and becomes rigid or has spasms.

The WHO definition of non-neonatal tetanus requires at least one of the following signs: a sustained spasm of the facial muscles in which the person appears to be grinning, or painful muscular contractions. Although this definition requires a history of injury or wound, tetanus may also occur in patients who are unable to recall a specific wound or injury. link

Prevention

Tetanus can be prevented through immunization with tetanus-toxoid-containing vaccines (TTCV), which are included in routine immunization programmes globally and administered during antenatal care contacts.

There are many kinds of vaccines used to protect against tetanus, all of which are combined with vaccines for other diseases: link

• Diphtheria and tetanus (DT) vaccines
• Diphtheria, tetanus, and pertussis (whooping cough) (DTaP) vaccines
• Tetanus and diphtheria (Td) vaccines
• Tetanus, diphtheria, and pertussis (Tdap) vaccines