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Tetanus: Causes, Symptoms, Prevention

May 31, 2023

Tetanus

The toxin-producing bacterium causes tetanus  which is  the cause of the fatal neurological disorder. The disease frequently causes muscle contractions, especially in the neck and jaw muscles. A typical tetanus symptom is lockjaw.

If tetanus effects are severe, they could be fatal. There is no known cure for tetanus. While the effects of the tetanus toxin are still being felt, the aim of treatment is to manage symptoms and adverse effects.

Due to the widespread use of immunisations, tetanus cases are infrequent in the United States and other industrialized countries. Those who have not had all of their recommended vaccines are still at danger for contracting the illness. It happens more commonly in developing countries.

Read this blog further to get a quick overview of this important topic for microbiology and ace your NEET PG exam preparation.

Epidemiology of Tetanus

Organism causing tetanus is clostridium tetani. It is gram-positive, anaerobic bacteria having a drumstick appearance. It is a spore-forming bacilli. The contamination of the wounds with the spores of the bacilli may transmit infection. Tetanus is mainly due to the production of exotoxin.

Clostridium tetani

What are the Types of Toxins?

  • Tetanolysin - It causes Hemolysis and this toxin is Oxygen labile and it resembles to toxin of S. Pyogenes & S. pneumoniae.
  • Tetanospasmin- it is the most potent and dangerous toxin in the world. It is a neurotoxin and it  causes presynaptic inhibition of Glycine/ GABA (inhibitory neuro- transmitters) which leads to constant stimulation causing Lockjaw (Trismus) · If not controlled it will lead to Opisthotonus Posture which has a bad prognosis and there will be increase deep tendon reflexes.

  The reservoir and source of these toxins is soil and the mode of transmission is by contamination of wounds with the organism's spores. There is no period of communicability and   the incubation Period is 6 to 10 days and it  can extend up to months.


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Neonatal Tetanus and Tetanus Neonatorum

It is also known as 8th-day disease . It is caused by Infection of the umbilical stump. Elimination of neonatal tetanus was achieved in India around 15th May 2015. Criteria for elimination is considered as  less than one case per 1000 live births.

Prevention of Maternal and Neonatal Tetanus  

It is achieved by following the methods listed below:

  • Safe and  clean delivery
  • Follow 7 cleans
    • Clean surface 
    • Clean hands 
    • Clean cord 
    • Clean cut 
    • Clean tie 
    • Clean water 
    • Clean towel
  • Never use an unsterilized blade or old blade. 
  • Cow dung should not be used on cord.

What are the symptoms of tetanus?

Symptoms of tetanus include:

  • Muscle rigidity (muscle rigidity) and excruciating jaw muscle spasms
  • The muscles around the mouth tighten up and then, give a permanent grin.
  • stiffness and excruciating neck muscle spasms
  • unable to swallow due to tense stomach muscles

What Are The Risk Factors Of Tetanus?

Risk factors of tetanus 

Infection with tetanus is also made more likely by the following factors:

  • Cuts or wounds that have been exposed to mud or feces
  • A background of immune-suppressing illnesses
  • Skin lesions with an infection in diabetics
  • Umbilical cord infection when a woman isn't fully immunized
  • Shared and unhygienic needles for the usage of illicit drugs
  • The failure to receive the initial vaccination or the 10-year booster dose is the biggest risk factor for contracting tetanus.

Prevention and Control For Tetanus

Active Immunization:

In a National immunization schedule, tetanus toxoid is given in the form of tetanus-diphtheria vaccine (Td vaccine). It is given as a pentavalent vaccine.

  • Time:

At the age of  6th week first dose is given known as  Penta 1

           At the age of 10th week, Penta 2 is given 

            At the age of 14th week, Penta 3 is given

  • Pentavalent vaccine protects from five diseases:
    • Diphtheria 
    • Pertussis
    • Tetanus
    • Haemophilus influenzae B
    • Hepatitis B
  • At 16 to 24 months- 1st DPT booster is given 
  • At 5 to 6 years  DPT 2nd booster is given 
  • 10 to 16 years tD 1 and tD 2 are given
  • 7 doses of tetanus are recommended.
  • TT vaccine: is given in Trauma cases 
  • tD vaccine: it is included in National immunization schedule

Passive Immunization:

Passive immunization is done by Human tetanus immunoglobulin. Its Dose is 250 IU for all age groups

Tetanus Management Protocol

CategoryClean woundUnclean wound
A - Full immunization within 5 years.Only wound care.Only wound care.
B - Full immunization > 5 years ago < 10 years.Wound Care + TT single dose.Wound Care + TT single dose.
C - Full Immunization > 10 years ago.Wound Care+ TT single dose.Wound Care + TT single dose + Human TetanusImmunoglobulin.
D - Unknown, not known, never taken immunization.Wound Care + TT complete course.Wound Care + TT complete course + Human TetanusImmunoglobulin.

Antibiotics are recommended for a non-immune person with sustained injury and Not  for active against spores. In this the Dose given is 1.2 mega units of Benzathine Penicillin

What Are the Complications of Tetanus?

Tetanus infection complications could include:

  • Breathing difficulties, Vocal cord constriction, as well as neck and abdominal muscle rigidity, might pose a serious threat to one's ability to breathe, particularly during a generalized spasm.
  • lung artery blockage (pulmonary embolism)- The major artery of the lung or one of its branches can become blocked by a blood clot that has spread from another part of your body.
  • Pneumonia-  A side effect of generalized spasms could be aspiration pneumonia, a lung infection brought on by unintentional lung inhalation.
  • Bone fractures. The spine or other bones may shatter as a result of generalized spasms.
  • Death- Tetanus frequently results in death due to an obstruction of the airway during spasms or injury to the nerves that control breathing, heart rate, or other organ functions.

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