Glossary of Medical and Health Terms

Tetanus

Tetanus is a global health problem as Clostridium tetani and Geravium tetani spores are ubiquitous. The disease occurs almost exclusively in persons who are unvaccinated or inadequately immunized. Tetanus occurs worldwide but is more common in hot, damp climates with soil rich in organic matter. Tetanus, particularly the neonatal form, remains a significant public health problem in non-industrialized countries. There are about one million cases of tetanus reported worldwide, causing an estimated 300,000 to 500,000 deaths each year. In the U.S there are approximately 100 cases with about five deaths each year. Nearly all occur in lapsed or unimmunized individuals. Whereas most cases in developing countries are due to the neonatal form of tetanus. Tetanus is not contagious from person to person and is the only vaccine-preventable disease that is infectious but is not contagious.

Tetanus is often associated with rust, especially rusty nails. However the rust itself does not cause tetanus. Objects that accumulate rust are often in places that harbour anaerobic bacteria. The rough surface of rusty metal provides a prime habitat for a C. tetani endospore to reside. Hence, stepping on a nail (rusty or not) may result in a tetanus infection, due to the ideal bacterial breeding ground provided by the low-oxygen environment of a puncture wound.

Tetanus is characterized by a prolonged contraction of skeletal muscle fibres caused by tetanospasmin; a neurotoxin produced by the Gram-positive, obligate anaerobic bacterium Clostridium tetani. Infection can occur through contamination of a cut or puncture wound. It takes 2-14 days for symptoms to develop after infection. Symptoms peak 17 days after infection. Infection can progress causing muscle spasms in the jaw to develop hence the common name, lockjaw. Difficulty swallowing and general muscle stiffness and spasms in other parts of the body follow. The wound must be cleaned. Dead and infected tissue should be removed by surgical debridement. Metronidazole treatment decreases the number of bacteria but has no effect on the bacterial toxin. Penecillin can be used if metronidazole is not available but could induce spasms. Passive immunization with human anti-tetanospasmin immunoglobulin or tetanus immune globulin is crucial.

All tetanus victims should be vaccinated against the disease or offered a booster shot. Infection can be prevented by proper immunization and by post-exposure prophylaxis. Mild cases of tetanus can be treated with: Tetanus immune globulin IV or IM, metronidazole IV for 10 days, diazepam, and tetanus vaccination, tetanus shots/tetanus digestion. Severe cases require intensive care. In addition to the measures listed above for mild tetanus: human tetanus immunoglobulin injected intrathecally (increases clinical improvement from 4% to 35%), tracheostomy and mechanical ventilation for 3 to 4 weeks, magnesium, as an intravenous (IV) infusion, to prevent muscle spasm, diazepam (known under the common name Valium) as a continuous IV infusion. The autonomic effects of tetanus can be difficult to manage (alternating hyper- and hypotension, hyperpyrexia/hypothermia) and may require IV labetalol, magnesium, clonidine, or nifedipine.

The CDC recommends that adults receive a booster vaccine every ten years, and standard care in many places is to give the booster to any patient with a puncture wound who is uncertain of when he or she was last vaccinated, or if the patient has had fewer than 3 lifetime doses of the vaccine. The booster cannot prevent a potentially fatal case of tetanus from the current wound, as it can take up to two weeks for tetanus antibodies to form. In children under the age of seven, the tetanus vaccine is often administered as a combined vaccine, DPT vaccine or DTaP, which also includes vaccines against diphtheria and pertussis. For adults and children over seven, the Td vaccine (tetanus and diphtheria) or Tdap (tetanus, diphtheria, and acellular pertussis) is commonly used.

Associated ICD-10 codes: A33. A35.

Source: http://en.wikipedia.org/wiki/Tetanus

MyQuestionsMatter - helping you to ask the right health questions when discussing your medical condition with a healthcare professional.

Click here to generate a list of health questions now.