Tetanus (lockjaw)

By Kemboi Kibet, Moi University School of Medicine

Tetanus is a bacterial infection of the nervous system caused by the deadly Clostridium tetani .It affects the nervous system leading to painful muscle contractions of the jaw and neck muscle. Tetanus also known as lockjaw is a very fatal condition but can be easily prevented with tetanus vaccine.The disease typically arises from a skin wound which becomes infected with the tetanus bacterium. Tetanus incidence is reduced drastically in the united states and other countries due to the tetanus vaccine. A booster shot is needed every 10 years after primary immunization or after a puncture or deep skin wound.

There is another form of tetanus called neonatal tetanus. This occurs when babies are born in unsanitary conditions.Routine immunizations for tetanus produce antibodies that mothers pass to their unborn babies. These antibodies together with delivering babies in better sanitary conditions have made neonatal tetanus very rare.

SYMPTOMS

Signs and symptoms of tetanus appear a few days or several weeks after infection with the bacterium. These may include

difficulty swallowing
Spasms and stiffness in your jaw muscles
fever
sweating
uncontrolled urination or defecation
stiffness in neck and abdominal muscles
drooling
elevated blood pressure
fever

CAUSES

Spores of Clostridium tetani lives in the soil,dust and animal feces.When they enter the body through wounds and deep cut, they produce powerful neurotoxins known as tetanospasmin that cause muscle spasm. The toxin travels through the body into the blood stream and lymph system. As the toxin takes over the whole body, it interferes with the normal activity of the nerves causing general muscle spasm and stiffness.

RISK FACTORS

Certain factors make it easier for the tetanus bacteria to divide and these include

Lack of immunization or inadequate immunization

A penetrating or deep wound

Presence of other infectious bacteria

DIAGNOSIS

Physical exam, immunization and medical history may help in diagnosing tetanus. Signs and symptoms may also help in diagnosing.

TREATMENT

There is no treatment for cure however medications are designed for supportive care and to ease symptoms of the disease.

Antibiotics. These are given to fight the tetanus infection. Some antibiotics given include penicillin, clindamycin, erythromycin, or metronidazole .

Antitoxin such as tetanus immune globulin are used to reverse the toxin

Vaccine Even when you’ve had the disease before, you can still get infected so vaccination is given to prevent future infection

Powerful Sedatives are given to control muscle spasm

Muscle relaxers such as diazepam

Surgery may also be used to clean the wound and remove the source of the poison

COMPLICATIONS

airway obstruction
pneumonia
heart failure
brain damage
respiratory arrest
fractures
permanent disability
death

PREVENTION

One sure way to prevent tetanus is to get the tetanus vaccination. It is recommended that a booster shot be given every ten years, after a deep wound or when travelling to areas prone to tetanus.

Thorough cleaning of all injuries and wounds and the removal of dead or severely injured tissue can also help prevent infection.

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