Tetanus is an illness characterized by an acute onset of hypertonia, painful muscular contractions (usually of the muscles of the jaw and neck), and generalized muscle spasms without other apparent medical causes.It affects skeletal muscle, a type of striated muscle used in voluntary movement. Tetanus is the only vaccine-preventable disease that is infectious but is not contagious.
There are four different forms of tetanus: Generalized tetanus Neonatal Tetanus Local Tetanus Cephalic Tetanus
Generalized tetanusis the most common type of tetanus, representing about 80% of cases. Symptoms include elevated temperature, sweating, elevated blood pressure, and episodic rapid heart rate. Spasms may occur frequently and last for several minutes with the body shaped into a characteristic form called opisthotonos. Spasms continue for up to 4 weeks, and complete recovery may take months.
In generalized tetanus, the initial complaints may include any of the following: Irritability, muscle cramps, sore muscles, weakness, or difficulty swallowing are commonly seen. Facial muscles are often affected first. Trismus or lockjaw is most common. This condition results from spasms of the jaw muscles that are responsible for chewing. A sardonic smile -- medically termed risussardonicus -- is a characteristic feature that results from facial muscle spasms.
Neonatal tetanusis a form of generalized tetanus that occurs in newborns. It usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with a non-sterile instrument. The World Health Organization estimates that 59,000 newborns worldwide died in 2008 as a result of neonatal tetanus.
Local tetanusis an uncommon form of the disease, in which patients have persistent contraction of muscles in the same anatomic area as the injury. The contractions may persist for many weeks before gradually subsiding. Local tetanus is generally milder; only about 1% of cases are fatal, but it may precede the onset of generalized tetanus.
Cephalic tetanusis a rare form of the disease, occasionally occurring with otitis media (ear infections) in which C. tetani is present in the flora of the middle ear, or following injuries to the head.
Tetanus is often associated with rust, especially rusty nails, but this concept is somewhat misleading. The rough surface of rusty metal merely provides a prime habitat for a C. tetaniendospore to reside, and the nail affords a means to puncture skin and deliver endosporeinto the wound.
Tetanus begins when spores of Clostridium tetanienter damaged tissue.Tetanus can only occur when the spores germinate and become active bacterial cells. Tetanospasmin and tetanolysin
The incubation period of tetanus may be up to several months but is usually about 8 days. In general, the further the injury site is from the central nervous system, the longer the incubation period. The shorter the incubation period, the more severe the symptoms.In neonatal tetanus, symptoms usually appear from 4 to 14 days after birth, averaging about 7 days.
The disease typically follows an acute injury that results in a break in the skin. Most cases result from a puncture wound, laceration (cut), or an abrasion (scrape). Other tetanus-prone injuries include the following: frostbite,surgery,crush wound,abscesses,childbirth, andIV drug users (site of needle injection). Wounds with devitalized (dead) tissue (for example, burns or crush injuries) or foreign bodies (debris in them) are most at risk of developing tetanus.
Tetanus can be prevented by vaccination with tetanus toxoid. The booster may not prevent a potentially fatal case of tetanus from the current wound, however, as it can take up to two weeks for tetanus antibodies to form.
When given to women of childbearing age, vaccines that contain tetanus toxoid (TT or Td) not only protect women against tetanus, but also prevent neonatal tetanus in their newborn infants
Overall, the mortality rate is approximately 45%. Clinical tetanus is less severe among patients who have a history of receiving a primary series of tetanus toxoid sometime during their life as compared with patients who are inadequately vaccinated or unvaccinated. The mortality rate in the United States is 6% for individuals who had previously received 1-2 doses of tetanus toxoid compared with 15% for individuals who were unvaccinated.
First Aid-Any wound that results in a break in the skin should be cleaned with soap and running water. -All open wounds are at risk to develop tetanus. Wounds from objects outdoors or crush injuries are at higher risk. -Apply a clean and dry cloth to stop or minimize bleeding. -Apply direct pressure to the site of bleeding to help minimize blood loss.