Tetanus is caused by Clostridium tetani bacteria which produces a neurotoxin. The bacteria is commonly found in soil and enters the body through breaks in the skin. The neurotoxin causes painful muscle spasms starting in the jaw and neck and can lead to death if untreated. Treatment involves a tetanus immune globulin injection to combat the toxin along with antibiotics and wound cleaning. Vaccination provides highly effective prevention through tetanus toxoid which stimulates antibody production and has dramatically reduced cases of tetanus in vaccinated populations.
Clostridium tetani (tetanus) - causes, symptoms, diagnosis, treatment, pathology. Tetanus is a toxin-mediated disease. The infectious agent of the disease is a neurotoxin produced by gram positive-anaerobic spore-forming organisms, Clostridium tetani. Movement of our voluntary muscles is controlled by our central nervous system. This animation describes the process of infection with Clostridium tetani and how the toxin it releases interrupts nervous control of our muscles, leading to tetanus. This loss of muscle control causes the convulsive muscle spasms typical of tetanus, which are so severe they can cause bone fractures and dislocations.infection of tetanus occurs when bacteria contaminates the wound and produce the exotoxin. The contaminated-wounds with deep puncture trauma and devitalized tissue, are at high risk for developing tetanus.
There is no person to person transmission for tetanus.
Three overlapping clinical pictures are shown, which are generalized, neonatal, and localized.
Complications include laryngospasm, fractures, arrhythmias, nosocomial-hospitalizations. Heroin users are at increased risk of tetanus.
Clostridium are anerobic gram positive rod shaped spore forming organisms responsible to cause various life threatening diseases in humans like Gas gangrene, Tetanus, Botulism, etc
Clostridium tetani (tetanus) - causes, symptoms, diagnosis, treatment, pathology. Tetanus is a toxin-mediated disease. The infectious agent of the disease is a neurotoxin produced by gram positive-anaerobic spore-forming organisms, Clostridium tetani. Movement of our voluntary muscles is controlled by our central nervous system. This animation describes the process of infection with Clostridium tetani and how the toxin it releases interrupts nervous control of our muscles, leading to tetanus. This loss of muscle control causes the convulsive muscle spasms typical of tetanus, which are so severe they can cause bone fractures and dislocations.infection of tetanus occurs when bacteria contaminates the wound and produce the exotoxin. The contaminated-wounds with deep puncture trauma and devitalized tissue, are at high risk for developing tetanus.
There is no person to person transmission for tetanus.
Three overlapping clinical pictures are shown, which are generalized, neonatal, and localized.
Complications include laryngospasm, fractures, arrhythmias, nosocomial-hospitalizations. Heroin users are at increased risk of tetanus.
Clostridium are anerobic gram positive rod shaped spore forming organisms responsible to cause various life threatening diseases in humans like Gas gangrene, Tetanus, Botulism, etc
Anthrax is also known as Wool sorter's disease and is zoonotic in nature. The organism responsible for this disease has been discussed here. The organism has also been used in bioterrorism attacks.
Anthrax is also known as Wool sorter's disease and is zoonotic in nature. The organism responsible for this disease has been discussed here. The organism has also been used in bioterrorism attacks.
This is general presentation which can be used by anyone. It contains short information about the history, mode of transmission of tetanus in human beings and what are the health problems due to tetanus in human beings. All the information is gathered from reliable sources and references are also given at the end of the presentation. it can be used by anyone for educational purposes.
2. What is tetanus?
Domain: Bacteria – Genus: Clostridium – Species: tetani
Gram positive, Bacillus (rod-shaped), Obligate anaerobe and in the presence
of O2 it forms endospores changing the shape into what looks like a drumstick
Reservoirs:
Everywhere in the environment – primarily in the soil and dust
(where O2 is not present)
4. Causes and Transmission
Common ways tetanus gets into the body
-Through broken skin, especially those breaks caused by a contaminated object
-Burns
-Cush Injuries
-Injuries with dead tissue
In more rare cases Tetanus can enter the body
-Through superficial wounds
-Surgical Procedures
-Insect bites
-Dental infections
-Compound fractures
-Chronic sores
-Intravenous drug use
(CDC, 2013)
5. Symptoms and Complications
Symptoms can emerge anywhere from 4 days to 3 weeks after infection. Most commonly taking about 10
days.
Muscular Symptoms
-Muscle Spasms
-Usually starts in the jaw area
-Spams spread to the neck throat and face from there
-The spine can arch back in severe cases
Other Symptoms
-Bloody Stool
-Diarrhea
-Fever
-Headache
-Tachycardia
-Sensitivity to touch
Gone untreated the infection can cause death by way of heart attack, kidney failure, Septicemia or
asphyxia
(Nordqvist, 2014)
6. Tetanospasmin the Neurotoxin
Clostridium tetani releases the neurotoxin tetanospasmin which causes the
clinical characteristics of tetanus
Tetanospasmin is one of the most potent toxins known and has a LD (lethal dose)
of 2.5 nanograms per kg of body weight
To put that in perspective that would only take 174 nanograms for someone 154lbs
to receive a lethal dose. (CDC)
What it does:
When the infection reaches the spinal cord it selectively blocks nerve transmission
from the spinal cord to muscles, thus, causing the uncontrollable spasms and
prolonged contractions of muscles.
http://youtu.be/L2Dr929zjY4?t=2m32s (YouTube Video)
7. Diagnoses and Treatment
Clinical syndrome without confirming lab tests
Diagnosed by the characteristic painful muscle contractions, usually of the
face and neck muscles as well as the abdomen
If they haven’t received the vaccination they may perform serological tests
to look for antibody presence
TIG (Tetanus Immune Globulin) is given to remove unbound tetanus toxoid
Due to extreme potency of toxin, immunization with tetanus toxoid should
be maintained ASAP *Tetanus disease doesn’t result in tetanus immunity
All wounds cleaned; Necrotic tissue and foreign material removed; If
spasms, then supportive therapy & maintained adequate airway are
critical
8. Vaccination!
Tetanus vaccine – tetanus immune globulin prevents the toxin from binding to
nerve endings preventing tetanus symptoms
The vaccine does decrease in effectiveness over time and should be
administered every 10 years for best prevention.
10. History
The etiology (or cause) of tetanus was
discovered by Carle and Rattone in 1884
The first tetanus toxoid was produced in
1924 and administered to the military first
during WWII and then the general
population with the TDaP vaccine
launching in 1942.
More Recently:
2001-2008 in the USA there has been 233
cases reported
49% 50yrs old +
59% male
Almost all reported cases were in
persons that never had been
vaccinated or had not had their
booster in the preceding 10 yrs.
11. Research/Unusual Cases
Case 1:
31-yr old male admitted to ER
with 2-day neck & jaw pain.
Tetanus antibody level of
8.4U/mL, which is considered
protective, yet he presented signs
of tetanus.
He was treated with TIG and by
day 6 post ER his symptoms had
cleared.
Case 2:
26-yr old male open fracture L
tibia and fibula, contaminated
with soil.
14 yrs since last vaccination
No clinical symptoms of tetanus
After many trips back and forth to
ER – serological tests and biopsy’s
confirmed an ongoing tetanus
infection that remained for 17 mo
post initial visit and resulted in
amputation.
12. References
CDC. 2011. Tetanus. Retrieved from www.cdc.gov/vaccines/pubs/pinkbook/downloads/tetanus.pdf
Kenyon College. 2011. Clostridium tetani. MicrobeWiki. Retrieved from
http://microbewiki.kenyon.edu/index.php/Clostridium_tetani
Levy, P. 2014. Clostridium tetani Osteitis without Tetanus. NIH. Retrieved from
http://www.ncbi.nlm.nih.gov.offcampus.lib.washington.edu/pmc/articles/PMC4178411/
Tetanus, Causes and Transmission, CDC. (2013). Retrieved
from http://www.cdc.gov/tetanus/about/causes-transmission.html
Nordqvist, C. (2014, September 26). "What is tetanus? What causes tetanus?." Medical News Today.
Retrieved from
http://www.medicalnewstoday.com/articles/163063.php.
Vollman, K. 2014. A case of tetanus infection in an adult with a protective tetanus antibody level.
Retrieved from
http://apps.webofknowledge.com.offcampus.lib.washington.edu/full_record.do?product=WOS&sea
rch_mode=GeneralSearch&qid=1&SID=3Fyvxb7T8OeWBrpdN65&page=1&doc=6
13. Tetanus is the only vaccine-
preventable disease that is infectious
but not contagious!
Questions?
Thank you!!
