Tetanus is caused by an exotoxin produced by Clostridium tetani, an anaerobic bacteria. The bacteria's spores are found in soil and animal feces and enter the body through wounds. The exotoxin causes painful muscle spasms, particularly of the jaw muscles (lockjaw). Tetanus has a high mortality rate and is typically treated with antitoxins, antibiotics, wound cleaning and management of symptoms. The disease is vaccine-preventable through routine immunization.

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2.  An acute disease induced by an exotoxin of
the tetanus bacillus, which grows
anaerobically at the site of an injury and is
characatrised by painful spasms of the
voluntary muscles, especially the
masseters(known as "lock-jaw")

3.  Clostridium tetani is a gram-positive,
anaerobic, spore-bearing organism. The
spores are highly resistant to a number of
injurious agents, including boiling, phenol,
cresol and autoclaving for 15 minutes at
120 deg.

4.  The spores germinate under
anaerobic conditions and
produce a powerful exotoxin
"tetanospasmin".

5.  The natural habitat of the organism is soil and dust.
The bacilli are found in the intestine of many
herbivorous animals, e.g., cattle, horses, goats and
sheep and are excreted in their faeces. The spores
survive for years in nature.

6.  Mode of transmission—Tetanus spores are usually
introduced into the body through a puncture wound
contaminated with soil, street dust or animal or
human feces through lacerations, burns and trivial or
unnoticed wounds

7.  Tetanus occasionally caused after surgical
procedures, which are performed under unhygienic
conditions. The presence of necrotic tissue and/or
foreign bodies favors growth of the anaerobic
pathogen.

8.  Incubation period—Usually 3–21 days,
although it may range from 1 day to several
months, depending on the character, extent and
location of the wound; average 10 days.

9.  clinically tetanus is characterized by muscular
rigidity which persists throughout illness.
 There is painful paroxysmal spasms of the
voluntary muscles, especially the masseters
(also known as "lock-jaw")

10. 

11.  There may be presence of spasm of the facial
muscles (known as risus sardonicus)
 Presence of spasm of the muscles of the back
and neck (known as opisthotonos)

12. 

13.  spasm of muscles of the lower limbs and
abdomen may also occur.
 Mortality of tetanus is very high. Mortality
range is between 40 to 80 percent.

14.  No special laboratory investigations are needed
for tetanus. Only sign and symptoms are
sufficient to confirm the diagnosis of tetanus.

15.  Treatment depends on the severity of the
symptoms. Tetanus is typically treated with a
variety of therapies and medications, such as:
 Antitoxins may be given to neutralize toxin.
 Antibiotics may also be prescribed

16.  Wound care- it is necessary to clean the wound
by removing dirt and foreign body and dead
tissue to prevent germination of spores and
growth of bacteria

17. Tetanus is a vaccine preventable disease.
Tetanus toxoid is available as single vaccine
and it is also available in combination as
DPT, DT or pentavalent.

18. Health education regarding complete
immunization and prevention of injury and
proper care of open wound helps in
prevention of tetanus

19.  Prophylaxis with penicillin also helpful in protecting
high risk group.
 Proper treatment and cleaning of wounds can also
help prevent the infection.
 Vaccination in pregnancy can prevent neonatal
tetanus.

20. By – SURESH KUMAR ( Nursing Tutor )