Tetanus is caused by the bacterium Clostridium tetani which produces a toxin that affects the nervous system. The spores can be found in soil and dust and enter the body through wounds. The toxin causes painful muscle spasms starting with the jaw and potentially affecting breathing. Tetanus is prevented through active immunization with tetanus toxoid vaccines as part of routine childhood immunization schedules with boosters recommended every 10 years. For wound management, thorough cleaning and antibiotics may be given along with a tetanus toxoid booster or immunoglobulin for non-immunized individuals.

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2. DEFINATION
 Tetanus is an acute , often fatal disease of
the nervous system that is cause of nerve
toxin.

3. Caused by clostridium tetani
Gram positive, spore formimg,Anaerobic bacilli

5. Source of infection
 The natural habitat of the organism is soil and dust.
The bacilli are found in the intestine of herbivorous
animals. The spores survive for years in nature.
sometimes spores may found in the intestine of man
without causing ill-effects.

6. EXOTOXIN
Tetanus bacilli produces soluble exotoxin. The toxin
acts on 4 areas of nervous system.
a) the motor end plates in skeletal system
b) the spinal cord
c) the brain
d) the sympathetic system

7. Its principle action is to back inhibition of spinal
reflexes.
Tetanus is not a communicable disease
condition.

8. Host factors
Age:
commonly, tetanus is a disease of the active age (5
to 40 years) because this period predisposes to all
kind of trauma
Sex:
females are more exposed to the risk of tetanus,
especially during delivery or abortion leading to
pueperal tetanus.

9. occupation: agricultural workers are at more risk.
Immunity: No age is immune unless protected by
previous immunization. The immunity receiving from
two doses of immunization is highly effective.
Herd immunity does not protect the
individual..

12. Modes of transmisson

14. Incubation period

16. Types of tetanus
1) Traumatic: Trauma is major and important cause of
tetanus. Sometimes tetanus may results from even
unnoticed wounds.
2) puerperal: Tetanus follows abortion more frequently
than normal labour. A post abortal uterus is a good site
for spore germination.

17. 3) Otogenic: Ear may be rare portal of entry. Otogenic
tetanus is a paediatric problem but cases may occur
in adult also.
4) Idiopathic: In these cases there is no definite history
of sustaining injury.

19. Signs and symptoms
1. Begins with mild spasms in the jaw muscles-
also known as “lock jaw” or “ trismus”.
2. spasms may affects chest, neck, back, buttocks,
abdominal muscles.
3. spasms may sometime affect muscles that help in
breathing which may lead to brearthing difficulty.

20. 5. Prolonged muscular action causes sudden, powerful
and painful contraction called “TETANY”.

21. Other symptoms

22. Prevention from tetanus

23. VACCINATION
1)Active immunization:
Tetanus is best prevented by active immunization with
tetanus toxoid,
Two preparations available for it are;
a) Combined vaccine- DPT
b) Monovalent
i) plain or fluid
ii) Tetanus vaccine,adsorbed

24. a)combined vaccine:
3 doses of DPT is given at 6, 10 and 14 weeks of
age…booster at 18 months, second booster
(only DT) at 5-6 years and third booster(only TT)
after 10 yrs of age.
b)Monovalent vaccine:
purified TT (adsorbed) has largely supplanted
plain toxoid.

25. 2)passive immunization:
injection of human tetanus hyperimmunoglobulin
(TIG), its is best prophylactic to use.

26. 3) Active and passive immunization:
It is widely carried out in non-immune persons.
The patient is given 1500 units of Ats or 250 units of
Igg in one arm and 0.5 ml adsorbed TT should be
followed 6wks later followed by 2nd and 3rd doses.

27. 4) Antibiotics:
A single IM injection of 1.2 megaunits of long lasting
penicillin.
 7 days course of erythromycin estolate 500mg 6 hrly
by oral will kill vegetative forms of “C.TETANI” but
not spores.
Antibiotic alone is ineffective in the prevention of
tetanus;it is not substitute to immunization.

28. Prevention from neonatal tetanus

30. Prevention from tetanus after injury
all wounds must be thoroughly cleaned soon after
injury
Removal of foreign bodies, soil, dust, nectrotic tissue
 tetanus toxoids can be given in case of suspected
exposure to tetanus
 tetanus immunoglobulin can be given alon with TT
It can be given IV or IM.