What is Tetanus?
Tetanus
is an infection caused by the bacteria Clostridium tetani. This
bacterium is a slender-shaped obligate anaerobe (it grows in the absence of
oxygen). The problem associated with the infection is called "Lockjaw".
In this condition, the person is unable to open its mouth and swallow due to
severe stiffness in the neck and jaw muscles. Spasms can also occur in
chest and abdominal muscles. Sometimes, severe muscle spasms may occur in back
muscles, leading to arching of the back with the head bent backwards,
causing a very uncomfortable and painful posture.
How Does it Cause Spasms or Muscle Stiffness?
This
occurs when Clostridium tetani releases an exotoxin (Tetanospasmin,
a protein-based neurotoxin) into the bloodstream. This neurotoxin has a
high affinity for the neuromuscular junction. Tetanospasmin interferes with the
action of neurotransmitters, gamma-aminobutyric acid (GABA), and
glycine, which are known to relax muscle activity. In the absence
of GABA, uncontrolled and forceful muscle contractions occur, leading to
muscle stiffness and spasms. Some muscle contractions are so forceful that they
can even cause bone fractures.
Infection
These
bacteria produce spores which may be present anywhere in dust, soil, and
feces. The spores are resistant to boiling and freezing and can remain
viable (capable of life) for many years in the environment. The spores can
enter the body through a wound or cut caused by any sharp object (such
as rusty nails) or a scratch. However, it cannot be transferred from one person
to another. Inside the body, the spores break down to release the actively
growing bacteria.
After
the entry of bacteria into the body, it may take 3 to 21 days to cause the
infection or symptoms. This time period is called the incubation period, which
depends on the load of bacterial cells entered and the immune status of the
person. The symptoms may include:
·
Cramps in jaw and neck
muscles.
·
Pain and stiffness in the body.
·
Involuntary muscle spasms.
·
Difficulty in swallowing and breathing
·
Fever and headache.
Serious Complications May Include:
·
Uncontrolled tightening of vocal
cords.
·
Fractures in
bones due to forceful contraction of muscles.
·
Blockage in
blood vessels of lungs affects breathing.
·
Due to severe muscle spasms, excessive
release of muscle protein in the blood may cause kidney damage.
·
In 10% of cases, tetanus can lead to death.
Types of Tetanus:
It
is based on the route of bacterial entry, severity of symptoms, and clinical
presentation, such as:
1. Localized
Tetanus: Symptoms remain confined to the muscles surrounding the
wound or puncture site, and systemic symptoms such as fever or spasms in other
body muscles are absent. For example, if a nail punctures the skin of the foot,
the person may feel difficulty in walking and spasms or stiffness in muscles
around the foot only.
2. Generalized
Tetanus: It is the most common and severe type,
characterized by widespread muscle stiffness and spasms affecting different
parts of the body, including lockjaw, neck, back, and limbs. It can also lead
to life-threatening respiratory complications if left untreated.
3. Neonatal
Tetanus: It occurs in newborns due to the transfer of infection
through the umbilical cord during deliveries conducted in unhygienic
conditions. It can become a significant cause of infant mortality in
regions with limited access to vaccination and healthcare facilities.
4. Cephalic
Tetanus: It is a rare form that occurs due to head trauma or ear
infections and affects the cranial nerves, causing facial paralysis and
difficulty in swallowing.
Diagnosis
There
are no specific hospital or lab tests available for the diagnosis of tetanus.
Hence, the diagnosis is purely based on signs and symptoms or the recent
history of injury, cuts, or wounds of the patient.
Treatment
Treatment
involves:
· Killing of bacteria using certain antibiotics
such as penicillin, metronidazole, or tetracycline (antibiotics may cause
severe allergic reactions).
·
Anticonvulsants to
relax the muscles and prevent spasms.
·
Muscle relaxants.
·
Those who feel difficulty in breathing may
need ventilator support.
· Tetanus immunoglobulins (TIG),
containing antibodies can be injected into the bloodstream of the
patient to neutralize the tetanus toxin.
Preventive Measures using Vaccination
·
Children should receive the five scheduled
doses of vaccines within the first 6 years of age. The booster doses
should be given every 10 years.
·
If infected, symptoms of tetanus may appear
within 3 to 4 days; therefore, a dose of tetanus booster shot should be given
within 48 hours of injury.
Vaccine Composition
The
vaccine contains the toxin of the tetanus-causing bacteria that has been
weakened using certain procedures and is no longer toxic but can
induce the formation of antibodies in the body. These antibodies fight
the bacteria Clostridium tetani and destroy them. The vaccine should be
given to pregnant women in the third trimester of pregnancy to protect the
newborns.
The mild
side effects of the vaccine include redness at the site of the injection,
low fever, headache, fatigue, vomiting, diarrhea, and loss of appetite. Rarely,
tetanus vaccination may cause severe allergic reactions, seizures, and high
fever.
.png)
.png)
.png)
0 Comments