by Kimberly Allen RN
Tetanus also called “lock jaw” is a serious disease caused by a bacterial infection. Tetanus is considered an international health problem. The World Health Organization estimates that there are approximately 1 million diagnosed cases of tetanus every year worldwide. It is more common in under developed countries with an average of 31 cases per year in the US with approximately 11% of those diagnosed cases being fatal. Tetanus is the only vaccine preventable disease that is infectious but not contagious. In the US almost all cases of tetanus occur in people that have either never been vaccinated for tetanus or have not kept their vaccination up to date.
Tetanus develops where an open wound, usually a puncture wound from a rusty nail, becomes infected by a bacteria called clostridium tetani. This bacteria lives in the soil as well as in animal feces. The bacteria releases toxins that cause muscle spams that in turn cause the skeletal muscles to contract. The infection causes the muscles of the jaw to contract. When the muscle of your jaw contract you can not make it move thus the name “lock jaw”. It is impossible to remove the tetanus toxins from your nerve endings once it has attached to them. Therefore, there are numerous complications that can develop if you have tetanus.
The treatment for tetanus is lengthy and recovery requires the nerves to grow new endings which takes several months. Also the main treatment for the muscle spasms that cause the contractions is strong sedatives like valium so you will spend most of the time either in bed sleeping or sitting in a chair dozing off. Just being immobile for that length of time can lead to problems. In infants and young children tetanus can cause long term problems with brain damage that can range anywhere from minor mental retardation to cerebral palsy. Should the tetanus infection be severe or you don’t respond to treatment the muscle spasms can affect your lungs and interfere with your breathing. As it progresses you will have longer and longer periods where you are unable to breathe at all. The most common cause of death in tetanus is respiratory failure.
The symptoms of tetanus usually develop a few days to a few weeks after exposure to the tetanus bacteria, but can take as long as several months. The average is 7 or 8 days. The symptoms of tetanus almost always develop in a specific order. First you’ll feel muscle spasms and stiffness in your jaw, soon after that your neck muscles start stiffening and you’ll have trouble swallowing. The muscle spasms then move down to your abdomen and your abdominal muscles start stiffening. Then the spasms spread through out the rest of your body causing painful body spasms that usually last for several minutes. Other symptoms that may accompany the muscle spasms include a fever with sweating and a fast heartbeat and frequently high blood pressure.
There is no cure for tetanus, however it can be treated just not always effectively. The highest rate of fatalities occurs in people that either haven’t had the vaccine or the effectiveness of the vaccine has worn out. Treatment involves the Dr cleaning out the wound to remove any dirt or particles that could have the toxin, the Dr may also give you the tetanus antitoxin. However, the antitoxin is only effective in neutralizing the toxins before they attach to the nerve endings. Your Dr will also give you antibiotics for the tetanus bacteria. You will also receive very strong sedatives to reduce and control the muscle spasms. Tetanus usually requires an extended period of treatment in an intensive care unit especially since the sedatives can cause your breathing to be shallow and you may require mechanical assistance.
The only effective way to prevent tetanus is with the vaccine. It is the season when people walk around barefoot and in flip flops and the potential for stepping on a nail or piece of broken glass and puncturing your foot increases. Be safe, be sure your vaccine is up to date. You need to get vaccinated every 10 years. If you can’t remember when you had your last tetanus shot and you puncture your skin even a little get a new one. Nobody likes getting shots but this one very well could save your life.