Tetanus(lock jaw)

Tetanus(lock jaw)

Tetanus

Tetanus is a serious bacterial disease that affects the muscles and nerves, which is mainly caused by contamination of wounds from bacteria that live in the soil, in animals and in human intestines. It is mainly caused by bacterium clostridium tetani(tetanus bacteria). The bacteria usually enter the body through a deep cut, or puncture wounds as caused by rusty nails, splinters or insect bite. Burns or any break in the skin are also potential entryways for the bacteria. It is acquired through contact with the environment; it is not spread from person to person.

Tetanus occurs when a wound becomes contaminated with bacterial spores. Infection follows when spores become  activated, multiply and then produce a very strong toxin(poison) called tetanospasmin that affects the muscles.

It is characterized by muscle stiffness that usually  involves the jaw and neck and then involves the other parts of body. Death occur due to breathing difficulties and heart abnormalities. Tetanus more commonly  occur in old people or in agriculture workers who contact with animal manure or in people having improper immunization. also occur in newborn because their mothers are not immunized against tetanus.

Tetanus toxin affect the site of interaction between the nerve and muscle called as neuro muscular  junction. The tetanus toxin amplifies the signals from nerve to the muscle which causes the muscle to tighten up in a continuous contraction. Tetanus toxin can also affect the neonates within first two weeks after the birth and can be associated with poor sanitation methods in caring for the umbilical cord stump of the neonate.

 

What causes tetanus

Tetanus is often associated with rust, especially rusty nails. The rough surface of rusty metal provides a  primary habitat for C.tetani and nail is to puncture the skin and deliver bacteria into the wound and cause infection in an environment that lacks oxygen. Hence, stepping on a nail(rust or without it)may result in tetanus infection.

 

Signs and symptoms

tetanus mainly affects the muscles. The incubation period(time between the exposure to the bacteria in a contaminated wound and development of initial symptoms) of tetanus ranges from 2 days to 2 months, but it is commonly within 14 days of injury.

It is estimated that further the injury site is from central nervous system, the longer the incubation period. The shorter the incubation period, the more severe be the symptoms. therefore different forms of tetanus

 

Generalized tetanus

It is the most common form of tetanus, usually presents with a sign of “lock jaw”(patient is not able to open his mouth), facial spasm followed my stiffness in the neck muscles, difficulty in swallowing. Other symptoms include increased temperature, sweating and elevated blood pressure and episodic rapid heart rate. Spasm(involuntary contraction of group of muscles)may occur frequently and lasts for few minutes.

 

Neonatal tetanus

It is a form of generalized tetanus occur in newborns, infants who have not acquired immunity because the mother has not been immunized with tetanus toxoid. It usually occurs  through infection of unhealed umbilical stump, particularly when the stump is cut with non-sterile instrument

 

Local tetanus

It is rare form of tetanus, in which patient has persistent contraction of muscles in the area of injury. Local tetanus is generally mild but sometime it become fatal.

 

Cephalic tetanus

This is also a rare form of disease, occur most commonly with ear infection in which C. tetani is present in the middle ear, or following injury to the head. In this there is the involvement of cranial nerve , especially in the facial area.

 

Treatment of tetanus

Treatment is directed towards stopping toxin production and controlling muscle spasm. In more severe cases, breathing assistance with an artificial respiratory machines. An effective vaccine called tetanus toxoid has been available. Adults should get a tetanus shot, or booster, every 10 years

All children should be immunized against tetanus by receiving a series of five DTaP vaccinations(protects from diphtheria, tetanus and pertussis) which generally started at 2 months of age and completed at 5 years of age. Booster vaccination is recommended at 11 years of age.

 

Side effect of tetanus immunization

The most frequent side effects are usually mild and include soreness, swelling or redness at the site of injection