TETANUS

General Information

DEFINITION--An infection in a wound or injury that causes severe muscle spasms. Tetanus is not contagious from person to person.

BODY PARTS INVOLVED--Injured tissue; muscles throughout the body, especially the jaw, neck, back and abdomen.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Stiffness of the jaw.
• Muscle pain, irritability and frequent, severe spasms.
• Severe swallowing difficulty.
• Fever.
• Difficulty using chest muscles to breathe.
• Fast pulse.
• Profuse sweating.

CAUSES--Bacteria (Clostridium tetani) that are present almost everywhere--especially in soil, manure or dust. Bacteria may enter through any break in the skin, including burns or puncture wounds. Toxins produced by the bacteria travel to nerves that control muscle contraction, producing muscle spasms and seizures.

RISK INCREASES WITH

• Diabetes mellitus.
• Adults over 60.
• Lack of up-to-date tetanus immunizations.
• Warm, humid weather.
• Crowded or unsanitary living conditions, especially for newborn infants born to non-immunized mothers.
• Use of street drugs administered with unclean needles and syringes.
• Burns, surgical wounds and skin ulcers.

HOW TO PREVENT--Obtain tetanus immunizations. These consist of 3 immunization shots, starting at 2 months of age with boosters at 18 months, 5 years, 10 years and every 10 years afterwards. An additional booster shot may be necessary at the time of injury. Private doctors or local health departments may provide immunizations at little or no cost.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood and culture studies.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization in a quiet, dark room. Treatment may include the use of breathing tubes, a respirator, intravenous fluid support, and medications.
• Surgery to remove infected tissue.

POSSIBLE COMPLICATIONS

• Pneumonia.
• Pressure sores.
• Irregular heartbeat.
• Respiratory paralysis and death.

PROBABLE OUTCOME--The death rate from tetanus is 50%. With early diagnosis and treatment, however, full recovery is likely. Allow 4 weeks for recovery.

How To Treat

GENERAL MEASURES----Provide the patient with reassurance and psychological support. Despite the seriousness of tetanus, patients are usually conscious.

MEDICATION--Your doctor may prescribe:

• Antitoxins to neutralize the nerve toxin.
• Muscle relaxants to control spasms.
• Sedatives to relieve anxiety.
• Anticonvulsants for seizures.
• Antibiotics for infections.

ACTIVITY--During hospitalization, bed rest is necessary with as little disturbance as possible. During recovery, activities should be resumed gradually.

DIET--During hospitalization, intravenous fluids will be necessary because of swallowing difficulty.

Call Your Doctor If

• You have symptoms of tetanus or observe them in someone else. Call immediately. This is an emergency!
• You or someone in your family needs basic or booster tetanus immunizations.
• You have a puncture wound or injury that breaks the skin, and you have not had an immunization or booster in 5 years.