Tetanus is a medical condition characterized by a prolonged contraction of skeletal muscle fibers. The primary symptoms are caused by tetanospasmin, a neurotoxin produced by the Gram-positive, rod-shaped, obligate anaerobic bacterium Clostridium tetani. The infection causes painful tightening of the muscles, usually all over the body. It can lead to “locking” of the jaw, which makes it impossible to open mouth or swallow. If this happens, person can die due to suffocation. It usually occurs when a flesh wound becomes contaminated. If it is not treated, tetanus may lead to complications, which can be fatal.
Stiffness in the jaws (lock jaw). Muscle spasms and stiffness can spread from jaw into neck and limbs over 24 to 72 hours. Other symptoms include:
High temperature (fever) of 38C (100.4F) or above
Rapid heartbeat (tachycardia)
High blood pressure (hypertension)
Tetanus is caused by the Clostridium tetani bacterium. Clostridium tetani spores can live outside the body and are widespread in the environment. They are commonly found in the manure of animals such as horses and cows, and in contaminated soil. After they enter the body, the tetanus bacteria quickly multiply and release tetanospasmin. This is a type of poison known as a neurotoxin. If tetanospasmin enters the bloodstream, it can spread around the body, causing the symptoms of tetanus to develop. Neurotoxins block the nerve signals that are sent from the brain to the spinal cord and then on to the muscles. This causes the muscle spasms and muscle stiffness associated with tetanus.
Usually, tetanus can be diagnosed through the symptoms. But with the symptomatic diagnosis, a spatula test is also performed to confirm the diagnosis.
Spatula test: It involves inserting a spatula into the back of the throat. If there is no infection, the spatula will cause a gag reflex and patient will try to push the spatula out of mouth. However, if the tetanus infection is present, the spatula will cause throat muscles to spasm and will bite down onto the spatula.
There are two types of treatment for tetanus:
Preventive treatment - For people who are believed to be fully or partially vaccinated against tetanus and who have an injury that makes them vulnerable to a tetanus infection. Medication called tetanus immunoglobulin (TIG) is recommended if have a tetanus-prone wound and there is a high risk that it could be contaminated by tetanus bacteria.
Symptomatic treatment - For people who have developed the symptoms of an active tetanus infection. Three main types of medication is used to treat the symptoms of tetanus:
Tetanus can be prevented by vaccination with tetanus toxoid. There are four combination vaccines used to prevent tetanus: DTaP, Tdap, DT, and Td. Two of these (DTaP and DT) are given to children younger than 7 years of age, and two (Tdap and Td) are given to older children and adults. The CDC recommends that adults receive a booster vaccine every ten years.