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If ye are prepared, ye shall not fear. (D&C 38:30)

October 2017

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Tetanus

Tetanus is a serious bacterial disease that affects your nervous system, leading to painful muscle contractions, particularly of your jaw and neck muscles. Tetanus can interfere with your ability to breathe and, ultimately, threaten your life. Tetanus is commonly known as "lockjaw."

Thanks to the tetanus vaccine, cases of tetanus are rare in the United States and the developed world. The incidence of tetanus is much higher in less developed countries. Around a million cases occur worldwide each year.

There's no cure for tetanus. Fatality is highest in individuals who haven't been immunized and in older adults with inadequate immunization. Treatment focuses on managing complications until the effects of the tetanus toxin resolve.

Signs and symptoms of tetanus may appear anytime from a few days to several weeks after tetanus bacteria enter your body through a wound. The average incubation period is seven to eight days.

Common signs and symptoms of tetanus, in order of appearance, are:

Other signs and symptoms may include:

When to see a doctor

See your doctor to obtain a tetanus booster shot if you have a deep or dirty wound and you haven't had a booster shot within the past five years or aren't sure of when your last booster was. Or see your doctor about a tetanus booster for any wound — especially if it may have been contaminated with dirt, animal feces or manure — if you haven't had a booster shot within the past 10 years or aren't sure of when you were last vaccinated.

Causes

The bacteria that cause tetanus, Clostridium tetani, is found in soil, dust and animal feces. When they enter a deep flesh wound, spores of the bacteria may produce a powerful toxin, tetanospasmin, which actively impairs your motor neurons, nerves that control your muscles. The effect of the toxin on your motor neurons can cause muscle stiffness and spasms — the major signs of tetanus.

Risk factors

In addition, certain factors are necessary for tetanus bacteria to proliferate in your body. These include:

Tetanus cases have developed from the following types of injuries:

Complications

Once tetanus toxin has bonded to your nerve endings it is impossible to remove. Complete recovery from a tetanus infection requires the growth of new nerve endings and can take up to several months.

Complications of tetanus infection may include:

AFTER INJURY

Preparing for your appointment

If your wound is small and clean but you're concerned about infection or whether you're immune from tetanus, start by seeing your family doctor. If your wound is severe or you're experiencing symptoms of tetanus infection (or your infant is), seek emergency care.

What you can do

If possible, let your doctor know the following information:

If seeking care for an infant other than your own, let the doctor know the mother's country of origin, her immune status and how long she's been in the United States.

For tetanus, some basic questions to ask your doctor include:

What to expect from your doctor

If a wound is obvious, your doctor will inspect it. He or she will likely ask you a number of questions, including:

Tests and diagnosis

Doctors diagnose tetanus based on a physical exam, medical and immunization history, and the signs and symptoms of muscle spasms, stiffness and pain. Laboratory tests generally aren't helpful for diagnosing tetanus.

Treatments and drugs

Since there's no cure for tetanus, treatment consists of wound care, medications to ease symptoms and supportive care.

Wound care

Cleaning the wound is essential to preventing growth of tetanus spores. This involves removing dirt, foreign objects and dead tissue from the wound.

Medications

Supportive therapies

Tetanus infection often requires a long period of treatment in an intensive care setting. Since sedatives may result in shallow breathing, you may need to be supported temporarily by a ventilator.

Lifestyle and home remedies

Puncture wounds or other deep cuts, animal bites or particularly dirty wounds may put you at increased risk of tetanus infection. Get medical attention if the wound is deep and dirty, and particularly if you're unsure of your immune status. Leave unclean wounds open to avoid trapping bacteria in the wound with a bandage.

Your doctor may need to clean the wound, prescribe an antibiotic and give you a booster shot of the tetanus toxoid vaccine. If you've previously been immunized, your body should quickly make the needed antibodies to protect you against tetanus.

If you have a minor wound, these steps will help prevent you from getting tetanus:

Prevention

You can easily prevent tetanus by being immunized against the toxin. Almost all cases of tetanus occur in people who've never been immunized or who haven't had a tetanus booster shot within the preceding 10 years.

The primary vaccine series

The tetanus vaccine usually is given to children as part of the diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. This vaccination provides protection against three diseases: a throat and respiratory infection (diphtheria), whooping cough (pertussis) and tetanus.

The DTaP vaccine consists of a series of five shots, typically given in the arm or thigh to children at ages:

The booster

A booster of the tetanus vaccine is typically given in combination with a booster of diphtheria vaccine (Td). In 2005, a tetanus, diphtheria and pertussis (Tdap) vaccine was approved for use in teens and adults under age 65 to ensure continuing protection against pertussis, too.

It's recommended that adolescents get a dose of Tdap, preferably between the ages of 11 and 12, and that a Td booster be given every 10 years thereafter. If you've never received a dose of Tdap, substitute it for your next Td booster dose and then continue on with Td boosters.

If you're traveling internationally, it's a good idea to have up-to-date immunity because tetanus may be more common where you're visiting, especially if you're traveling to a developing country. If you receive a deep or dirty wound and it's been more than five years since your last booster shot, get another booster shot.

To stay up to date with all of your vaccinations, ask your doctor to review your vaccination status regularly.

If you were never vaccinated against tetanus as a child, see your doctor about getting the Tdap vaccine.