TETANUS

Signs and symptoms of tetanus

The symptoms of tetanus usually develop within 4 to 21 days after infection. On average, they start after around 10 days.

The main symptoms include:

• stiffness in your jaw muscles (lockjaw) – this can make it difficult to open your mouth
• painful muscle spasms – these can make swallowing and breathing difficult
• a high temperature (fever) of 38C (100.4F) or above
• sweating
• a rapid heartbeat (tachycardia)

Once tetanus toxin has bonded to your nerve endings it is impossible to remove. Complete recovery from a tetanus infection requires new nerve endings to grow, which can take up to several months.

Complications of tetanus infection may include:

• Broken bones. The severity of spasms may cause the spine and other bones to break.
• Blockage of a lung artery (pulmonary embolism). A blood clot that has traveled from elsewhere in your body can block the main artery of the lung or one of its branches.
• Death. Severe tetanus-induced (tetanic) muscle spasms can interfere with or stop your breathing. Respiratory failure is the most common cause of death. Lack of oxygen may also induce cardiac arrest and death. Pneumonia is another cause of death.

Diagnosis

Tetanus can be diagnosed by doctors through history and thorough physical examination.  Blood tests are generally not helpful in diagnosing tetanus.

Treatment

If a patient acquires trauma, it is important to thoroughly clean the wound with water and soap.  It is also important to consult a doctor for the possibility of tetanus infection.  If the doctor suspects infection, then tetanus immunoglobulin is given to the patient.  This antitoxin contains antibodies that kills the tetanus bacteria, and it offers immediate but short-term protection from tetanus.

If symptoms of tetanus infection occurs, it is advisable to seek consult immediately in a highly specialized hospital with an intensive care unit.

Patients with tetanus infection are given antibiotics, to help kill the tetanus bacteria.  Patients are also given the Tetanus toxoid vaccine, and sedatives to control the powerful muscle spasms.

Tetanus vaccination

Tetanus vaccination is not only given in patients with trauma in their skin, but it is also given in pregnant women, healthy children and adults, and those with higher predilection in acquiring the infection.

The full course of the vaccination requires five injections, usually given on the following schedule:

• the first three doses are given as part of the 5-in-1 vaccine for babies at eight, 12 and 16 weeks
• a booster dose is given as part of the 4-in-1 pre-school booster at three years and four months of age
• a final booster is given as part of the 3-in-1 teenager booster at 14 years of age

This course of five injections should provide long-lasting protection against tetanus. However, if you or your child has a deep or dirty wound, it’s best to get medical advice.