Tetanus germs live in a place where there is but little oxygen. For this reason, deep penetrating wounds are the most dangerous. When they are contaminated by dirt or soiled clothes and sealed over by injured tissue, the danger that tetanus may develop is much greater.
Tetanus is caused by a toxin found in dirt, dust and animal feces produced by spores of bacteria, Clostridium tetani. They develop into bacteria that can produce a potent toxin, tetanospasmin, when the spores penetrate a deep flesh wound. The toxin activates the nerves (motor neurons) that control the muscles.
The toxin can cause muscle stiffness and spasms ' that's tetanus key signs and symptoms.
Nearly all tetanus cases occur in people who have never been vaccinated or in adults who have not maintained their 10-year booster shots.
Tetanus cases have developed from the following:
- Puncture wounds — including from splinters, body piercings, tattoos and injection drugs
- Gunshot wounds
- Compound fractures
- Surgical wounds
- Injection drug use
- Animal or insect bites
- Infected foot ulcers
- Dental infections
- Infected umbilical stumps in newborns born of inadequately vaccinated mothers
Signs and symptoms of tetanus 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 10 days.
Signs and symptoms of tetanus occur anywhere from a few days to several weeks, when tetanus bacteria invade the body through a wound. The median time of incubation is 7 to 10 days.
Common tetanus symptoms include:
- Spasms and stiffness in your jaw muscles (trismus)
- Stiffness of your neck muscles
- Difficulty swallowing
- Stiffness of your abdominal muscles
- Painful body spasms lasting for several minutes, typically triggered by minor occurrences, such as a draft, loud noise, physical touch or light
Possible other signs and symptoms include:
- Elevated blood pressure
- Rapid heart rate
Prevention of Tetanus
Any wound should, therefore, be thoroughly cleaned or wash with soap and any bruised tissue should be removed. It should also be integrated with hydrogen peroxide, for this supplies free oxygen into the potentially dangerous area.
Three to six thousand units of antiserum should be given. However, if the wound is extensive, up to 10,000 units should be given and if not healed within ten days this dosage should be repeated.
If the patient has been vaccinated against tetanus, instead of the above treatment he should be given another tetanus booster vaccination once. No antiserum is necessary. It should be noted that we are considering the prevention of tetanus.
The treatment requires larger doses as described below.
When tetanus develops, two complications are especially noted. The patient will be unable to open is jaw ( from which paralysis the term 'lock jaw ' has been derived ) and he goes into convulsions upon being disturbed by any noise or even by the movement of the limb. His face takes on a rigid appearance when some of these convulsions occur, so much that the muscles of respiration cannot function properly.
Treatment of Tetanus:
Most authorities prescribed 100,000 units of antiserum for these cases and cover the dosage with antihistamines. This injection is given intramuscularly immediately on admission to the hospital and no further serum is given thereafter. A skin test is always done before the serum is injected.
Five million units of penicillin are administered daily as a prophylactic against the possibility of pneumonia.
Should the patient be sensitive to penicillin, Terramycin (Oxytetracycline) can be used. The wound is usually not trimmed or disturbed until the second day, but some authorities advice injection of 10,000 to 20,00 units of antiserum around the wound and also around the affected limb near the torso (body).
Mephenesin ( 2 tablets ) is given every six hours to relax the muscles, and phenobarbital ( 30 MG ) three times a day to help prevent convulsions.
A special nurse must be on hand at all times to watch the patient.
Absolute quiet must be maintained at all times, for any unusual noise could trigger a convulsion and the patient could die at once. If the patient is not doing well after two or three days, some authorities give an additional 20,000 units of serum. In doing this, great care must be exercised against sensitivity.
By the tenth-day serum reactions generally begin, which are controlled by antihistamines and cortisone.
After recovery, the patient still needs to be vaccinated for tetanus. In fact, not only the patient but all healthy people as well should be regularly vaccinated against the disease.
Also, it should be noted, and we state this with emphasis, that even after having been thus immunized against tetanus, no one should ignore a contaminated wound, especially on the foot. At once he should go for a "booster " injection.
This will quickly boost his immunity, raising it to a level as high or higher than a prophylactic dose of tetanus antiserum. It will do this, however, only if previous tetanus vaccinations have been regularly kept up.
And One More Advice to The Nurses or physician :
Be sure that every cut is washed out thoroughly with soap and water and rinsed with hydrogen peroxide. Even for a small wound, such precautions should be taken lest tetanus infection should set in. If there is any question give tetanus vaccination booster for those who have been vaccinated for tetanus and three to six thousand units of antiserum for those who have not had the vaccination.
- The New Health and Longevity by A. C. Selmon a. The Oriental Watchman Publishing House, 1960.
- Mayo Clinic organization