Tetanus
tetanus; child; lockjaw; muscle; spasm; jaw; mouth; infectious; diseases; immunisation; immunise; vaccine; vaccination. ;
Contents
Tetanus is a serious illness, which can be fatal. It is caused by the tetanus bacteria (germs) getting into a wound or cut and producing a toxin (poison) which affects the nervous system.
Spores of these bacteria are in the soil world wide. Few people in Australia get tetanus because of the protection given by immunisation but tetanus kills many hundreds of thousands of people world wide every year, many of them very young babies.
ALERT!
Deep cuts and bites are likely places for tetanus bacteria to grow but they can grow in a small clean wound. If a child or adult has an injury which cuts the skin, it is important to check as soon as possible whether the person is fully immunised against tetanus.
What is tetanus?
- Tetanus is a disease of the nervous system caused by a toxin (poison) made by bacteria (germs) called clostridium tetani.
- The toxin causes painful spasms of muscles, starting with the muscles of the jaw (which is why it has been called 'lock jaw'), spreading to muscles of the neck, shoulders and back, and the rest of the body.
How tetanus is spread
- Tetanus spores ("seeds") can stay in the soil/environment for years, especially in areas where horses have been kept.
- The germs grow where there is dead tissue in a cut or wound in the skin, and they produce toxin which spreads to the nervous system.
- Wounds where tetanus can grow are:
- wounds that have been in contact with soil or animal droppings
- deep wounds such as when a person treads on a rusty nail
- a wound that has something in it, such as a deep splinter
- a deep graze or cut
- a compound fracture ( eg a broken leg or arm where the skin is broken as well as the bone)
- a burn
- an unclean needle when using illegal drugs.
There is more dead tissue in a deep or dirty wound, which is why these are called 'tetanus prone wounds'.
However tetanus germs can also grow in what seem to be very small and clean wounds, such as from a rose thorn.
- Tetanus is not passed from one person to another so keeping the person with tetanus away from others is not necessary.
Who is at risk?
- Any person who has NOT been immunised against tetanus is at risk.
- In Australia, adults are affected by tetanus more often than children either because they have not been immunised or because the protection they originally had from immunisation has decreased as they have grown older.
- Approximately 10 adults per year are diagnosed with tetanus in Australia.
- Newborn babies can get tetanus if the mother has not been immunised, often after unsterile treatment of the umbilical cord stump.
Time tetanus takes to develop
- From 4-21 days after the injury (usually 7 to 10 days).
Signs and symptoms
- The toxins affect the nervous system causing painful muscle tightening (spasms) while the person is still conscious.
- Early signs are increasing tightness of the jaw muscles, then stiffness of the neck, shoulders and back.
- Spasms of tightness can effect the whole body.
- There can be problems with swallowing and breathing.
Health problems from tetanus
- In Australia, 1 in 10 people with tetanus die - very young and very old people are the ones most likely to die.
- Death can occur because of breathing difficulties, high or low blood pressure or effects on the heart.
- If the person recovers with treatment, there are usually no long term health problems from tetanus.
- Neonatal tetanus is a frequent cause of death in parts of Asia, Africa and South America, killing about 800,000 babies each year.
- Make sure that all family members are fully immunised and get a booster if a person has a deep or dirty wound (see below).
- A person with tetanus will need hospital treatment.
- The person will be watched closely for any breathing problems and given medicine to control the spasms. The person will often need to be in hospital, in intensive care, for several months.
Protecting your family from tetanus
- Immunisation works! In World War 2 all Australian Servicemen were immunised against tetanus and none developed tetanus (unlike previous wars).
- Because tetanus germs can grow in even small wounds, the only protection is a full course of immunisation for all the family.
- The first 3 doses (the "primary course") are given at 2, 4 and 6 months with the whooping cough (per tussis) and diphtheria vaccines.
- Booster immunisations are needed to keep up immunity - boosters are recommended for children before they start school (4-5 years) then around 15 years of age. If the person has had a full course of immunisations, one extra booster around 50 years of age is recommended unless the person has had a booster dose in the previous 5 years.
- Any adult who has not had 5 doses of the vaccine should have the vaccine at any age.
See your doctor if you get a deep injury or a 'dirty' wound such as a splinter that cannot be fully removed or a bite from an animal to decide whether an extra injection is needed.
- If an immunisation for tetanus has not been given for 5 years and you have an injury which may result in tetanus, you should be given a booster dose of the tetanus vaccine.
- If a person has a 'tetanus prone' wound and has not had 3 or more doses of the tetanus toxoid, or if immunisation status is unknown, tetanus immunoglobulin can be given. Tetanus toxoid immunisation should be started at the same time, because the immunoglobulin does not give ongoing protection.
- Adults born in other countries may not be fully immunised. They should be encouraged to be immunised. Adults as well as children need protection against tetanus.
Department of Health, South Australia 'Tetanus'
http://www.dh.sa.gov.au/pehs/ygw/tetanus-pehs-sahealth-2009.pdf
Immunise Australia Program
http://immunise.health.gov.au/
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
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