Tetanus

Tetanus also called lockjaw is a very serious disease caused by a bacterium called Clostridium tetani. The bacteria affect the nervous system and lead to painful contractions of the muscles especially the neck and jaw muscles.

The toxin produced by Clostridium tetani also affects the brain system. The disease can interfere with a person’s ability to breath and can be fatal. If the bacterial toxins are deposited in a wound, they interfere with the nerves that are responsible for muscle movement.

The infection can cause serious breathing problems, severe muscle spasms, and can be fatal. The tetanus spores can be found nearly everywhere in the environment especially in ash, soil, intestinal tracts of humans and animals, and on the surfaces of rusty tools such as needles, nails, and barbed wire among others.

The spores are highly resistant to most antiseptics and heat, and thus, it can survive for years. the World Health Organization reports that in 2015, about 34, 000 newborn babies died from neonatal tetanus. Although the figure is still high, it is a 96% reduction compared to 787, 000 newborn deaths reported in 1988 that resulted from tetanus within the first month of life for the babies.

Fortunately, Kenya is not at high risk of tetanus deaths because there is a good control program. According to reports released by UNICEF and WHO in 2018, Kenya has attained maternal and neonatal tetanus elimination status (MNTE) after a successful validation process done by WHO confirmed the elimination of the disease.

Symptoms

Signs and symptoms of tetanus show up any time from a few days to many weeks after the bacteria enter a person’s body through a wound. The average incubation period is 7 to 10 days.

Common symptoms include:

  • Stiffness of the neck muscles
  • Spasms and stiffness of the jaw muscles
  • Difficulty swallowing
  • Stiffness of the abdominal muscles
  • Painful body spasms that last for several minutes and mostly prompted by occurrences such as loud noise, a draft, light, or physical touch

Other potential signs and symptoms of tetanus include:

  • Sweating
  • Fever
  • Rapid heart rate
  • High blood pressure

Diagnosis

Tetanus is diagnosed based on clinical features and does not need laboratory confirmation. The doctor will ask a number of questions to determine how the patient feels.

If the patient demonstrates the above-mentioned symptoms, then the doctor will confirm he/she has tetanus and proceed to treatment.

Treatment

Tetanus is a severe disease that requires:

  • Care in the hospital
  • Aggressive wound care
  • Immediate treatment with a medication called human tetanus immune globulin (TIG)
  • Tetanus vaccination
  • Antibiotics
  • Drugs to control muscle spasms

The TIG medicine is readily available in Kenya in the form of intravenous immunoglobin (ivig), and since it is an injection, its cost varies from one medical facility to another.

It is important to note that individuals who recover from tetanus do not have a natural immunity to fight it and can be infected again. To prevent such occurrence, such people need to be immunized.

Prevention

Immunization: Tetanus vaccine called tetanus-toxoid-containing vaccines (TTCV) is available and often included in routine immunization programs in Kenya and other parts of the world. It is administered during the antenatal care period.

To be safe throughout one’s lifetime, WHO recommends that you receive 6 doses of TTCV – 3 primary plus 3 booster doses. The doctors are aware of this and commence issuance when new mothers take their babies for the clinic. 

Other vaccines for tetanus that are combined with vaccines of other diseases include:

  • Diphtheria, tetanus, and pertussis (DTaP) vaccines
  • Diphtheria and tetanus (DT) vaccines
  • Tetanus and diphtheria (Td) vaccines
  • Tetanus, diphtheria, and pertussis (Tdap) vaccines

Neonatal tetanus is prevented through immunizing women of reproductive age with TTCV during pregnancy or sometimes outside pregnancy.

For further protection, WHO recommends clean delivery and cord care during childbirth as well as suitable wound care for dental and surgical procedures. 

Sources

https://www.medicalnewstoday.com/articles/163063.php

https://www.who.int/news-room/fact-sheets/detail/tetanus

https://www.mayoclinic.org/diseases-conditions/tetanus/symptoms-causes/syc-20351625