Tetanus, also known as lockjaw, is a life-threatening but preventable disease that affects the body’s muscles and nerves.
It is caused by a type of bacteria called Clostridium tetani that usually live in the soil. The bacteria makes a toxin that attaches to nerves around a wound area which travels inside the nerves to the brain or spinal cord. There, it interferes with the normal activity of nerves, particularly the motor nerves that send direct messages to the muscles.
Almost all cases of tetanus follow a contaminated cut or deep puncture injury, such as a wound that is caused by stepping on a nail. Sometimes, the injury is so small, the child is never taken to see a doctor but if left untreated, it can be life-threatening.
Neonatal tetanus, occurs in newborns born in unsanitary conditions, specially if the umbilical cord stump becomes contaminated. Routine immunizations and sanitary cord care have newborn tetanus very rare in developed countries.
Signs and Symptoms
It often begins with muscle spasms in the jaw (called trismus) which can spread to the muscles of the belly, upper arms and thighs. A child can also have difficulty swallowing and stiffness or pain in the muscles of the neck, shoulders or back.
Other symptoms include:
• In newborns, difficulty sucking and constant crying
• Muscle spasms that are gravely painful, often set off by noise, light or touch
• Rigid facial muscles, or raised eyebrows with lips pulled into a smile
• Rigid abdomen, arm and leg muscles
• Feeling uncomfortable or irritable, or a fast heartbeat or difficulty breathing
• A headache or seizures
• Sweating, difficulty urinating, or a low fever
What increases a child’s risk for tetanus?
• His mother was not immunized against tetanus at all
• His umbilical cord stump was not kept properly clean
• Missed doses of the tetanus vaccine in an older child
• In adolescents, use of injected drugs, or use of a needle that was not sterilized at all, such as during tattooing or piercing
• An acute or chronic wound, like a burn, crush, injury, or puncture wound
• A dirty wound, or a clean wound that scraped off the top layer of your child’s skin
• Surgery or a dental procedure
• An insect bite
Treatment
A child who has tetanus will be treated in a hospital, very often in the intensive care unit. Antibiotics are administered to kill the bacteria including,tetanus immune globulin to neutralize the toxin already released. Supportive treatment are given to control the muscle spasms and to support vital body functions.
Prevention
The two most significant ways to prevent tetanus are;
1. Getting vaccinated against tetanus
2. Getting a shot (post-exposure tetanus prophylaxis) after an injury that could cause tetanus
Tetanus immunization is a part of the DTaP (diptheria, tetanus and acellular pertussis) vaccinations. Children usually get:
• A series of four doses of DTaP vaccine before 2years of age
• Another dose of 4-6years of age
• A booster dose at 11-12years of age, or later, if it was missed
Then, they should get a DTaP or a tetanus & diptheria (TD) booster every 10years through adulthood. The vaccine is also recommended for all pregnant women during the second half of each pregnancy regardless of whether they had the vaccine before, or when it was last given.
Neonatal tetanus can be prevented by ensuring that all pregnant women have had their tetanus immunizations, by delivering babies in sanitary conditions and by proper umbilical cord care.
Post-exposure tetanus prophylaxis usually involves getting tetanus shots immediately after an injury. Shots given will depend on;
• When the patient last had a booster
• The accumulated number of tetanus vaccinations the patient has had
• The nature of the wound
Any skin wound, especially a deep puncture or a wound that maybe contaminated with feces, soil or saliva, should be cleaned and dressed right away
Dr.favvy
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