All about Tetanus: what it is, symptoms, causes and transmission

What is tetanus?

Tetanus is a serious disease caused by infection with the bacterium Clostridium tetani , which enters the body through wounds and produces a toxin that acts on the central nervous system, causing strong muscle contractions that can kill. It is possible to prevent tetanus through a vaccine.

Types

There are some types of tetanus to pay attention to. Are they:

Localized tetanus

In this variety of the disease, muscle contractions affect only specific places, often extremities such as hands, arms and feet. It is usually the result of weak or poor immunization.

Generalized tetanus

The most common version of tetanus affects the entire body. The person is in severe pain and the muscles contract strongly.

Head tetanus

One of the rarest versions of tetanus, cephalic tetanus usually comes from head injuries or ear infections. It has a short incubation period, from one to two days, due to its proximity to the Central Nervous System  and often evolves into generalized tetanus.

Neonatal tetanus

Another rare version of the disease, neonatal tetanus, also known as seven-day sickness , occurs when the tetanus bacteria infects the umbilical cord stump of a newborn baby.

Causes and etiologic agent

Open wounds are the pathway for the bacterium Clostridium tetani , which, contrary to popular knowledge, does not live only on rusty nails.

Walking barefoot

The bacteria can be in the soil, in plants and animal or human feces. It is harmless when in the intestine, but it does damage if it infects the body. Walking barefoot with a wound on your feet facilitates contamination. In addition, in 10 to 20% of cases, tetanus occurs even without an apparent wound.

Lack of vaccination

It is possible to be immunized against tetanus through the tetanus vaccine. Since the bacteria can be found almost anywhere, the vaccine is the best defense. The lack of it allows the bacteria to find its way into the host’s body.

Once in the bloodstream, in an oxygen-free environment, the bacteria releases two toxins: tetanolysin, whose effect on the disease is unknown and uncertain, and tetanospasmin, which is a neurotoxin that reaches the central nervous system and attacks it. This toxin is the causative agent of tetanus.

Tetanospasmin

Called tetanospasmin, the toxin spreads through the circulatory system and reaches the central nervous system, causing the spasms and contractions characteristic of tetanus.

Its effect causes the muscles to contract involuntarily, progressing over several weeks, often from the jaw to the rest of the body. This can lead to death from respiratory failure when the diaphragm, the muscle that controls breathing, is affected.

Transmission: how can we contract tetanus?

Spores of the bacterium Clostridium tetani can be found in the most diverse places. Wounds, especially those caused by piercing objects (but not only these), are the pathway that the bacteria uses to enter the body.

It is also possible to catch the bacteria in other ways. Babies are contaminated by cutting the umbilical cord without sterilization, for example.

Accidents such as cuts, perforations and scratches in contact or with contaminated objects are the most common way of transmitting the bacteria. The use of contaminated perforating materials, such as tattoo needles or syringes, also transmits the disease, in addition to infected insect bites.

Risk factors

Open wounds

Open wounds are the main risk factor. Tetanus bacteria can be anywhere, so any wound can be used to enter the bloodstream.

Perforations

Perforations take the bacteria to places where a simple wash will hardly be enough, so it is recommended that the vaccine is up to date.

Contaminated cosmetic utensils

Using tattoo needles, piercing the ear or any part of the body and any type of wound opened by non-sterile material can cause tetanus.

Walking barefoot

Animal feces can carry the bacteria, so if you walk barefoot in places where animals can defecate, double the care with any wounds.

In addition, these people are in the risk group:

  • Kids;
  • Seniors;
  • Patients with chronic leg ulcers;
  • Civil construction workers;
  • People with leprosy (leprosy).

Symptoms

A characteristic symptom of tetanus, muscle contraction begins with the jaw, but spreads to the rest of the body. Contractions can be initiated for no reason, or through stimuli like scares or the turning on of lights. Other symptoms, consequences of contraction, are:

Trism

Trismus is the difficulty in opening the mouth caused by the contraction of the jaw and mandible.

Muscular stiffness

Neck, back and abdomen are rigid.

Sardinian rice

Facial muscles contract, giving the face a forced expression of involuntary laughter.

Contraction of arms and legs

Limbs, both lower and upper, contract violently. The contraction can weaken and even break bones during its duration.

Opistotone

Extremely characteristic of tetanus, opisthotone is the name given to the strong spasm of the muscles of the spine. The patient’s head, neck and spine is shaped like a concave arch to the rear. The body rests on the floor by the head and heels.

Respiratory failure

Symptom that usually leads the patient to death, respiratory failure is caused by muscle contraction in the region of the diaphragm, which is the main muscle of respiratory control.

How is tetanus diagnosed?

Tetanus is diagnosed by observing symptoms and lesions where the bacteria may have entered. Generally, laboratory tests are only used to rule out other conditions, such as meningitis , rabies or other illnesses with similar symptoms.

Is tetanus curable?

There is no guaranteed cure.  It is possible to eliminate the bacteria that causes tetanus by treating the infection, but the toxin must be metabolized by the body and, as long as this does not happen, the disease persists.

The cure depends on the patient’s immune system and his ability to withstand side effects.

What is the treatment?

Treating tetanus is treating the infection, eliminating the bacteria and seeking to neutralize the toxin.

Close the wound

It is necessary to treat, clean and heal the wound through which the bacteria entered.

The spores of the bacteria can be there, and eliminating it is extremely important, as long as it is present, it will continue to produce the toxin that causes tetanus.

The bacterium is resistant to alcohol, but hydrogen peroxide, iodine and glutaraldehyde are able to eliminate its infectious capacity.

Antibiotics

Eliminating the bacteria with antibiotics prevents it from continuing to produce tetanospasmin.

Nullify toxin

The use of immunoglobulin  serves to neutralize the toxin. It is also possible to use anti-tetanus serum . Both substances have an effect on free tetanospasmin, that is, the portion of the toxin that has not yet fixed itself to the central nervous system (CNS).

In addition, it is necessary to wait for the body to metabolize the toxin that has already been fixed to the CNS.

Treat the symptoms

After administering antibiotics and agents to neutralize the toxin, treatment consists of relieving symptoms and facilitating the body’s recovery. For this, calming and muscle relaxants are administered, which reduce spasms.

Artificial respiration may be necessary if the respiratory muscles are paralyzed.

If you have prior knowledge of the infection, the tetanus serum can be used soon after exposure to the bacteria and this may be enough to prevent the disease from manifesting itself.

When the disease sets in, the patient must be hospitalized for 3 to 15 days and can be intubated in case of paralysis of the diaphragm. It is necessary to keep an eye on the patients at all times, so they can be kept in an ICU.

Barely seven days

Neonatal tetanus is known as the seven-day disease . It happens when, after delivery, the umbilical cord is cut with infected materials, or the protection of the cord stump is poorly done and it ends up contaminated.

Symptoms in newborns are:

  • Constant crying;
  • Difficulty opening the mouth and suckling;
  • Stiffness in the neck, trunk and abdomen;
  • Abdominal contractions that can be mistaken for colic;
  • Clenched hands and flexed fists.

When the disease gets worse, the baby stops crying and can stop breathing more often and for longer, which can lead to death.

The name of seven-day evil comes from the ancient popular belief that the newborn should stay in a dark room for seven days after birth to protect him from harm. The “evil” would be neonatal tetanus, which usually affects the baby in the first week of life and was not known at the time, but the dark room did not protect the baby from it.

Babies infected with tetanus have a mortality rate of 80%, as well as the elderly. Neonatal tetanus is extremely dangerous, but it can be prevented with care during childbirth and prenatal care.

Animals

Domestic animals are the main victim of tetanus, especially after mankind has developed vaccines. Horses, like horses, are especially vulnerable to the disease. Right behind are sheep (sheep), goats (goats) and cattle.

Tetanus can also affect dogs and cats. The symptoms are the same, as is the treatment. It is necessary to observe domestic animals well, taking care that they do not have possible infected wounds.

Medicines for tetanus

Antibiotics, muscle relaxants and tetanus serums are the drugs used to treat tetanus. Are they:

  • Amoxicillin ;
  • Diazepam;
  • Immunoglobulin ;
  • Longactil.

Attention!

NEVER  self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Prognosis

Tetanus progresses rapidly and in the elderly and children, and the mortality rate is extremely high, reaching 80%, but in adults, 70% of patients survive. It is a dangerous and lethal disease, but neither the disease nor the treatment, when effective, leave sequelae.

Complications

With a mortality rate of 30% among adults, tetanus is a dangerous and suffered disease. If not treated, the chances of death are even greater. Spasms can cause terrible pain, as well as fractures in long bones, such as those in the arms or ribs, in addition to breaking muscle fibers. It is a serious disease.

Death

Death is the greatest risk that the patient runs. Tetanus can cause repeated spasms in the diaphragm, killing by asphyxiation. In some cases, assisted breathing is used to keep the patient alive, but this is not always possible.

Prevention: how to avoid tetanus?

Vaccination

Getting vaccinated is the easiest and most accurate way of preventing tetanus. It is included in the tetravalent vaccine, given to children under the age of one. It is necessary to renew the tetanus vaccine every 10 years, as the amount of antibodies in the body drops with time.

In the case of injuries, if the person does not remember or has not had the vaccine in the last ten years, it is necessary to apply it again, especially if the wound was made somewhere that appears to be poor hygiene.

Remember that someone who has had the disease can still get it again and the vaccine is the only way to get immunized.

Wound cleaning

Cleaning the wounds thoroughly with soap and water as soon as they happen can prevent the bacteria from entering the body.

The Clostridium tetani  is resistant to phenol, formaldehyde and ethanol, but can be sterilized with hydrogen peroxide. If the wound is deep, the doctor may recommend tetanus serum.

Neonatal tetanus

Avoiding tetanus in newborns is also easy. The mother’s prenatal vaccination immunizes the baby as well and is the most effective way to prevent neonatal tetanus.

The cleaning of the materials for cutting and protecting the umbilical cord is necessary to avoid any more serious infection.


Although extremely dangerous, tetanus is an easily preventable disease. The vaccine has made it a rare disease and it is extremely important for it to stay that way. Remember to get vaccinated and share this text with your friends to alert them to the dangers of tetanus!

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