Tetanus can be a serious condition if you do not stay up on your immunizations. Find out more about tetanus, including who is most at risk and how to defend yourself against it.
Tetanus is caused by a toxin produced by a bacterium called Clostridium tetani. Spores (reproductive cells) of C. tetani are found in soil and enter the body through a skin wound. Once the germinating spores develop into mature bacteria, the bacteria produce a tetanospasmin, a neurotoxin (a protein that acts as a poison to the body's nervous system) that causes muscle spasms.
In the developed world, tetanus is a rare but serious illness. It often begins with muscle spasms in the jaw, called trismus, or "lockjaw." These spasms are accompanied by difficulty swallowing and painful stiffness in the muscles of the neck, shoulders, or back. These spasms can spread to the muscles of the abdomen, upper arms, and thighs. If diagnosed and treated early, recovery is possible but takes several weeks.
Keep in mind that stepping on a rusty nail is not the only way to contract tetanus. Skin punctures from nonsterile needles, such as those used for tattooing or piercing, can cause tetanus. Remember, too, that even if the instrument or wound site looks clean, it can still be contaminated.
Another form of tetanus, neonatal tetanus, occurs in newborns who are delivered in unsanitary conditions, especially if the umbilical cord stump becomes contaminated. This is very rare in the United States.
Who's at Risk for Tetanus
Tetanus cannot be spread from person to person -- it occurs after the tetanus-causing bacterial spores enter the body. Children who have not received the full schedule of DTP or DTaP vaccines and adults who have not had a booster in ten years are at risk. Newborns who are born to unimmunized mothers in unsanitary conditions are also at risk of getting tetanus.
Defensive Measures Against Tetanus
The prevention of tetanus is a relatively simple task. First, clean all wounds and remove any foreign material or dead tissue. Tetanus bacteria are strict anaerobes -- that is, they only grow in the absence of oxygen -- so good wound care is very important.
However, because it can be difficult even for medical professionals to completely clean out a puncture wound, you must also be sure your child receives routine tetanus vaccinations. The DTP or DTaP vaccine is given at 2, 4, and 6 months of age, with a booster given at 12 to 18 months and another when the child is between 4 and 6 years old. After that, a tetanus and diphtheria booster (Td) is recommended at 11 to 12 years of age, and then every ten years through adulthood.
If you or your child have been previously immunized but are injured in a way that increases tetanus risk (such as stepping on a rusty nail or cutting your hand with a knife), a booster shot may be necessary if it's been several years since the last one. This shot is known as postexposure tetanus prophylaxis.
Neonatal tetanus can be prevented when a pregnant woman receives tetanus immunizations and delivers her baby in sanitary conditions. If you are pregnant, you should discuss your immunization record with your obstetrician well before your due date.
Another highly contagious bacterial infection is whooping cough. Find out how to get your child vaccinated for whooping cough on the next page.
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