Treatment and Prevention Guide for TETANUS

Tetanus, or "lockjaw", is caused by a toxin produced by the tetanus bacillus. The bacillus, a type of bacteria, infects a wound and grows only in the absence of oxygen. Tetanus spores enter the wound, usually at the time of the initial injury, and the bacilli develop from the spores. The source of the spores is usually dirt, dust, or excretory matter. Spores are capable of surviving in their dormant state for prolonged periods of time.

Tetanus is a very serious disease with a fatal outcome in about half the cases. The incubation period ranges from seven to twenty­ one days. Symptoms usually begin with painless stiffness of the neck and difficulty in opening the mouth. Rigidity of the muscles ensues, with severe spasms, especially of the jaw, neck, and some­times the trunk muscles. These spasms may be confined to the area of the wound. Convulsions, spasms of the throat, and extreme difficulty in breathing may result.

Treatment for TETANUS
Treatment is supportive. Hospitalization and various medica­tions are required. Tracheotomy and mechanical support of breathing may be necessary.

Prevention for TETANUS
Tetanus has been very successfully controlled by widespread immunization during childhood. The disease is relatively uncom­mon in the United States now, with about 100 cases occurring each year.

While deep, penetrating wounds with much debris or dead tissue are most commonly associated with tetanus, about one ­third of the cases seen today are in individuals with either no obvious wound or with a wound that was thought to be insigni­ficant.

All wounds should be cleaned immediately and carefully. Any dirt or dead tissue present should be thoroughly removed by a physician. Antibiotics are used if needed, but are never a substi­tute for immunization.

Immunity to tetanus is achieved when antibodies are marshalled against the highly potent tetanus toxin. Tetanus toxin antibodies may be obtained in two ways. Tetanus toxoid is toxin that has been made harmless but can still stimulate the production of anti­bodies. Antitoxin consists of antibodies that have been produced in horses or humans. Immunity is reliable and longlasting, and is considered complete after four doses of toxoid have been given. Boosters are recommended every ten years thereafter. Antitoxin is used when there is not sufficient time for the individual to generate his or her own antibodies, i.e., in people who have re­ceived fewer than two doses of the toxoid.