Tetanus is a very dangerous disease which occurs when microbe Clostridium tetani enters the body through damaged skin where it produces a poison tetanus toxin.
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Tetanus toxin is one of the most dangerous poisons we know. Clostridium tetani lives in soil, dust and manure because it likes to grow in an environment without air. To get infected you must get in contact with it, and you can't get tetanus through contact with other people.
So, every skin damage is a great opportunity for that nasty microbe, but you must pay a special attention in cases of deep and dirty cuts, punctures, large burns, and wounds when broken bones damage the skin, or objects such as wood penetrate it.
We would like to emphasize, because many tend to forget that even a smallest wound (for example, if you pick a rose and get a prick from a thorn) can let tetanus in.
What happens if you get tetanus?
Tetanus toxin (tetanospasmin) spreads through the bloodstream and it blocks the nerve signals from the spinal cord to the muscles. This causes muscle spasms throughout the body, particularly in the neck, face, abdomen, back, and jaw.
After that stiffness in affected muscles appears and it is most visible in jaw, that's why tetanus is also called "lockjaw".
To get the picture how bad and painful spasms can be, let's just say that the patient can involuntarily end up in a body bridge. In some people a fever can be increased too.
The doctor will diagnose tetanus based on the signs of muscle spasms, stiffness and pain because laboratory tests are not helpful for diagnosing tetanus.
The bad news: the incubation period for tetanus infection is between 4 and 21 days, and the average incubation time is 10 days.
The even worse news is that first spasm can appear on Day One and this is particularly dangerous situation and the explanation is simple: that means that the patient has very weak immune system and that, of course, can complicate treatment greatly.
It is very important to remember that tetanus infection must be treated quickly because the final condition can be death.
The mortality vary from country to country but in general it's between 10 and 50 percent, and we'll say this again: an infected person can die - even with the best intensive care treatment.
How can you protect yourself from tetanus?
The good news is that immunisation against tetanus is very effective in preventing the disease. The vaccine is called tetanus toxoid and is available alone or in combination with other vaccines.
The vaccine is made by taking a small amount of the tetanus toxin and making it inactive. The body learns to recognize and attack this toxin, making antibodies to it.
When the body meets the real tetanus toxin, these antibodies destroy it before any harm is done.
Everybody needs an initial course of three doses of the vaccine to teach the immune system to recognise the tetanus toxin and then "booster doses" to help keep the body's memory active.
Children need several vaccinations: at 2, 4, 6 and 18 months, at the age of 5 years, and again at ages 15-19.
Adult person needs a booster dose every 10 years. If the patient gets a wound that is likely to grow the tetanus germ, he may need another booster if he hadn't one in the last five years.
Several groups of people are considered to be members of the "risk group".
Those are people who have never been immunised, farmers (their working conditions include dirt and manure), people who didn't get enough doses of the vaccine, and especially older people because their immune system weakens with age.
No matter are you in any of those groups, if you have deep or dirty wound, especially if you were touching the ground, don't wait for symptoms to appear - go and see your doctor immediately.
Treatment for tetanus does exist and it includes a combination of several drugs, but it is lengthy and the outcome can't be predicted.
So, the best defence against tetanus is by preventing it with vaccinations and by properly caring for wounds. ■