What is Tetanus? Symptoms, Vaccine, and Treatment | What You Need to Know About Tetanus

Tetanus

Tetanus is a health problem that occurs when Clostridium tetani bacteria enter the body, leading to changes in the nervous and muscular systems. Bacterial spores can enter the human body through wounds or cuts and start an infection. Clostridium tetani bacteria produce toxins in the body that cause painful muscle contractions. Contractions caused by bacterial spores usually occur in the jaw and neck muscles. For this reason, tetanus can be described in the form of a lockjaw. Tetanus can manifest itself within 14 days in infected individuals. However, it is not one of the diseases transmitted from person to person.

Tetanus can cause serious complications in some cases and can be life-threatening. Emergency medical interventions are aimed at improving symptoms and serious complications. Tetanus, which has no specific cure, can be prevented with vaccination applications. Individuals who have had tetanus and recovered have a chance of reinfection. The disease of tetanus, which can occur in anyone, often carries a high risk in unvaccinated and low-immunity individuals. In addition, it can be seen more commonly in males compared to females, in residential areas such as farms, and in regions with hot climates. It can be diagnosed based on clinical features and does not require specific tests.

What is Tetanus?

Tetanus is an acute and bacterial disease affecting the nervous system. Spores of Clostridium tetani bacteria can enter the human body through contaminated wounds and lead to tetanus. Toxins produced by bacteria entering the body cause tetanus symptoms. Toxins can irreversibly bind to nerve endings and prevent the release of certain substances. As a result, tonic seizures can occur, causing repeated stimulation of the muscles and stiffening of the person. Clostridium tetani spores can be found abundantly in the environment in substances such as soil, rusted objects, human and animal feces or nails, needles, and ash.

Since spores are resistant to antiseptics and heat, they can survive for years. Spores, which can take over the nervous system and have control over skeletal muscles, can in some cases only affect the area around the wound through which they entered the body. Every age group, including children, adults, and the elderly, can be affected by tetanus. However, it can be seen commonly, especially in unvaccinated pregnant women and newborns. It can occur in pregnant women as “maternal tetanus” and in newborns as “neonatal tetanus”. In addition, there may be a high risk in geographies where vaccination is inadequate and incorrect birth practices are observed. The development of tetanus can be prevented with vaccines containing tetanus toxoid.

What is the Tetanus Vaccine?

The tetanus vaccine is a protective immunization application called “tetanus toxoid”. Protection against tetanus can only be provided through vaccination. Moreover, even if a person contracts tetanus, they are not fully protected against tetanus and can get sick again if vaccination is not performed. Therefore, vaccination is recommended in infancy and childhood. There are multiple types of vaccines for protection against tetanus. These vaccine types are combined vaccines that can also be used against other diseases. The main tetanus vaccines are:

DT: Diphtheria and tetanus vaccine (for children)

DTaP: Diphtheria, tetanus, and pertussis vaccine (for children)

Td: Tetanus and diphtheria vaccine (for adults)

Tdap: Tetanus, diphtheria, and pertussis vaccine (for adults)

The tetanus vaccine (DTaP), which is administered free of charge to every newborn baby through vaccination programs, is recommended in 5 doses. Babies should receive one dose each at 2, 4, 6, 18 months and 4-6 years of age. However, since the validity period of the tetanus vaccine administered in childhood is short, it cannot provide lifelong protection. Therefore, booster doses may need to be administered. In children around 11-12 years of age, the tetanus vaccine can be recommended as Td or Tdap. These doses can be repeated every 10 years. Neonatal tetanus cases can be prevented in women who receive the tetanus vaccine during pregnancy. Neonatal tetanus can be a serious risk for those who do not get the tetanus vaccine during pregnancy.

What Are the Symptoms of Tetanus?

Tetanus symptoms can appear within 3-21 days after infection with Clostridium tetani. Although this period is the incubation period, it may include bothersome findings. The first commonly seen symptom is lockjaw, which develops as a spasm in the jaw muscles. In this case, individuals become unable to open their mouths. Tetanus disease symptoms may additionally include:

Sudden muscle spasms, usually in the abdomen, back, and limbs,

Painful muscle spasms triggered by sudden noises,

Muscle stiffness covering the general body,

Difficulty swallowing,

Difficulty breathing,

Headache,

High blood pressure,

Tremors or seizures,

High fever and sweating,

Uncontrolled urine and stool output,

Changes in heart rate, blood pressure, etc.

Tetanus symptoms in newborns can often be in the form of loss of sucking and breastfeeding ability resulting from muscle spasms, excessive crying, and restlessness. Diagnosis can be made for babies who lose normal sucking and crying ability between the 3rd and 28th days of early life.

How is Tetanus Diagnosed?

There is no specific method or test determined for the diagnosis of tetanus. Clinical diagnosis usually involves the evaluation of physical examination, medical history, and family history. Recently occurring trauma, cuts, abrasions, etc., can be questioned. Muscle stiffness, lockjaw, muscle spasms, and seizures are evaluated. The person's medical and vaccination history can be checked. If there is a health problem suspected other than tetanus, laboratory and imaging tests can be used. Tetanus can be confused with meningoencephalitis in some cases. However, unlike meningoencephalitis, the presence of normal cerebrospinal fluid, normal sensory functions, and muscle spasms in the person may point to tetanus.

How is Tetanus Treated?

Tetanus treatment generally includes long-term supportive care. Treatment planning may vary depending on the severity of the tetanus infection. Various processes such as alleviating tetanus symptoms, treating existing wounds, care applications, and drug therapy can be maintained. The basic treatment plan for tetanus patients requiring urgent medical care may include:

Wound care: Debris, dirt, and foreign substances present in the wound can allow Clostridium tetani bacteria to harbor and multiply. Therefore, the wound needs to be cleaned thoroughly and quickly. In addition, dead tissues suitable for bacterial proliferation around the wound may need to be removed.

Drug therapy: Antitoxins given as passive immunization target free toxins that have not attacked nerve cells. They can act as human antibodies against the activity of toxins. Sedatives aimed at relieving muscle spasms are drugs that slow down the functioning of the nervous system. Antibiotics are drugs that can be taken into the body orally or intravenously against bacteria. In addition, other drugs may be preferred to regulate conditions such as blood pressure, heart rate, and shortness of breath.

Supportive treatment: Respiratory support applied for muscle spasms that prevent breathing in moderate and severe cases. A breathing tube or ventilator is used, and a tube is passed down into the stomach for feeding.

In addition, bed rest is recommended in environments away from triggers such as bright light and loud noises.

Frequently Asked Questions

The duration of the tetanus vaccine is approximately 10 years. After the doses administered to newborns and children, a booster dose can be administered to children aged 11-12. However, repeated doses every 10 years may be recommended. Side effects such as pain, redness, and swelling may occur after the tetanus vaccine. The tetanus vaccine is an immunization application that supports antibody formation during pregnancy. With the tetanus vaccine during pregnancy, the production of protective antibodies against the disease can be ensured in the mother's body, and these antibodies can be transferred to the baby. Babies can be protected against the development of disease in the first months of life. Unvaccinated pregnant women can give birth to newborns at high risk of developing tetanus. Side effects of the tetanus vaccine during pregnancy can cause swelling, bleeding, pain, and redness at the injection site. The duration of a single dose of tetanus vaccine in childhood is on average 4-10 years. The tetanus shot may be recommended every 10 years for adulthood. Individuals who contract the disease cannot gain immunity against bacteria, and therefore continuous vaccination is required. Among the benefits of the tetanus vaccine are minimizing the risk of infection and preventing severe spasms. Individuals with tetanus findings should seek emergency medical intervention. Complications caused by tetanus can lead to life-threatening hazards. It may be necessary to clean wounds and cuts if any, clear healthy tissue from dead tissue, and start drug therapy to alleviate spasms and other symptoms. If the tetanus vaccine is not administered, antibody levels in the body may decrease over time. Low levels of antibodies may not be effective in protecting the body against infection. In addition, tetanus can cause fatal results in some cases. In the untreated tetanus picture, complications such as pulmonary embolism, pneumonia, bone fractures, and breathing problems can be seen. The tetanus vaccine is not a curative application but a preventive action. Therefore, it is administered before tetanus patients become infected. There is still no definitive cure for tetanus. Instead, there are care applications that reduce the risk of complications and help alleviate symptoms. It is possible to be infected with Clostridium tetani bacteria even without excessive bleeding. Open wounds connected to the bloodstream are frequently the areas where bacteria enter the body. Animal bites, rusty metals scratching the skin, plant thorns such as roses piercing, purulent wounds, burns, and unclean wounds (soil, dust, feces, etc.) are suitable conditions to become infected. However, deep wounds containing foreign bodies are the areas with the highest risk of infection. A single dose of tetanus vaccine is not considered sufficient. Tetanus vaccine effects do not remain valid for long periods. Individuals who have had tetanus or have been vaccinated face the risk of contracting tetanus again. Therefore, booster doses must be administered at intervals of approximately 10 years. Since people cannot gain natural immunity after tetanus, multiple doses of vaccination are administered. Symptoms commonly seen in tetanus patients include lockjaw, muscle spasms in other body parts such as the abdomen and back, muscle stiffness, high fever and sweating, headache, seizures, difficulty in swallowing and breathing, and changes in blood pressure and heart rate. Tetanus patients have normal sensory function, but neuro-muscular system symptoms are abnormal. The tetanus vaccine is a vaccine that can be administered at a primary health care center. However, the tetanus vaccine can be administered by healthcare personnel in hospitals, health centers, family health centers, and vaccination centers.

Tetanus is a serious infectious disease that can pose a vital risk if early precautions are not taken. If you are unsure about your vaccination follow-up or have encountered a suspicious wound, it is of great importance to apply to a health institution without wasting time. The most effective way to protect against tetanus is to ensure regular vaccination and proper wound care. Do not neglect your routine checks for your health.