health talk:with Dr Johannes Marisa
A lot of people seem to underestimate tetanus yet it is a serious disease that causes between 213 000-293 000 deaths worldwide each year and is responsible for 5-7% of all neonatal deaths and 3-5% of all maternal deaths globally. The World Health Organisation in 2017 recorded 134 deaths in Zimbabwe, which were due to tetanus. Tetanus is a serious disease caused by a bacterial toxin that affects your nervous system, leading to painful muscle contractions, particularly of your jaw and neck muscles. Tetanus can interfere with your ability to breathe and can threaten your life.
Tetanus is caused by a toxin made by spores of a bacteria called Clostridium tetani, found in soil, dust and animal faeces. Clostridium tetani is an obligate anaerobic gram-positive bacillus that forms spores that can be found in soil and house dust, and in animal and human faeces. The spores remain viable for years in the environment and are resistant to boiling and freezing. When the spores enter a deep fresh wound, they grow into bacteria that can produce a powerful toxin. The tetanus toxin is transported with blood and lymph and is taken up by nerve cells. Once inside the neurons, tetanus toxin cannot be neutralised by an antitoxin. The toxin impairs the nervous system that controls your muscles. The toxin can cause muscle stiffness and spasms.
How does one get tetanus?
The following increase your likelihood of getting tetanus:
lFailure to get vaccinated or to keep up-to-date with booster shots against tetanus.
lAn injury that lets tetanus spores into the wound.
lA foreign body such as nail or splinter.
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Cases of tetanus develop from the following:
lPuncture wounds, including from splinters, body piercing, tattoos.
lGunshot wounds.
lCompound fractures.
lAnimal and insect bites.
lBurns.
lSurgical wounds.
lInfected umbilical stumps in new-borns.
lInjection drug use.
Signs and symptoms
lSpasms and stiffness in your jaw muscles.
lStiffness of your neck muscles.
lDifficulty in swallowing.
lStiffness of your abdominal muscles.
lFever.
lSweating.
lRapid heart rate.
Prevention
Primary vaccine series: It is the tetanus vaccine given as part of the immunisation schedule in children. Ideally, three doses of vaccine are given. A tetanus booster shot should be given after 10 years.
After sustaining a penetrating wound or laceration, you should get an anti-tetanus toxoid vaccine as soon as possible usually within the first 48 hours. This means you ought to present with your injuries within two days. Please do not ignore injuries.
Tetanus toxoid vaccine during pregnancy is usually, recommended between 27 weeks and 36 weeks of pregnancy.
Diagnosis and treatment
Tetanus is diagnosed based on medical and immunisation history, physical examination and the signs and symptoms of muscle spasms, stiffness and pain.
Laboratory tests generally are not helpful for diagnosing tetanus
Treatment
There’s no cure for tetanus. Treatment consists of:
lWound care.
lMedication to ease symptoms such as:
1. Tetanus antitoxin, however, the antitoxin can neutralise only toxin that hasn’t yet bonded to nerve tissue
2. Antibiotics to fight tetanus bacteria.
3. Sedatives to control muscle spasms.
4. Supportive therapy.
Complications
Once tetanus toxin has bonded to your nerve endings, it is impossible to remove. Complete recovery from a tetanus infection requires new nerve endings to grow, which can take up to several months. Complications of tetanus infection include:
lRespiratory failure.
lLack of oxygen may also induce cardiac arrest and death.
lBroken bones: The severity of spasms may cause the spine and other bones to break.
Let us be wary about tetanus. Let us observe proper immunisation schedules. Seek medical care when you have injuries or wounds!
lDr Johannes Marisa is a medical practitioner, an educationist and a public health expert who can be accessed on [email protected].
