My last article, "Childhood Diseases – On a Mission to Educate: Asthma" we learned that Asthma is a disease that cannot be cured but with appropriate management, one can learn to control this disease and lead a good quality of life. There are short-term medications that can relieve symptoms but people with persistent symptoms must take long-term medications daily, to control the underlying inflammation which impact airflow to the lungs, and to prevent asthma symptoms and episodes of exacerbations. It is equally important to avoid any triggers that may elicit an asthma attack. Today I will like to move onto another childhood disease, Tetanus.
What Is Tetanus?
According to Stanford Children’s Hospital (http://www.stanfordchildrens.org/en/topic/default?id=tetanus-in-children-90-P02549) Tetanus is an “acute, sometimes fatal, disease of the central nervous system, caused by the toxin of the tetanus bacterium, which usually enters the body through an open wound.” This tetanus bacteria actually lives in soil and manure but can also be found in the human intestine, animal saliva and other places:
- Tetanus occurs more often in warmer climates or during the warmer months.
- Tetanus is very uncommon in the U.S. due to widespread immunization.
Tetanus is also known as Lockjaw where the infection starts with muscle spasms in the jaw and later progresses to the rest of the body. According to Kids Health (http://kidshealth.org/en/parents/tetanus.html) “once the bacteria are in the body, they produce a neurotoxin (a protein that acts as a poison to the body's nervous system) that causes muscle spasms. The toxin can travel throughout the body via the bloodstream and lymph system. As it circulates more widely, the toxin interferes with the normal activity of nerves throughout the body, leading to generalized muscle spasms. Spasms can be so forceful that they tear muscles or even cause spine fractures. Without treatment, tetanus can be fatal.”
How Is Tetanus Transmitted?
Tetanus is not a contagious disease but occurs when an individual gets a skin or deep tissue wound or puncture. An example of this is like stepping on a rusty nail. Tetanus can also be seen in the umbilical stump of infants primarily in underdeveloped countries. Unfortunately this occurs in areas where immunization to tetanus is not available or where women are not educated about proper stump care after the baby is born. Once an individual is exposed to tetanus, it takes 3 - 21 days for symptoms to develop. Infants symptoms take between 3 to two weeks to emerge.
What Are the Symptoms of Tetanus?
It should be noted that each individual may experience different symptoms but the most common ones are as follow according to Stanford Children’s Hospital:
- Stiffness of the jaw (also called lockjaw)
- Stiffness of the abdominal and back muscles
- Contraction of the facial muscles
- Fast pulse
- Painful muscle spasms near the wound area (if these affect the larynx or chest wall, they may cause asphyxiation)
- Difficulty swallowing
The above symptoms of tetanus may resemble other medical conditions so it is very important that you consult the doctor for a diagnosis, especially if it involves a young child.
What Are the Risk Factors of Tetanus?
Some of the risks factors are as followed according to many sources including Mayo Clinic (https://www.mayoclinic.org/diseases-conditions/tetanus/symptoms-causes/syc-20351625) and About Kids Health (http://www.aboutkidshealth.ca/En/HealthAZ/ConditionsandDiseases/InfectiousDiseases/Pages/Tetanus.aspx):
Failure to get vaccinated properly.
Failure to get up to date booster shots against tetanus. It is recommended that you get a tetanus shot every 10 years.
International travel without being vaccinated.
Getting an injury that lets tetanus spores into the wound and not having it treated.
Encountering a foreign body such as a nail or splinter.
Mayo Clinic also included other possible situations where people have developed a case of tetanus that one should be aware of:
- Puncture wounds — including from splinters, body piercings, tattoos, injection drugs
- Gunshot wounds
- Compound fractures
- Surgical wounds
- Injection drug use
- Animal or insect bites
- Infected foot ulcers
- Dental infections
- Infected umbilical stumps in newborns born of inadequately immunized mothers
How Is Tetanus Treated?
Usually children who have tetanus are treated in a hospital, usually in the intensive care unit where they typically get antibiotics to kill the bacteria and also receive medications that can control muscle spasms. Other interventions are done depending on the child’s condition. According to Stanford Children’s Hospital a tracheostomy may be performed where a breathing tube is inserted surgically in the windpipe for very severe cases that involve respiratory problems. Other interventions are also administered to support vital body functions.
Complications of Tetanus
According to Everyday Health (https://www.everydayhealth.com/tetanus/guide/) some of the complications of Tetanus may include:
- Fractures and broken bones: Intense muscle spasms can cause the spine and other bones to break.
- Disability: Prolonged use of strong sedatives to control muscle spasms can lead to permanent disability.
- Brain damage: Since spasms can restrict oxygen, tetanus may cause lasting brain damage in infants, from minor mental deficits to more serious conditions like cerebral palsy.
- Death: Severe muscle spasms from tetanus can cause airway obstruction and the inability to breath. Respiratory failure is the most common cause of death in people with tetanus.
- Cardiac arrest may also occur from lack of oxygen, as well as pneumonia. With proper treatment, less than 15 percent of people with tetanus die.
According to the Centers For Disease Control & Prevention (https://www.cdc.gov/tetanus/about/symptoms-complications.html) their list of complications include the following:
- Uncontrolled/involuntary tightening of the vocal cords (laryngospasm)
- Broken bones (fractures)
- Infections gotten by a patient during a hospital visit (hospital-acquired infections)
- Blockage of the main artery of the lung or one of its branches by a blood clot that has travelled from elsewhere in the body through the bloodstream (pulmonary embolism)
- Pneumonia, a lung infection, that develops by breathing in foreign materials (aspiration pneumonia)
- Breathing difficulty, possibly leading to death (1 to 2 in 10 cases are fatal)
Prognosis of Tetanus
According to Emedicine (https://emedicine.medscape.com/article/229594-overview#a4) the prognosis is dependent on the incubation period, the time from spore inoculation to first symptom and the time from first symptom to first tetanic spasm. They stated that the following statements typically hold true:
- In general, shorter intervals indicate more severe tetanus and a poorer prognosis
- Patients usually survive tetanus and return to their predisease state of health
- Recovery is slow and usually occurs over 2-4 months
- Some patients remain hypotonic
- Clinical tetanus does not produce a state of immunity; therefore, patients who survive the disease require active immunization with tetanus toxoid to prevent a recurrence
How To Prevent Tetanus
About Kids Health stated that most children catch tetanus through an open wound and having contact with dirt, dust or animal droppings. It is suggested that the only safe and reliable way to avoid tetanus is through immunization in early childhood. Tetanus vaccines are normally given at 2 months, 4 months and 6 months of age. Then at 18 months another vaccine is given followed by another injections between 4 to 6 years of age. Boosters are recommended once every 10 years.
Some Interesting Facts About Tetanus
There are some interesting facts about Tetanus according to Emedicine:
- Only 12-14% of patients with tetanus in the United States have received a primary series of tetanus toxoid. During 1998-2000, only 6% of all patients with tetanus were known to be current with tetanus immunization, with no fatal cases reported among this group.
- In 73% of patients with tetanus in the United States, tetanus occurred after an acute injury, including puncture wounds (50%), lacerations (33%), and abrasions (9%).
- Stepping on a nail accounted for 32% of the puncture wounds.
- Tetanus was found to occur in burn victims; in patients receiving intramuscular injections; in persons obtaining a tattoo; and in persons with frostbite, dental infections (eg, periodontal abscesses), penetrating eye injuries, and umbilical stump infections.
- Other reported risk factors included diabetes, chronic wounds (eg, skin ulcers, abscesses, or gangrene), parenteral drug abuse, and recent surgery (4% of US cases).
- During 1998-2000, 12% of patients with tetanus in the United States had diabetes (with mortality, 31%), compared with 2% during 1995-1997; of these patients, 69% had acute injuries and 25% had gangrene or a diabetic ulcer.
- The median time interval between surgery and onset of tetanus was 7 days.
- Tetanus was reported after tooth extractions, root canal therapy, and intraoral soft tissue trauma.
So in summary, Tetanus is a serious disease that attacks the nervous system with the deadly bacteria called Clostridium Tetani. Because it can cause painful spasms and stiffness in the jaw muscles it is sometimes referred to as Lockjaw. Not only is the jaw affected, this bacteria can also cause muscle contractions in the neck and throughout the body affecting breathing. Tetanus can be prevented from a vaccine which provides immunity against Tetanus. If you get a deep wound or other injury such as open wounds with the presence of infective bacteria, animal bites, fractures, drug injections, ulcers, foreign objects such as a nail or splinter, swelling, etc. you should see your doctor especially if you have not been vaccinated or have up to date booster shots.
I hope you learned something from this article about Tetanus. There are many resources on the internet if you need more specific information. I will continue this series with another childhood disease post. I hope you will continue to join me in this quest to learn about these illnesses that children usually encounter when they are young. Thank-you for reading my article on Childhood Diseases – On a Mission to Educate: Tetanus. If you would like to follow me, please check HERE
These are my previous articles. if you are interested in reading it:
Neuroplasticity: Hope For People With Anxiety?
Neuroplasticity: How to deal with Anxiety Disorders Like Panic Attacks
Neuroplasticity: Cognitive Behavior Therapy (CBT)
Neuroplasticity: Mindfulness Based Cognitive Therapy
Neuroplasticity: Self-Directed Neuroplasticity Exercises
Neuroplasticity: Music & Music Therapy
Neuroplasticity: Meditation and Anxiety
Neuroplasticity: Brainwave Entrainment
Anxiety and CBD: An Introduction to Cannabinoid
Childhood Injuries: Concussions
Childhood Injuries: Post Concussion Syndrome & Recovery & Safety Measures To Prevent Concussions
Youth Sports: The Benefits of Youth Sports & Increase Incidents of Concussions
Are You Ready For Some Football? - The Continuing Saga of Concussion & Chronic Traumatic Encephalopathy in Former NFL Players & Other Concussion Victims
An American Tragedy: Story of Mike Webster, Pro Hall of Famer & CTE
Chronic Traumatic Encephalopathy – The Tragedy Continues: Not Just In the NFL
Should Our Children Be Playing Contact Sports or Not?: Dr. Bennet Omalu
Teachers & Parents Beware of Impetigo: I Gave It To My Teacher
Childhood Diseases –On a Mission to Learn: Chicken Pox
Childhood Diseases – On a Mission to Educate: Strep Throat
Childhood Diseases – On a Mission to Educate: Fifth Disease
Childhood Diseases – On a Mission to Educate: Measles
Childhood Diseases – On a Mission to Educate: Mumps
Childhood Diseases – On a Mission to Educate: Croup
Childhood Diseases – On a Mission to Educate: Pertussis (Whooping Cough)
Childhood Diseases – On a Mission to Educate: Asthma