Tetanus is a disease caused by an infection with the bacterium Clostridium tetani.

Tetanus is a global disease, but it usually occurs in underdeveloped or agricultural areas, mainly because of high exposure to animal waste by local patients or incomplete local vaccination.

With the mortality rate of tetanus as high as 10-90%, especially in the elderly and infants, Taiwan in recent years, however, has reported fewer than 20 cases annually, and the number of deaths has decreased year by year.

Clostridium tetani infection is confined to necrotic tissue only and does not cause tissue destruction or inflammatory response. However, the neurotoxin produced by the bacterium can affect the central nervous system and autonomic nervous system, leading to severe neurological symptoms and death.

Etiology

• Clostridium tetani is a kind of bacterium in the human intestine. The disease is mainly caused by the invasion of the bacterium into the blood through open wounds, laceration, burns or injection of contaminated drugs after soil or media is contaminated by animal or human feces.

Incubation Period

• The incubation period of typical tetanus is about 3 to 21 days, usually within 14 days.

Symptoms

• The most common initial symptoms are abdominal stiffness and muscle spasm. The typical tetanus spasm is characterized by "opisthotonus" and "convulsive smile" on the face, accompanied by intense muscle contraction pain.

Precautionary Approaches

• The most effective way to prevent tetanus is to "get a tetanus vaccine on time".
• After injured, clean the wound with disinfectant and dress it properly.
• If a wound is contaminated by soil, dust or animal or human feces, or cut by a rusty appliance, the patient should seek medical treatment as soon as possible, and inform the doctor of the wound contamination.

Treatment and Medical Information

• At present, there are no specific drugs with proven effects. Only anti-tetanus immunoglobulin can treat initial tetanus with supportive therapy.
• If a wound is found to be contaminated by soil, dust or animal or human feces, or cut by a rusty appliance, the patient should seek medical treatment as soon as possible, and inform the doctor of the wound contamination.

Vaccination Recommendations

• Currently, the government offers 5-in-1 vaccines for children aged 2, 4, 6 and 18 months.
• Children receive 5-in-1 vaccine free of charge against diphtheria, tetanus, acellular pertussis, Haemophilus type B and inactivated polio.
• After vaccination, about 95% of the people can produce antibodies, which can maintain the protective immunity for more than 10 years, and every 10 years a dose of reduced diphtheria and tetanus toxoid with acellular pertussis vaccine can be administered.