Tetanus

Tetanus is a serious disease caused by a toxin from the Clostridium tetani bacterium, which lives in soil, dust, and animal faeces. It enters the body through wounds — even small ones — and causes painful muscle spasms that can be life-threatening. Tetanus is fully preventable with vaccination, but it remains a risk in unvaccinated or partially-vaccinated people.

How it enters the body

• Deep puncture wounds — nails, splinters, thorns
• Contaminated wounds — with soil, rust, dung
• Cuts, burns, crush injuries
• Animal bites
• Surgical wounds or injections with unsterile equipment
• Unclean childbirth — can cause neonatal tetanus in the baby if the umbilical cord is cut with unclean instruments or handled unhygienically. Prevented by maternal vaccination and clean birth practices.
• Sometimes entry site isn't identified

Symptoms

Symptoms usually appear 3-21 days after the wound, typically around 10 days:

• Lockjaw — stiffness and spasm of the jaw muscles; classic early sign
• Difficulty swallowing
• Stiffness of the neck, then back, abdomen, and limbs
• Painful muscle spasms — can be severe enough to cause fractures
• Fever, sweating
• Rapid heart rate
• In severe cases — seizures, breathing difficulty, autonomic instability
• Neonatal tetanus (in babies) — poor feeding, spasms, rigidity in the first 2 weeks of life; high mortality without urgent care

Treatment

Tetanus is a medical emergency, treated in hospital:

• Tetanus immunoglobulin (TIG) to neutralise circulating toxin
• Antibiotics — to kill the bacteria
• Muscle-spasm control — sedatives, sometimes muscle paralysis and ventilation in severe cases
• Wound care — cleaning, removal of dead tissue
• Intensive care support — breathing, blood pressure, nutrition
• Tetanus vaccination — given during treatment, since infection does not create lasting immunity

Recovery can take weeks to months. Mortality is high without prompt treatment.

Prevention

• Tetanus vaccination — part of India's Universal Immunisation Programme in childhood (DPT, then Td boosters in adolescence)
• Adult booster every 10 years, and after a significant injury if the last dose was more than 5 years ago
• Tetanus vaccination in pregnancy — prevents neonatal tetanus; part of routine antenatal care
• Clean wound care — wash all wounds with soap and water; see a doctor for deep, dirty, or puncture wounds
• Clean birth practices — use of sterile instruments, hygienic cord care
• Tetanus vaccine status should be known and kept up to date by every adult