Tetanus

It usually takes a puncture wound to jog a parent's memory about the dreaded disease tetanus. and whether or not their child's immunizations are up to date. Although tetanus is feared and talked about, it is probably one of the least understood diseases of childhood. For those unfamiliar with tetanus, it is the "T" in the DTAP shot.

Tetanus is caused by the bacterial organism Clostridium tetani. Thanks to the wide spread use of tetanus immunization, it is an uncommon illness in the United States, with fewer than 200 cases occurring each year.

The bacteria responsible for this illness inhabits soil, animal and human feces and in any area contaminated by fecal material. Two features of the organism make it particularly dangerous. First, it can live silently in the form of a spore for many years. These spores have been found in fresh and salt water, and are very resistant to boiling. Second, Clostridium tetani is an 'anaerobic" bacteria, meaning that it grows in an airless environment.

The bacteria responsible for tetanus is durable and widespread. Therefore, any wound has the potential for becoming contaminated. However, an injury caused by a dirty object, especially if contaminated by fecal material, would be much more likely to become infected. Because growth of the organism is enhanced by an airless environment, deep puncture wounds and wounds associated with severe tissue damage are also more likely to allow growth of this organism. These types of wounds often include burns and severe crushing injuries.

The symptoms of tetanus are not caused by the organism but by a toxin that it produces which attacks the victim's nervous system. The disease usually begins days to a week after the initial wound. The first symptom is usually spasm of the jaw and neck muscles resulting in the so-called "lockjaw."

Since treatment often cannot cure this illness, the best approach is prevention. The series of five DTAP shots started in infancy and ending before school entry, followed by boosters every 10 years, will effectively prevent the infection. In an adequately immunized child, boosters need not be given for superficial wounds unless 10 years have elapsed since the last shot. However, treatment for severe burns, deep wounds or severe wounds with extensive tissue injury will often include a tetanus shot.

It is important to remember that adults are also susceptible to tetanus. Therefore, they should also receive a tetanus booster every 10 years. Are you due for a tetanus booster?