Tetanus - What is Lockjaw?

tetanus or lockjaw is caused by the bacterium Clostridium tetani.it has existed in air, water, animal and human intestine, and especially the soil. the bacteria enter a wound in small numbers and produced powerful toxins. the toxins provoke sustained and uncontrolled contraction of the muscles and spasm occurs throughout the body and the victim experiences a violent death.

Causes and symptoms of tetanus:

Tetanus, (lockjaw), is a bacterial infection. In which, the cramps begin in the jaw and then move on in the rest of the body. Other symptoms of tetanus may include fever, sweating, headache, difficulty in swallowing, high blood pressure, and high heart rate. The symptoms usually start from three to twenty-one days after the infection. Approximately ten percent of the cases prove fatal. Tetanus occurs in all parts of the world, but it is most in hot and wet climates where there is much organic matter in the soil.



Clostridium tetani:

the bacterium exists as a spore in the intestines of many animals and humans .however intestinal infection does not occur. the bacterium is excreted in faces to the soil, from where the spores are introduced to the anaerobic environment of dead necrotic tissue in a deep puncture. wound contamination may also occur. rusty nail is a threat because spore may cling to the rough edges of the nail.

Lockjaw:

the symptoms develop very rapidly, within hours of entry, the spore rever to vegetative cells which produce several toxins including tetanospasmin. the toxin spreads through the bloodstream and along the axons of the nerve cells to the nerve endings where it inhibits the removal of acetylcholine in the synapse. there is muscles contraction, muscle stiffness, especially in the jaw and swallowing muscles, soon the back arches, the jaws clench, and a fixed smile come over the face these symptoms give the disease its traditional name of lockjaw.




types of tetanus.

1. Generalized tetanus,
2. Newborn tetanus,
3. Local tetanus,
4. Cephalic tetanus.

Generalized tetanus:

Normally this tetanus is the most common type of tetanus, which represents approximately 80% of cases. Its main symptoms are trismus, or lockjaw, and facial cramps (rhesus sardonicus), neck stiffness, difficulty swallowing. Other symptoms include fever, sweating, high blood pressure, and rapid heart rate.



Newborn tetanus :

Newborn tetanus is a form of generalized tetanus that occurs in infants, if the mother is vaccinated against tetanus, the infants receive passive immunity and stay safe. This is usually done through the infection of the unhealed Imperial Stump, especially when the stump is cut with a non-sterile means.



Local tetanus :

Local tetanus is an abnormal form of the disease, in which patients have the same contraction of the muscles in the same physical area as injury. The contraction can continue for several weeks before gradually occurring. Local tetanus is usually milky; Only 1% of cases are fatal.




Cephalic tetanus :

Cephalic is a rare form of tetanus disease (0.93% of cases) and is limited to the muscles and nerves in the head; it usually occurs after trauma in the area of ​​the head, in which the scalp fracture, wound, eye injury, dental extraction, and Otitis include.




The cause of tetanus:

Tetanus disease is caused by infection with bacterial clostridium tetany, which is usually found in soil, saliva, dust, and compost. Bacteria usually enter the body through cuts or wounds. Tetanie endospores are ubiquitous. Endospores are entering the body through a puncture wound. Due to the presence of anaerobic bacteria, this and its endospores grow in an environment that lacks oxygen, such as puncture wounds or cuts. This disease is especially inadequately protected in people. The soil treated with compost may be spore because they are widely distributed in many animals such as sheep, cattle, dogs, cats, rats, guinea pigs, and chickens intestines and seals.




Signs and symptoms :

Tetanus often begins with light spasms in the jaw muscles - also known as lockjaw or trimmers.
The spasm can also affect the muscles of the face, which results in an appearance that is called rhesus sardonicus. Chest, neck, back, abdominal muscles, and buttocks may be affected.
The muscles of the back are cramped, which is called opisthotonos. Occasionally cramps affect the muscles which help in breathing, thereby causing problems in breathing.
The long-term muscle action causes a sudden, powerful and painful contraction of muscle groups, which is called "tittle".



Other symptoms :

1. fever,
2. Headache,
3. Restlessness
4. Irritability,
5. Shortness of breath,
6. There is a reduction in irritation, 
7. urinary retention 
8. and stool control during urination.

Incubation period :

The incubation of tetanus can last for several months, but usually, it is about ten days. The lower the incubation period, the symptoms will be as severe. In neonatal tetanus, symptoms usually appear after 4 to 14 days of birth, on average, approximately 7 days.



Protection from tetanus :

by personal hygiene :

1. Tetanus can be prevented with vaccination with the tetanus vaccine.
2. If there is a wound in the body and the vaccine is less than three doses, then the tetanus immune globulin should be applied.
3. The wound should be cleaned with antiseptic and any dead tissue should be removed.
4. The body should be well-cleaned.
5. He should leave the body after he wound up.
6. to immunize the civil population, especially road workers, agricultural workers, industrial workers.

By tetanus Vaccine :

Tetanus  Toxoid (Adsorbed ) T.T

It is a sterile cloudy uniform suspension of tetanus toxoid adsorbed on aluminum phosphate and suspended in isotonic sodium chloride solution.


Indication/ for uses :

1. To adult 
2. To active immunization all children from 3 months onwards...

Dosage :

For active primary immunization 
Two doses each 0.5 ml by intramuscular route at intervals :

day 1 - first dose.

4- 6 weeks of interval - second dose.

Reinforcing doses should be given 9 to 12 months later to increase the level of immunity.


Booster dose  :

In case of all person actively immunized a booster dose of 0.5 ml should be given every 5 years To maintain an adequate level of immunity.