Tetanus is no longer a major concern in developed nations but the risk will always persist, especially for people who have not been immunized. This bacterial infection is quickly spread when there is an injury with an object that is contaminated with soil, animal feces or dust. Often these are injuries caused by rusty nails that were lying outdoors but even minor abrasions with indoor object can result in tetanus. Without rapid treatment, tetanus can be deadly.
What Does Tetanus Mean?
Tetanus is a disease caused by toxins from bacteria known as Clostridium tetani (C. tetani). These bacteria are found throughout the world. The highly resistant spores of this bacterium usually can be found in soil, animal feces and dust. Similarly the tetanus bacterium may also be found on various objects, especially if these objects are contaminated with soil, feces or dust.
Once these bacterial spores can gain entry into the body through a break in the skin, it may germinate and the bacteria then releases toxins. One of these toxins is tetanospasmin. It disrupts nerve activity and causes muscles to contract forcefully (spasms). The toxin may spread throughout the body and can be life threatening if not properly treated and managed.
There is no cure for tetanus but this does not mean it will always be fatal. Proper wound care immediately after the injury can minimize the risk of an infection. Various drugs may be administered to ease symptoms, neutralize some of the tetanus toxin and limit the growth of the bacteria. Supportive care like ventilation may be necessary in some cases.
Read more on tetanus.
What Does Tetanus Look Like?
The symptoms of tetanus do not appear immediately after the infection is contracted. There is an incubation period of approximately 7 days but it can vary from 4 to 14 days. This means that during the incubation period there are no symptoms of tetnus although the bacteria are multiplying and toxins are released. At most there may be signs of the injury, where the bacteria entered the body.
A wound usually precedes tetanus. Therefore it is important to take note if the symptoms below arise after an injury or appearance of a wound. However, the injury may not always be severe for tetanus to arise. Similarly a person may not always immediately associate the symptom below with tetanus as the injury may have occurred up to 2 weeks earlier.
Read more on how to prevent an infection.
Although tetanus is uncommon in developed nations due to immunization early in life, it can still occur if a person does not have a regular booster shot. Therefore tetanus should not be ignored as a possible cause of the symptoms below. Early diagnosis and treatment is essential to prevent life-threatening complications of tetanus.
The tetanus toxin causes muscles to contract uncontrollably. Therefore the muscles become stiff and the affected part of the body may be difficult to move. In the early stages it may affect the muscles near the site of the injury where the infection was contracted.
However, the toxins can spread throughout the body and therefore muscles even at distant sites may be affected. The muscles of the neck, jaw and face are commonly affected in tetanus. This is one of the reasons why it is also referred to as lockjaw. The abdominal muscles may also be affected.
Painful spasms are one of the hallmark signs of tetanus. It usually involves the limbs and may resemble epileptic seizures but without loss of consciousness. These spasms tends to be episodic, lasting for a few minutes at a time.
These episodes may be triggered by touch, light, noise or even wind. The stimulus does not always have to be strong to elicit an episode of painful spasms. Sometimes these episodes may occur spontaneously, with no clearly identifiable trigger.
Swallowing is made possible by the muscles of the throat and esophagus. This is a coordinated process whereby the muscles contract and relax to push food down the throat and into the esophagus. However, if these muscles are disrupted by the action of the tetanus toxin then swallowing can be difficult. It may even lead to choking.
Difficulty breathing is another complication of tetanus but is not common. It occurs when the muscles of the respiratory tract, like those of the vocal cords, contract forcefully and narrow the airway. It is further complicated when breathing muscles like the diaphragm go into spasm. This is a serious complication of tetanus that requires emergency medical treatment.
Cardiovascular disturbances are also signs of tetanus. Blood pressure is elevated (hypertension) and the heart beats faster than normal (tachycardia). This means that the blood pressure is above 120/80 mmHg and the heart rate is above 100 beats per minute. The cardiovascular disturbances are due to overactivity of the sympathetic nervous system which is a complication of tetanus.
Fractures and Dislocations
Fractures and dislocations are complications of tetanus. It may occur as a result of the strong muscle spasms that place excessive force on the attached bones. Fractures are more likely to occur in the long bones. Dislocations tend to affect the temporomandibular joint (TMJ or jaw joint) or the glenohumeral joint (shoulder joint).
Fever and Sweating
An elevation of body temperature (fever) is a non-specific sign of tetanus. This means that it occurs with most infections and is therefore not a specific sign of tetanus. However, a person with tetanus may not experience any fever in the early stages. In addition, there may be excessive sweating. While this also occurs with most fevers due to infections, it may be excessive in tetanus partly due to the overactivity of the sympathetic nervous system that occurs in this infection.
Although tetanus should be monitored by a medical professional, there are certain warning signs to look out for and attend to immediately. Any difficulty breathing, loss of consciousness, chest pain that may indicate a heart problem or paleness or bluish discoloration of the skin requires emergency medical attention. Go to the emergency room if a doctor is not immediately available.