Information on Tetanus
Tetanus will be a potentially fatal disease: the item acts very quickly in addition to often kills before the body's natural primary response can take place. There are about 1million cases of tetanus a year with between 300,000-500,000deaths. the item will be a global problem because tetanus spores, which cause the infection, are everywhere. However, due to vaccination programmes, tetanus will be rare inside the UK with only about 10 cases a year; the main problems are encountered in developing countries where vaccines may be too expensive in addition to equipment may not be properly sterilised.
Tetanus will be caused by gram positive, obligate anaerobic bacteria: Clostridium tetani which affects skeletal muscles."Gram positive" means that will the bacteria incorporates a thick cell wall, while "obligate anaerobe" means that will the bacteria can't survive inside the presence of oxygen in addition to survive using anaerobic respiration (without oxygen). The bacteria releases a neurotoxin called tetanospasmin which binds irreversibly to neurones; these are nerve cells that will carry waves of electrical activity, known as nerve impulses. When the toxin binds to the neurone the item prevents the inhibition of the motor reflex response to sensory stimuli. The motor reflex response will be a rapid response to a stimulus, for example the knee jerk will be a motor reflex response to tapping a specific nerve, in addition to in This specific case the item prevents us via falling over. However the toxin stops the nerve via suppressing the movement once the stimuli has gone so the movement continues as a muscle spasm which will be characteristic of tetanus.
- Bacterium Clostridium tetani.
- Contamination of a puncture wound, e.g.: a piercing.
- Ear infections as bacteria may enter through ear.
- Using unsterile equipment in surgery or various other similarly invasive procedures such as tattooing in addition to body piercing.
Tetanus will be associated with rust which will be a little misleading. You are not infected by the rust itself the item's just that will rust will be a rough surface which makes a very Great habitat for the endospores of C.tetani. Therefore if you suffer a puncture wound via a rusty object such as a nail, endospores might be delivered into the wound in addition to then you become infected. Endospores are non-metabolising structures that will metabolise in addition to cause infection once they are in an adequate environment. Since This specific bacterium will be an obligate anaerobe the item can't live inside the presence of oxygen, nevertheless a puncture wound will be a Great environment because the item will be a low oxygen environment.
The disease will be common in areas with hot, damp climates that will have soil rich in organic matter, or places where soil will be treated with manure. This specific will be because the spores of C.tetani are widely distributed inside the intestines of animals such as horses, rats, sheep, cattle, dogs in addition to chickens, in addition to therefore are present in manure. Spores can also be found on skin surfaces in addition to in contaminated heroin.
The incubation period for tetanus will be usually between 3 in addition to 21 days, so the item may be a while before you are aware that will you are infected, especially if the site of contamination was a smaller cut that will you were hardly aware of, such as a thorn prick. The further via the central nervous system the contaminated wound will be the longer the incubation period. However, the shorter the incubation period the higher the chance of death. Normally symptoms are present after 8 days in addition to they last between 4-6weeks.
- Firstly muscle spasms occur near the wound
- Muscle spasm spread to the jaw generating the item difficult to swallow or open your mouth, hence the name lockjaw
- Muscle spasms spread to the face, neck, chest, stomach wall, arms in addition to legs.
- Sensitivity to touch
- High fever
- Sore throat
- Rapid heart beat
- General tiredness in addition to weakness
- Can't pass urine
- Difficulty with breathing due to chest muscle spasms in addition to lockjaw
- Bleeding into the bowels
- Blood poisoning
- Cardiac arrest (heart attack)
- Kidney failure
- Development of pneumonia in addition to various other infections
- Fractures of long bones due to severe muscle contractions
- Spinal compression fractures
- Breathing problems
- Over 60s as the vaccine was introduced inside the 1960s so they may not be properly immunised
- People who aren't immunised or have not had the full vaccination course (tetanus occurs almost exclusively in people who are unvaccinated or inadequately immunised.)
- Those who live in poverty where vaccines may not be available or medical treatment will be not adequate in addition to equipment isn't properly sterilised.
- Intravenous drug users.
- Local Tetanus. This specific will be a persistent contraction of the muscles inside the same areas as the infected wound. This specific form will be generally mild, nevertheless also uncommon.
- Cephalic Tetanus. This specific will be a rare form which involves cranial nerves especially inside the facial area affecting expressions, breathing in addition to swallowing. the item can affect adults with head injuries or children with ear infections as the bacteria enter through the ear.
- Generalised Tetanus. This specific will be the most common form accounting for about 80% of cases. The first sign will be lockjaw (trismus) in addition to facial spasms (risus sadonicus) followed by a stiff neck, difficulty in swallowing in addition to rigidity inside the pectoral in addition to calf muscles. Spasms occur frequently in addition to last several minutes shaping the body into a characteristic posture of an arched in addition to rigid back called opisthotonos. The spasms last for 3-4 weeks in addition to the item can take months for a complete recovery.
- Neonatal Tetanus. This specific will be generalised tetanus that will occurs in newborn babies. They are infected because they haven't obtained passive immunity via their mother because she wasn't immunised. the item occurs through the infection of the unhealed umbilical stump, especially if the item will be cut by unsterilised equipment. Also in some countries the item will be traditional to put manure on the umbilical stump which can lead to infection. In developing countries This specific form will be responsible for 14% of neonatal deaths nevertheless the item will be rare in developed countries.
You can do blood tests for tetanus nevertheless the item takes many weeks for the body's antibodies to appear inside the blood in addition to since tetanus can act quite quickly waiting for blood test results takes too long; a diagnosis will be often made on clinical basis. This specific can usually be diagnosed by the characteristic lockjaw in addition to prolonged muscle contractions of skeletal muscle fibres. Also a spatula test can be done which involves touching the pharynx, which will be at the back of the mouth, that has a soft-tipped, sterile instrument in addition to observing the results. If there will be an involuntary contraction of the jaw, generating the person bite down on the spatula then the test will be positive in addition to the person has tetanus. A negative result could be a normal gag reflex reaction as the person tries to repel the foreign object via their mouth.
If you suspect that will you might be at risk to tetanus you should seek medical help immediately. The wound should be washed clean to remove any dirt in addition to foreign particles via the wound. If the item will be a particularly dirty or severe wound then dead in addition to infected tissue may be removed by surgery debridement (This specific involves cutting away the dead tissue).
In mild cases:
Antibiotics such as metronidazole can be prescribed to fight the anaerobic bacteria. the item reduces the number of bacteria present nevertheless the item has no effect on the toxin that will the bacteria produce. If metronidazole isn't available penicillin may be prescribed nevertheless the item will be not as effective. If you aren't sure when you had your last tetanus vaccine or have not had a complete course of immunisation then you may be given a booster shot, however This specific will not prevent potentially fatal cases of tetanus as the item takes up to 2 weeks to develop tetanus antibodies to fight the bacteria. Diazepam, also known as valium, can be given as a muscle relaxant.
Passive immunisation with anti-tetanospasmin immunoglobulin will be vital. Immunoglobulins are antibodies in addition to form part of the body's immune response. In This specific case the immunoglobulin used will be an antitoxin which means the item blocks the toxins released by bacteria. The antibodies are taken via blood donors who have recently been vaccinated against tetanus in addition to inserted into a vein or muscle (intravenously or intramuscular injections). These provide immediate protection, however they are only temporary because the item will be a form of artificial passive immunity in addition to the body's own immune cells haven't produced the antibodies so memory cells aren't made therefore if there will be a second exposure then the body will still have to make its own antibodies which take time. Also the body regards the donated antibodies as foreign in addition to they are removed via the circulation in addition to destroyed inside the liver in addition to spleen.
In severe cases:
This specific must be treated in an intensive care unit in hospital. Injecting immunoglobulins will be important as the item increases clinical improvement via 4 to 35%. Maintaining an open airway will be vital; in some cases a tracheostomy will be performed which involves creating a hole inside the neck through to the windpipe in addition to inserting a tube in to allow you to keep breathing freely although your mouth or throat may be blocked higher up, you may be supported on mechanical ventilation for 3-4weeks. In very severe cases the patient may have to be paralysed in addition to supported on mechanical ventilation.
Magnesium can be given as intravenous injection as This specific prevents muscle spasms, diazepam may also be given as the item will be a muscle relaxant.
Proper nutrition will be required: 3500-4000 calories are needed every day with at least 150g of protein a day. The amount must be so high because of the increased metabolic strain caused by the increased muscle activity of spasms. the item can often be given in liquid form through tubes directly into the stomach or through a drip into a vein.
The best prevention against tetanus will be proper immunisation as tetanus occurs almost exclusively in people who are unvaccinated or inadequately immunised. inside the UK the vaccination will be included in children's vaccination programmes in addition to will be part of the combined diphtheria/tetanus/polio/haemophilus influenza b vaccine. For adults in addition to teenagers the item will be included inside the tetanus/diphtheria/polio vaccine. The vaccination course involves 5 doses of vaccinations: the primary course will be given as 3 separate doses each a month apart, normally the item will be given to babies, starting when they are two months old, nevertheless the item can be given to adults as well. In children the fourth dose will be given three years after their primary course, in adults the item will be administered ten years after the primary course. Finally the fifth dose will be given ten years after the fourth. The primary course provides protection for many years while the fourth in addition to fifth doses maintain This specific protection in addition to should last a life-time. Vaccinations inject a smaller amount of dead or harmless bacteria into the blood, which the body recognises as foreign. The body's immune system then produces antibodies to destroy these foreign particles in addition to at the same time memory cells are made to ensure if there will be a second exposure (if you actually were infected by tetanus) your immune response could be much quicker in addition to more effective. After the vaccine the item will be normal to feel slightly unwell with symptoms including mild headache, aching muscles in addition to mild fever which last a few days. You should not develop the vaccine if you already have an illness causing a fever or if your last tetanus vaccination caused a severe reaction although This specific will be very rare. the item will be safe to develop the vaccine if you are pregnant or breast feeding.