From the Guidelines
Tetanus is a life-threatening but vaccine-preventable disease caused by a potent neurotoxin produced by Clostridium tetani, which can be prevented through vaccination and proper wound care.
Definition and Cause
Tetanus is a serious bacterial infection caused by Clostridium tetani, which produces a toxin that affects the nervous system. The bacteria typically enter the body through wounds contaminated with soil, dust, or animal feces.
Prevention and Treatment
The disease can be prevented through vaccination with the tetanus toxoid vaccine, which is typically given as part of combination vaccines like DTaP or Tdap 1. For prevention after potential exposure, a tetanus booster is recommended if your last dose was more than 5 years ago for dirty wounds or 10 years for clean wounds 1. Treatment for tetanus includes tetanus immune globulin to neutralize unbound toxin, antibiotics, wound cleaning, and supportive care.
Key Considerations
Some key considerations for tetanus prophylaxis in routine wound management include:
- The number of doses of adsorbed tetanus toxoid–containing vaccines the patient has received
- The type of wound (clean and minor or all other wounds)
- The use of tetanus immune globulin (TIG) in certain situations, such as for persons with unknown or uncertain previous tetanus vaccination histories or for those with contaminated wounds 1. Tetanus can be life-threatening, causing breathing difficulties, severe muscle spasms, and autonomic nervous system dysfunction. The bacteria's spores are highly resistant to environmental conditions and can survive for years in soil, making vaccination crucial for prevention 1.
From the FDA Drug Label
The occurrence of tetanus in the United States has decreased dramatically from 560 reported cases in 1947, when national reporting began, to a record low of 48 reported cases in 1987.(2) The decline has resulted from widespread use of tetanus toxoid and improved wound management, including use of tetanus prophylaxis in emergency rooms. Historically, such passive protection was provided by antitoxin derived from equine or bovine serum; however, the foreign protein in these heterologous products often produced severe allergic manifestations, even in individuals who demonstrated negative skin and/or conjunctival tests prior to administration HyperTET supplies passive immunity to those individuals who have low or no immunity to the toxin produced by the tetanus organism, Clostridium tetani. The antibodies act to neutralize the free form of the powerful exotoxin produced by this bacterium Tetanus is a local infection caused by the bacterium Clostridium tetani, which produces a powerful exotoxin. It can be prevented by vaccination with tetanus toxoid and managed with wound care and passive immunization using tetanus immune globulin (TIG) in individuals with low or no immunity to the toxin 2.
From the Research
Definition and Cause of Tetanus
- Tetanus is an acute toxemic illness caused by Clostridium tetani infection at a laceration or break in the skin 3.
- It can also occur as a complication of burns, puerperal infections, umbilical stumps (tetanus neonatorum), and surgical-site infection 3.
- The disease is caused by the toxin of the bacterium Clostridium tetani and is characterized by muscle spasms and autonomic nervous system dysfunction 4.
Symptoms and Treatment
- Tetanus is manifested mostly by neuromuscular dysfunction, caused by tetanal exotoxin (tetanospasmin), a potent exotoxin produced by C. tetani 3.
- It starts with tonic spasms of the skeletal muscles and is followed by paroxysmal contractions, with muscle stiffness initially involving the jaw (lockjaw) and neck and later becoming generalized 3.
- Treatment goals include interrupting the production of toxin, neutralizing the unbound toxin, controlling muscle spasms, managing dysautonomia, and appropriate supportive management 3.
- Specific therapy includes intramuscular administration of tetanus immunoglobulin to neutralize circulating toxin before it binds to neuronal cell membranes 3.
Prevention and Management
- The disease can be prevented by immunization with tetanal toxoid and appropriate wound care 3.
- Active tetanus toxoid vaccination is the method of choice for prophylaxis of the disease 5.
- Management of tetanus involves neutralization of free circulating toxin, adequate antibacterial and symptomatic therapy, as well as intensive care of the patient 5.
- Recent research has focused on intravenous magnesium sulphate and intrathecal antitoxin administration as methods of spasm control that can avoid the need for ventilatory support 4.