{"id":3963,"date":"2019-08-08T10:14:37","date_gmt":"2019-08-08T00:14:37","guid":{"rendered":"https:\/\/mvec.mcri.edu.au\/?page_id=3963"},"modified":"2024-11-01T11:38:40","modified_gmt":"2024-11-01T00:38:40","slug":"tetanus-prone-wounds-management","status":"publish","type":"references","link":"https:\/\/mvec.mcri.edu.au\/hi\/references\/tetanus-prone-wounds-management\/","title":{"rendered":"Tetanus"},"content":{"rendered":"

What is it?<\/span><\/b>\u00a0<\/span><\/h2>\n

Tetanus <\/span>is <\/span>caused<\/span> by <\/span>infection with <\/span>the bacteria<\/span> <\/span>Clostridium Tetani<\/em>.<\/span><\/span> The <\/span>bacteria <\/span>secrete<\/span> a potent<\/span> exoto<\/span>xin <\/span>that <\/span>enter<\/span>s<\/span> the bloodstream<\/span>,<\/span> act<\/span>ing<\/span> on the <\/span>central nervous <\/span>system<\/span> to <\/span>caus<\/span>e <\/span>muscle rigidity and painful spasms<\/span>. <\/span>Tetanus can be fatal when the muscles controlling respir<\/span>ation are affected<\/span>.<\/span><\/span>\u00a0<\/span><\/p>\n

What to look for<\/span><\/b>\u00a0<\/span><\/h2>\n

The incubation period of tetanus is 3 to 21 days. The most common time frame for presentation of tetanus is around 14 days after exposure. Although, it can present as early as 1 day or as long as several months after the exposure.<\/span>\u00a0<\/span><\/p>\n

The initial symptom is muscle rigidity. This can affect all muscles in the body but may be more pronounced in those closest to the site of the injury. In some cases, symptoms may include hyperreflexia (hyperactive reflexes) resulting in back, neck or limb stiffness; trismus (lockjaw); or sardonic smile (dystonia, or involuntary muscle contractions, producing a fixed smile). As the disease progresses, painful muscle spasms occur, affecting any muscles simultaneously. When spasms and rigidity affect the respiratory or laryngeal muscles, sedation and\/or prolonged ventilation in the intensive care setting is required. Examples of complications of tetanus include hypertension (high blood pressure), hypotension (low blood pressure), respiratory failure, cardiac arrythmias (irregular heartbeat), pneumonia, fractures, muscle rupture, deep vein thrombophlebitis, pulmonary emboli, decubitus ulcers and rhabdomyolysis.<\/span> In severe cases, <\/span>tetanus can be fatal.<\/span><\/span><\/p>\n

How is it transmitted?<\/span><\/b><\/h2>\n

Tetanus spores are found in dirt, dust and animal faeces. They can survive in the environment for many years.\u00a0 Spores can be introduced into the body via a wound where the bacteria can grow and cause infection. Spores can survive in a wound for as long as 3 months before becoming active.\u00a0<\/span>\u00a0<\/span><\/p>\n

Tetanus can occur following a significant wound or after trivial or even unnoticed wounds. Examples of wounds that are considered tetanus-prone include:<\/span>\u00a0<\/span><\/p>\n

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  • bites, either animal or human<\/span>\u00a0<\/span><\/li>\n
  • deep penetrating wounds<\/span>\u00a0<\/span><\/li>\n
  • minor lacerations, for example, from cat scratches, rose thorns, glass or other foreign bodies (e.g. splinters)<\/span>\u00a0<\/span><\/li>\n
  • contusions or burns<\/span>\u00a0<\/span><\/li>\n
  • compound (open) fractures<\/span>\u00a0<\/span><\/li>\n
  • cuts or lacerations with outdoor equipment<\/span>\u00a0<\/span><\/li>\n
  • tooth reimplantation post avulsion (knocked out tooth)<\/span>\u00a0<\/span><\/li>\n
  • IV drug use sites.<\/span>\u00a0<\/span><\/li>\n<\/ul>\n

    Tetanus cannot be passed directly from person to person.\u00a0<\/span>\u00a0<\/span>\u00a0<\/span><\/p>\n

    Epidemiology<\/span><\/b>\u00a0<\/span><\/h2>\n

    The incidence of tetanus is rare in Australia. Since 2001, there have been fewer than 8 cases reported each year, with a total of 84 cases since 2000. The case fatality rate in Australia is about 2%. Globally, tetanus is fatal in approximately 11% of reported cases.<\/span>\u00a0<\/span><\/p>\n

    Tetanus can affect people of any age. However infections in Australia are more commonly seen in older adults who have never been vaccinated or were vaccinated more than 10 years ago.\u00a0<\/span>\u00a0<\/span><\/p>\n

    In countries with low rates of vaccination, Maternal and Neonatal Tetanus (MNT) remains a common life-threatening consequence of unhygienic deliveries and umbilical cord care practices. Mortality rates associated with MNT are extremely high, especially when appropriate medical care is not available, as is often the case.<\/span><\/p>\n

    Prevention<\/span><\/b>\u00a0<\/span><\/h2>\n

    Vaccination is the most effective way to prevent tetanus. Vaccines target the tetanus toxin (toxoid) and, in Australia, are available only in combination with diphtheria. Vaccines may also include other antigens, such as pertussis, inactivated poliovirus, hepatitis B and haemophilus influenzae type B.<\/span>\u00a0<\/span><\/p>\n

    Table: Tetanus-toxoid containing vaccines by age\u00a0<\/strong><\/p>\n

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