Introduction

Tetanus, also known as lockjaw, is a bacterial infection caused by Clostridium tetani. The bacteria produce toxins affecting the nerve controlling muscle movement to cause tetanus characterised by muscle spasms. The disease can be life threatening when the muscles responsible for breathing are affected. The invention of the tetanus vaccine has rendered tetanus a preventable disease. In this article we will look into detail about tetanus, and answer the common question on whether tetanus can be cured without treatment.

What causes tetanus?

The spores of Clostridium tetani are the root cause of tetanus. It is found mostly in the soil, ash, skin, and faeces of animals or humans. The spore can enter the body through puncture wounds, cut in skin, or animal/insect bites. Upon entering the body, the spore will grow into bacteria that release toxin which interferes with the nerve in control of muscle relaxation. As a result, it causes muscle spasm and stiffness. Tetanus cannot be transmitted from person to person.

Symptoms

Symptoms usually occur 14 days upon infection. The muscle spasm usually begins from the jaw and subsequently spreads to the whole body. The first sign starts with lockjaw before progressing to facial spasm, difficulty in swallowing, neck stiffness, rigid calf and lastly back spasm that can lead to the characteristic pattern of tetanus known as “bridging” of the body. Tetanus is also associated with other symptoms such as fever, rapid heart rate and high blood pressure. Muscle spasm can occur for up to four weeks.

Complication

1. Bone fracture and muscle tear

• The muscle spasm caused by tetanus can be powerful enough to cause muscle tear and bone fracture, including the spine.

2. Tightening of vocal cord

• Tightening of the vocal cord is a life-threatening complication which can lead to sudden obstruction in the airway, blocking the air supply to the lungs.

3. Breathing difficulty

• Breathing difficulty can happen due to spasm of respiratory muscles which might lead to death.

Treatment

Tetanus is a medical emergency which requires immediate treatment in the hospital.

Wounds or cuts will be cleaned thoroughly to prevent infection. Patients will be administered injections containing tetanus immunoglobulin. Tetanus immunoglobulin is a medication containing antibodies to specifically neutralise the tetanus toxin. It is used as an immediate short-term protection for tetanus in patients who are having high risk wounds prone to infection and in those who did not receive any tetanus vaccination.

In order to relieve the muscle spasm, your doctor might prescribe you with muscle relaxant or anticonvulsant.

In cases where respiratory muscle is affected, a ventilator might be needed for those patients.

Can the disease go by on its own?

Unlike other infectious diseases, most of the patients who recovered do not develop natural immunity against tetanus infection. Hence, it is possible to be re-infected in the future without vaccination.

Prevention

Vaccination

The invention of the tetanus vaccine has rendered tetanus a preventable disease. Tetanus vaccine is made of harmless toxins that stimulate the immune system to produce antibodies. Whenever the body encounters the disease in the future, the immune system can elicit the immune system to clear the toxin without causing any symptoms.

In Malaysia, the vaccine for tetanus is given in combination with those for diseases affecting nose and throat (Diphteria) and prolonged cough (Pertussis) in the form of DTaP. The vaccine is given in four doses and one booster dose.

Good wound care

Disinfect the skin with antiseptic and apply dressing if necessary to reduce infection and contamination. If there is any sign of infection such as fever, pain of increasing severity or other associated symptoms, do visit your nearest doctor immediately.

Conclusion

Tetanus is a bacterial infection caused by Clostridium tetani. The disease is caused by toxin stimulating muscle spasm. Tetanus can be life-threatening when it affects the respiratory muscle, leading to breathing difficulty. Immediate treatment is required to treat the disease as the disease will not cure naturally with time once infected. Tetanus vaccination is the most effective way to prevent the disease.