Tetanus Wound Bacteria
The incubation period for tetanus is 3 to 21 days (with the average being about 8 days). For neonates, the incubation period is 4 to 14 days, with 7 days being the average.
Most of the time, the further the wound is from the central nervous system, the longer the incubation period. Incubation period length and likelihood of death are inversely proportional.
The first sign of tetanus is lockjaw (trismus), followed by stiffness of the neck and back, risus sardonicus, difficulty swallowing, and muscle rigidity in the abdomen.
The stiffness and spasming of muscles expands throughout the body inferiorly. Typical signs
include an increase in body temperature by 2 to 4 °C, diaphoresis (excessive sweating), an elevated blood pressure, and an episodic rapid heart rate.
Spasms and muscle contraction last for 3 to 4 weeks, and complete recovery may take months. About 30% of
the victims die, most of whom are elderly patients. In developing countries, the mortality rate may be as high as sixty percent.
Complications of the disease include spasms of the larynx (vocal cords), accessory muscles (chest muscles used to aid in breathing), and the diaphragm (the primary breathing muscle); fractures of long bones secondary to violent muscle spasms; and hyperactivity of the autonomic nervous system.
for wound bacteria
The wound must be cleaned. Penicillin and metronidazole will help decrease the amount of bacteria but it has no effect on the toxin produced by the bacteria. Human anti-tetanospasmin immunoglobulin should be given. Diazepam and DTaP vaccine booster are also given.
Tetanus can be prevented by vaccination. A booster vaccine is recommended every ten years, and standard care in many places is to give the booster to any patient with a puncture wound who is uncertain of when he or she was last vaccinated.
There was a shortage of
the vaccine in the United States in 2001 and 2002, but this supply issue was corrected in 2003.
There are, on average, around 150 cases annually in the USA.
Association with rust
and wound bacteria
disease is often associated with rust, especially rusty nails, but this is somewhat misleading.
Rust itself does not cause tetanus or contain more C. tetani bacteria. Objects that accumulate rust are often found in the outdoors or places that generally contain more bacteria.
Since C. tetani is an anaerobic bacterium, it will thrive in an environment that lacks oxygen. Therefore, stepping on an old forgotten nail in a stable could easily result in tetanus, partly because C. tetani is found in animal feces (which is abundant in a stable) and the puncture wound would effectively create an ideal breeding ground for the bacteria (because of the lack of oxygen).
Such an old nail would likely be rusty, but a lack of rust would provide no protection. On the other hand, someone scratching themselves against a rusty fire escape ladder in an urban setting would have a much lesser chance of getting tetanus since fire escape ladders do not often come into intimate contact with soil, dirt or organic waste and the wound itself (a scratch) does not create an oxygen-poor environment.
Around the globe
is a global health problem since Clostridium tetani spores are ubiquitous. The disease occurs almost exclusively in persons who are unvaccinated or inadequately immunized.
Tetanus occurs worldwide but is more common in hot, damp climates with soil rich in organic matter. Tetanus, particularly the neonatal form, remains a significant public health problem in non-industrialized countries, causing an estimated 400,000 deaths each year.
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© Anthony George 2005 Tetanus Wound Bacteria
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