Tetanus

This article is about the disease. For the physiological use of the term, see Tetanic contraction.
Tetanus
Other namesLockjaw
Muscle spasms (specifically opisthotonos) in a person with tetanus. Painting by Sir Charles Bell, 1809.
SpecialtyInfectious disease
Symptomsfever, cramped-up jaw, muscle spasms, headache, seizures, sweating, and trouble swallowing
Usual onset3–21 days following exposure
DurationMonths
CausesClostridium tetani
Risk factorsBreak in the skin
Diagnostic methodBased on symptoms
PreventionTetanus vaccine
TreatmentTetanus immune globulin, muscle relaxants, mechanical ventilation
Medicationdiazepam and methocarbamol
Prognosis6.4% risk of death
Frequency209,000 (2015)
Deaths56,700 (2015)

Tetanus (from Ancient Greek τέτανος 'tension, stretched, rigid'), also known as lockjaw, is a bacterial infection caused by Clostridium tetani and characterized by muscle spasms. In the most common type, the spasms begin in the jaw, and then progress to the rest of the body. Each spasm usually lasts for a few minutes. Spasms occur frequently for three to four weeks.[1] Some spasms may be severe enough to fracture bones.[2] Other symptoms of tetanus may include fever, sweating, headache, trouble swallowing, high blood pressure, and a fast heart rate. Onset of symptoms is typically 3 to 21 days following infection. Recovery may take months; about 10% of cases prove to be fatal.[1]

C. tetani is commonly found in soil, saliva, dust, and manure. The bacteria generally enter through a break in the skin, such as a cut or puncture wound caused by a contaminated object.[1][3] They produce toxins that interfere with normal muscle contractions.[4] Diagnosis is based on the presenting signs and symptoms. The disease does not spread between people.[1]

Tetanus can be prevented by immunization with the tetanus vaccine. In those who have a significant wound and have had fewer than three doses of the vaccine, both vaccination and tetanus immune globulin are recommended. The wound should be cleaned, and any dead tissue should be removed. In those who are infected, tetanus immune globulin, or, if unavailable, intravenous immunoglobulin (IVIG) is used.[1] Muscle relaxants may be used to control spasms. Mechanical ventilation may be required if a person's breathing is affected.[4]

Tetanus occurs in all parts of the world, but is most frequent in hot and wet climates where the soil has a high organic content.[1] In 2015, there were about 209,000 infections and about 59,000 deaths globally.[5][6] This is down from 356,000 deaths in 1990.[7] In the US, there are about 30 cases per year, almost all of which were in people who had not been vaccinated.[8] An early description of the disease was made by Hippocrates in the 5th century BC. The cause of the disease was determined in 1884 by Antonio Carle and Giorgio Rattone at the University of Turin, and a vaccine was developed in 1924.[1]

  1. ^ a b c d e f g Atkinson, William (May 2012). Tetanus Epidemiology and Prevention of Vaccine-Preventable Diseases (12 ed.). Public Health Foundation. pp. 291–300. ISBN 9780983263135. Archived from the original on February 13, 2015. Retrieved 12 February 2015. Public Domain This article incorporates public domain material from websites or documents of the Centers for Disease Control and Prevention.
  2. ^ "Tetanus Symptoms and Complications". cdc.gov. January 9, 2013. Archived from the original on 12 February 2015. Retrieved 12 February 2015.
  3. ^ "Tetanus Causes and Transmission". www.cdc.gov. January 9, 2013. Archived from the original on 12 February 2015. Retrieved 12 February 2015.
  4. ^ a b "Tetanus For Clinicians". cdc.gov. January 9, 2013. Archived from the original on 12 February 2015. Retrieved 12 February 2015.
  5. ^ Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. (GBD 2015 Disease and Injury Incidence and Prevalence Collaborators) (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  6. ^ Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. (GBD 2015 Mortality and Causes of Death Collaborators) (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  7. ^ Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, et al. (GBD 2013 Mortality and Causes of Death Collaborators) (January 2015). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442.
  8. ^ "About Tetanus". Centers for Disease Control and Prevention. United States Government. Retrieved 4 August 2019.