Tetanus

What Is It?

Tetanus, also called lockjaw, is a life-threatening infection caused by Clostridium tetani bacteria. Although these bacteria are especially common in the soil and manure of farms, they can be found almost anywhere. They live in the dirt of suburban gardens and in the dirty waters of floods. They also contaminate dust in cities, and are carried on the skin of people who have never visited rural areas.

Tetanus bacteria usually enter the body through a dirty puncture wound, cut, scrape or some other break in the skin. Once inside the skin, they multiply and produce a toxin, or poison, that affects the body's nerves. This toxin causes severe muscle spasms, cramps and seizures. Spasms in the jaw muscles produce lockjaw. There are also spasms in muscles of the throat, chest, abdomen and extremities. If the person doesn't receive proper treatment, the toxin's affect on respiratory muscles can interfere with breathing. If this happens, the infected person may die of suffocation.

A tetanus infection may develop after almost any type of skin injury, major or minor. This includes cuts, punctures, crush injuries, burns and animal bites. In rare cases, a tetanus infection also can occur after surgery, an ear infection, a dental infection or an abortion. Among drug users, tetanus infections have followed heroin injections, especially if the heroin has been mixed with quinine. Tetanus also can develop after body piercing, tattooing, an insect sting or even a tiny splinter.

In the United States, only 50 to 100 cases of tetanus occur each year, because so many Americans have been immunized against the infection. Almost everyone who develops tetanus in the United States these days has been inadequately immunized against tetanus. Some have immigrated from developing countries where vaccines are not available to everyone. Others were born in the United States, but their families did not believe in immunization. Still others simply failed to keep up with their normal schedules of tetanus shots. This is a common problem among adults, especially those over age 60.

Symptoms

On average, symptoms of tetanus begin seven to eight days after tetanus bacteria enter the body. These symptoms may include:

• Spasms in the jaw muscles (lockjaw)
• Stiffness of muscles in the neck, shoulder and back
• Difficulty swallowing
• Prolonged contraction of the facial muscles, which may produce what looks like a sneer or grimace
• An arched back resulting from contractions of the back muscles
• Muscle spasms and muscle rigidity in the chest, abdomen and extremities
• Fever and profuse sweating
• High blood pressure
• Rapid or irregular heartbeat