Tetanus infection and vaccine by Ray Sahelian, M.D.
March 12 2016

Tetanus is a nervous system infection that leads to severe and painful muscle spasms. It's caused by a bacterium that is commonly found in soil, dust and animal waste. For more information on bacteria. The bacteria enter the body through an open cut or sore. Most often tetanus is contracted from a deep puncture wound caused by a sharp object like a knife or a nail.

Tetanus and diphtheria are diseases that still cause significant morbidity and mortality. Clostridium tetani produces the tetanus toxin, a 150-kDa protein. The diphtheria toxin is synthesized by Corynebacterium diphtheriae as a protein of 58 kDa.

Tetanus vaccine
A tetanus vaccine is commonly given to children, combined with inoculations against diphtheria and pertussis vaccines, in a multi-shot vaccine called DTP.

Tetanus prevention
Prevent tetanus by thoroughly cleaning any wound -- especially a deep puncture -- with water and antiseptic.

Crit Care. 2014. Pharmacological management of tetanus: an evidence-based review. Tetanus is becoming rarer in both industrialized and developing nations due to an effective vaccination program. In 2010, the World Health Organization estimated there was a 93% reduction in newborns dying from tetanus worldwide, compared to the situation in the late 1980s. Due to its rarity, many diagnostic delays occur as physicians may not consider the diagnosis until the manifestations become overt. Without timely diagnosis and proper treatment, severe tetanus is fatal (mortality is also influenced by the comorbidities of the patient). The principles of treating tetanus are: reducing muscle spasms, rigidity and autonomic instability (with ventilatory support when necessary); neutralization of tetanus toxin with human antitetanus immunoglobulin or equine antitetanus sera; wound debridement; and administration of antibiotics to eradicate locally proliferating bacteria at the wound site. It is difficult to conduct trials on different treatment modalities in tetanus due to both logistical and ethical reasons. However, it is imperative that physicians are aware of the best evidence-based treatment strategies currently available to improve the outcome of patients. This review concentrates on analyzing the current evidence on the pharmacological management of tetanus.