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Tetanus

Tetanus is a reportable disease in Oklahoma.  Tetanus, commonly called lockjaw, is a disease caused by the bacterium Clostridium tetani.  As a result of widespread immunization, tetanus is now a rare disease.  Anyone may get tetanus if they have not been appropriately immunized. In the United States, most cases occur in elderly individuals and in agricultural workers for whom contact with animal manure is more likely and immunization is inadequate.

Tetanus can be introduced into the body through a puncture wound dirty with soil or animal feces. The bacteria may also be introduced through cuts, scrapes, burns and unnoticed wounds, or by infected, contaminated street drugs. Tetanus may occasionally follow surgical procedures performed under unhygienic conditions. It is not spread from person to person.  C. tetani is present throughout the environment and is commonly found in soil contaminated with manure.

A common first sign of tetanus is muscular stiffness in the jaw (lockjaw), followed by stiffness of the neck, difficulty in swallowing, rigidity of abdominal muscles, spasms, sweating, and fever.  Signs and symptoms occur from three to 21 days after infection, although it may occur as soon as one day after infection depending on the type and location of the wound.  Shorter incubation periods are associated with more heavily contaminated wounds.

Recovery from tetanus may not result in lifelong immunity. Individuals can develop symptoms of tetanus multiple times if exposure occurs.  Immunization is indicated after recovery. The most common complication associated with tetanus includes spasms of the respiratory muscles causing breathing problems. Other complications include fractures of the spine or long bones, hypertension, abnormal heartbeat, coma, clotting in the blood vessels of the lung, pneumonia and death.
 

What can be done to prevent tetanus?

  • Wounds should be thoroughly cleaned.
  • If an individual has not had a tetanus shot in the previous ten years, a single booster injection should be administered following a puncture wound injury.  For severe wounds, a booster may be given if more than five years have elapsed since the last dose. Tetanus immune globulin (TIG), antitoxin or antibiotics may be given by your healthcare provider.
  • The best prevention against tetanus is the vaccine.  The Tetanus vaccine, (usually given in combination with diphtheria and acellular pertussis vaccines called DTaP), is given at two, four, six and twelve to fifteen months of age, and between four and six years of age. Persons who are seven years of age or older should receive either Tdap (tetanus, diphtheria and acellular pertussis vaccine) or Td (tetanus and diphtheria) every ten years. Ask your healthcare provider which vaccine is appropriate for you.
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