What is it about ?
Tetanus is a serious, life-threatening infection caused by the bacteria Clostridium tetani. This bacterium secretes toxins capable of blocking the functioning of certain nerves. Tetanus occurs in people who have not been vaccinated recently.
The tetanus bacteria live in the normal intestinal flora of horses and other herbivores. It is then found in the environment (soil, waste, …) through their excrement. Contamination occurs through skin wounds. The bacteria thrive more easily in an environment poor in oxygen. The dirty and deep wounds mainly increase the risk. These include, for example, stab wounds, bites animal or human, injuries sustained after stepping on a rusty nail, wounds contaminated with filth, burns, shards or thorns embedded in depth, … If it is not carefully cleaned and disinfected, any wound also carries an increased risk of contamination by the tetanus bacteria.
Tetanus can also be contracted from a severe generalized infection (sepsis), in both mother and child, after miscarriage and childbirth.
What is its frequency?
Thanks to the Belgian vaccination policy, tetanus has practically disappeared from our country. A few cases are still observed sporadically. However, the number of cases can increase again if vaccination is neglected.
How to recognize it?
First of all, the wound is infected by the tetanus bacteria. The bacteria secrete a poison that blocks the functioning of the nerves responsible for controlling muscles. After a few days or weeks, the bacteria spread throughout the body, causing a general infection.
The first signs of tetanus are often stiff jaws and headaches. The rigidity can be such that the jaws tighten completely and it is no longer possible to open the mouth. You can also have fever.
Then come the involuntary muscle contractions generalized (spasms). These usually start near the wound. Impairment of the respiratory muscles can cause difficulty in breathing and cause death.
How is the diagnosis made?
The doctor will consider tetanus based on your story and the characteristic symptoms. The usefulness of additional examinations is limited.
What can you do ?
The prevention is essential and comes in two parts: good wound care and vaccination.
Wound care
Begin by thoroughly cleaning each dirty wound with soap and water. Then use a disinfectant (hydrogen peroxide and / or iso-Betadine®). The effect of a disinfectant is unfortunately limited, because the tetanus bacteria are very resistant to it. Always cover the wound with a sterile dressing. Each wound should be treated as soon as possible after it occurs.
Vaccination
Contact the doctor if you have a risky wound. They will work with you to assess the need for a new tetanus vaccine (see below). As a preventive measure, make sure you are always in order with your vaccines. Vaccination is even more important if you come into frequent contact with soil or rubbish or if you are planning a long trip.
What can your doctor do?
Tetanus vaccine
In our country, the tetanus vaccine is included in the basic immunization program for each child. These vaccinations are recorded in the ONE health record book and in the medical file.
As the duration of action of the tetanus toxoid vaccine is limited, it is recommended that adults have a booster shot every 10 years by default. In Belgium, this vaccine is fully reimbursed. In the presence of a risk wound, a booster vaccination is administered if the last vaccination was more than 5 years ago.
If you were not (fully) vaccinated in childhood, the vaccination schedule can be completed or restarted by administering the 3 primary vaccination injections. If this is the case and you have a risky wound, you will also be given anti-tetanus antibodies, which neutralize the toxins from the tetanus bacteria. These antibodies work immediately, while the vaccine takes some time to produce antibodies.
Processing
Treatment of tetanus requires hospitalization and is primarily aimed at supporting the patient by keeping their airways clear and administering medication for muscle spasms. a antibiotic treatment is started to try to fight the infection. Antibodies against tetanus are also injected. Despite the establishment of intensive care, the risk of death remains high.
- Tetanus: a bacterium that wants us harm – mongeneraliste.be – SSMG – Scientific Society of General Medicine
- Tetanus – Vaccination-Info.be
- For the vaccine, I hesitate … Is it serious doctor? – Health question
- The vaccine explained to children – Plaster