Tetanus is a severe bacterial infection that affects the human nervous system. This disease often leads to painful muscle contractions, especially in the neck of the jaw, which is why they are also called trismus of the chewing muscles. The tetanus bacillus (which produces the toxin) is found in animal feces and soil, so the infection usually spreads through puncture wounds on the legs or arms. This disease can cause respiratory failure, and if not properly treated, it can be fatal. Preventive tetanus vaccines are available, but there is no cure as such. If you have tetanus, you need to get treatment in a hospital. Treatment involves relieving and countering the symptoms until the effects of the toxin wears off.
Part 1 of 2: Getting Medical Help
Step 1. Go to the hospital
In addition to stiffness and spasms in the muscles of the neck and jaw, tetanus also leads to squeezes / cramps in the abdominal and back muscles, extensive muscle twitching, difficulty swallowing, fever, excessive sweating, and heart palpitations. If you have symptoms of tetanus, go to the hospital immediately. This is a serious infection that cannot be treated at home.
- Tetanus symptoms can occur at any time from a few days to a couple of weeks after the bacteria enters the body. Typically, the bacteria gets in through a puncture wound in the leg (if, for example, you step on an infected nail).
- The doctor will rely on physical examinations, medical history and vaccinations to make a diagnosis. Neither laboratory tests nor blood tests show tetanus.
- The doctor needs to rule out diseases that cause similar symptoms to tetanus. Such diseases include meningitis, rabies, and strychnine poisoning.
- The medical staff will clean the wound, remove all debris, dead tissue and foreign particles from it.
Step 2. Receive an injection of tetanus antitoxin
Your doctor may give you an injection of tetanus antitoxin, such as tetanus immunoglobulin. The decision to inject or not will depend on the time elapsed between the injury and the onset of symptoms. It is not a drug, but it can neutralize “free” toxins that have not blended with nerve tissue. The antitoxin will not act on toxins that have already bonded to the nerve tissue.
- Time plays a very important role. The sooner you see your doctor (when you notice symptoms), the more effective immunoglobulin will be at preventing severe symptoms from developing.
- As soon as the diagnosis is confirmed, you will be injected with a dose of 3000-6000 units intramuscularly. Equine tetanus serum is used in countries where immunoglobulin is not available.
- Don't wait for symptoms to appear. If you get a deep wound (such as a puncture wound) with a sharp object that may be contaminated with soil, rust, faeces, or other debris, you should wash the wound, get a tetanus shot, or seek medical attention as a preventive measure.
Step 3. Be prepared to take antibiotics
Antibiotics kill bacteria, including tetanus bacillus, but the problem with tetanus is the toxin that is produced by bacterial spores. A powerful toxin produced by bacterial spores (after being ingested) is responsible for most of the symptoms. This is due to the fact that the toxin is attached to the nerve tissues and causes irritation, which explains the occurrence of extensive muscle twitching and cramps.
- If treatment is started early, antibiotics are more effective because they can kill the bacteria before they produce large amounts of toxin.
- If you start the disease, antibiotics are practically useless, and their side effects cannot outweigh the potential benefits.
- You will be injected with 4th generation antibiotics. The preferred treatment for tetanus may be injections of 500 mg metronidazole every 6 to 8 hours. The treatment lasts seven to ten days.
Step 4. Expect to be given muscle relaxants (muscle relaxants) and sedatives
The most noticeable and potentially fatal symptoms of tetanus are severe muscle contractions, medically called tetany. If tetany touches the muscles needed for breathing, the person could die, so taking strong muscle relaxants (such as metaxalone or cyclobenzaprine) can be life-saving and help relieve pain caused by spasms.
- Muscle relaxants have no direct effect on tetanus bacteria or toxins, but can reduce the effect that irritated nerves have on muscle contractions.
- Tetania can lead to muscle tears and avulsion fractures (tearing off a piece of bone where the tendon is attached).
- Sedatives like diazepam (Valium) can also help relieve muscle spasms, including anxiety and heart palpitations, caused by moderate to severe tetanus.
Step 5. Get ready to leave
If you have a severe case of tetanus, you may need the help of a breathing machine or ventilator. Even if the tetanus toxin hasn't touched the respiratory muscles too much, you may still need a breathing apparatus if you are on strong sedatives. This is due to the fact that taking them often leads to rapid breathing.
In addition to airway obstruction and respiratory arrest (the most common cause of death in tetanus), possible complications also include the following: pneumonia, heart failure, brain injury, and bone fractures (most often rib and spinal fractures)
Step 6. Ask your doctor about other possible medications
There are medications that are sometimes used to reduce the symptoms of tetanus, such as magnesium sulfate (to reduce muscle spasms), some beta blockers (to help lower heart rate and breathing rate), and morphine (a strong sedative and pain reliever).
Part 2 of 2: Reducing the Risk of Tetanus
Step 1. Get vaccinated
Tetanus can be prevented by immunization (vaccination). For this, a series of injections of acellular DTP vaccine is made, which includes protective antibodies against diphtheria, tetanus and pertussis. But protection against tetanus only lasts 10 years, so booster immunizations should be given in older adolescence and repeated as an adult.
- In Russia, tetanus vaccination is recommended at 18 months. Revaccination is done at 7 and 14 years old, and then every 10 years.
- Vaccination of tetanus patients is usually part of their treatment, as the disease itself does not confer immunity to future threats.
Step 2. Treat the wound quickly
It is very important to cleanse and disinfect a deep wound (especially if it is a puncture wound on the leg) in order to kill the tetanus bacterium and prevent the production of toxin in the body. When the bleeding has stopped, rinse the wound thoroughly with clean water or saline solution, if you have one. Then clean the wound with an alcohol-based antibacterial antiseptic, and then bandage it with a clean bandage.
- You can also use an antibiotic cream such as neosporin or polysporin. They will not speed up healing, but they will help prevent bacterial growth and infection.
- Change your bandage regularly. The dressing should be changed at least once a day or when it gets wet or dirty.
Step 3. Wear suitable shoes
Most tetanus infections occur when a person steps on something sharp that has been covered in animal feces or contaminated soil with tetanus bacillus spores. It can be nails, glass, or a splinter. Therefore, wear sturdy, thick-soled shoes, especially if you are on a farm or in the countryside, as a good preventative measure.
- Always wear flip flops or sandals when walking on the beach or in shallow water.
- When working in the garden or in the shop, don't forget about hand protection as well. Wear thick gloves made of leather or similar material.
- In developed countries, cases of tetanus are quite rare, but in developing countries, the number is much higher. About a million cases of tetanus are recorded each year.
- Although tetanus toxin is dangerous for a short period of time, there is no permanent damage to the nervous system after healing.
- Tetanus is not contagious. It cannot be picked up from an infected person.
- Without vaccinations and medical care, approximately 25% of tetanus-infected people die. This is especially true for people with weakened immunity (newborns, the elderly and people with chronic diseases).
- If you have signs and symptoms of tetanus, do not try to treat it at home. This is a serious infection that needs outpatient treatment.