This disease occurs due to the toxin produced by a gram positive organism known as clostridium tetani. This organism enters our body through wounds.
This poisonous chemical (exotoxin) excites the muscles and the nerves causing tetanus. The muscles get spasms; there is difficulty in opening the jaws (lockjaw). Along with this, arching of the muscles of the neck, back and chin occurs. Initially, the problem is less and gradually withinhours or days, the muscles are continuously excited and the patient starts getting spasms. Finally, it starts affecting the respiratory system and the swallowing muscles and seizures also start. Sometimes when the tetanus limits itself to the wounds, the chances of recovery are more, but in the full blown cases of tetanus, the death rate is around 60% despite treatment.
The treatment begins by giving Hyper Immune Globulin (3000 to 10000 units). The wound is properly cleaned and a surgical dressing is done. Penicillin is the most reliable antibiotic for tetanus, which is given for 10 to 14 days. If the patient is allergic to penicillin, he is given tetracycline.
The patient is kept in a dark room and diazepam is given intravenously in proper dose to prevent seizures and spasms. Sometimes, neuromuscular blocking is done after keeping the patient on a ventilator. There can be problems like irregular blood pressure, fever, or heart trouble due to the irregularities of the involuntary nervous system, which also have to be treated carefully. Prevention is always better than cure.
Anyone above the age of two months or who has not been vaccinated systematically or who has recovered recently from tetanus, should be given the tetanus toxin (TT) vaccination. The second dose of TT injection is given after one month after the first dose; and the third dose is administered after six month. After every 10 years a booster dose of TT needs to be taken. Pregnant women are given extra doses of TT. In this way the entire course of TT needsto be taken, which gives immunity against tetanus. When a person suffers from an injury he is given a dose of TT again and if the wound is dirty then the patient should be given a dose of human tetanus immunoglobulin (250 units/ I.M). These are the general guidelines for the prevention of tetanus because every individual/case has different factors and thus it is for the doctor to decide the treatment for each individual case. This disease is unfortunately still prevalent in our country because of poor hygiene, illiteracy and ignorance. The lack of cleanliness and proper medical services in the villages, thousands of lives, to such a preventable disease.
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