Tetanus (Lock Jaw); mode of transmission, clinical features, management and prevention

Introduction

It is an acute and serious bacterial disease, characterized by painful muscle spasms. Tetanus is potentially fatal, it affects the nerves and has no cure.

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Causative organism: Clostridium tetani. Note that it is the toxins of the disease.

Incubation period: 4-21 days.

Mode of transmission

• Infection of wounds by contaminated soil and dust.
• Circumcision with infected instruments.
• Sometimes, it may follow injuries or burns through contamination.
• Piercing the body with infected article.
• Dressing the cord stump with contaminate materials.
• Cutting the umbilical cord with infected instruments.

Signs and Symptoms

1. It starts with spasms of the face and jaw muscles (trismus).
2. Risussardonicus occur (peculiar smiling grimace often noted in tetanus patients).
3. Opisthotonus.
4. Rigidity of the neck and jaw muscles (locked jaw).
5. Photophobia.
6. Sensitive to sound.
7. Spasms later affect the whole body.

Management

1. Report to the hospital immediately for treatment.
2. Anti-tetanus serum can be administered.
3. Muscle relaxants such as valium and phenobarbitone are also given.
4. Large doses of penicillin are given to treat the wound and stop further production of toxins by the organisms.
5. Nurse patient in dark and quite environment.
6. Daily dressing of the wound.

Prevention and control

• Passive immunization with anti-tetanus serum to all injured persons.
• Active immunization to all pregnant women with tetanus toxoid.
• Active immunization with DPT/HibHepB to all children.
• Use of sterile instruments.
• Health education on the disease.