Tetanus is caused by a bacterial neurotoxin that blocks muscle relaxation, leading to spasms and stiffness. It can be prevented through vaccination and treated with antibiotics, muscle relaxants, and hospital care. In developing countries, it is a significant cause of death in newborns.
The effects of tetanus come from a bacterial neurotoxin released into wounds during infection. This substance blocks the ability of skeletal muscles to relax and instead causes them to contract and spasm. Lockjaw or similar muscle stiffness is a common symptom. The effects of tetanus can be prevented through vaccination and are often successfully reversed in hospital settings that include respiratory support. In developing countries, tetanus is a significant cause of death in newborns.
Clostridium tetani is a bacterium found in soil around the world, contaminating wounds in humans and other animals. The effects of tetanus are caused by a strong neurotoxin, tetanospasmin, produced by bacteria and released when their cells shed. As it circulates in the bloodstream, the toxin is gradually absorbed into the nerves, first peripherally and then into the spinal cord itself. In just a week, tetanospasmin blocks neurotransmitter communication, preventing the neurons that control muscles from receiving commands from the brain. Inhibits muscle relaxation, so skeletal muscles are in constant contraction.
Muscle contractions throughout the body often begin with lockjaw, one of the most important effects of tetanus. This is followed by general muscle stiffness, difficulty swallowing, and paralysis. The patient is tormented by powerful recurring spasms that can tear muscles and ligaments and even fracture the spine. If it reaches neurons in the brainstem, the tetanus toxin threatens basic functions such as breathing. The smooth muscles of the heart do not develop tetany and can still relax because tetanospasmin only blocks the neural control of skeletal muscle.
Because it is rare in vaccinated individuals, the best way to prevent tetanus is to be vaccinated at regular intervals, at least once every ten years for adults. Treatment includes antibiotics, muscle relaxants, and hospital care. Because the most common cause of death from the effects of tetanus is respiratory failure, rescue breathing may be necessary until the toxin suppresses normal breathing. Cure rates are quite high outside of the elderly and some unvaccinated patients. Death rates vary widely, from less than a tenth of cases in some parts of the developed world to over half in the poorest countries.
In infants, the effects of tetanus are similar to those in adults but take a more rapid and often lethal course. Neonatal tetanus is often acquired from cutting the umbilical cord with an inadequately sterilized knife or scissors, although soil contact may be a factor. It is a common cause of early infant mortality in developing countries, although rare elsewhere. If a baby’s mother has been vaccinated, the neonatal chances of contracting tetanus decrease, regardless of sanitation, because passive immunity can be acquired by a fetus during the course of pregnancy.
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