Tetanus, also known as lockjaw, is caused by a bacterial toxin called tetanospasmin. The bacteria live in soil and can enter the tissue of dirty wounds. The disease causes muscles to convulse, starting with those in the jaw and face. A vaccine called tetanus toxoid is used to prevent the disease, and booster shots are required every 10 years. Vaccines for tetanus are usually combined with vaccines for other diseases. The side effects of the vaccine are usually minimal.
Tetanus is a disease also known as lockjaw, caused by a bacterial toxin. It is so named because the condition causes muscles to convulse, starting with those in the jaw and face. The bacterial poison is called tetanus toxin or tetanospasmin. An inactivated form of this compound, known as tetanus toxoid, is used as a vaccine for children or adults, along with vaccines for many other once-common diseases. A tetanus vaccine is also used to treat adults every 10 years – to keep their resistance to tetanus active – and on patients with blemished wounds who have not received a tetanus vaccine in the previous 10 years.
The Clostridium tetani bacterium lives in the soil and produces endospores that can enter the tissue of dirty wounds. This is the onset of tetanus. The bacteria themselves do not cause the affliction, although they do multiply within the oxygen-free confines of the tissue. When they die, however, they release the tetanus toxin. After activation by proteases, the toxin migrates through the nervous system until it reaches the central nervous system (CNS).
Once in the CNS, the muscles prepare to respond to the slightest stimulation. This causes the convulsions and muscle spasms characteristic of the disease. The tetanus toxin is very powerful. All it takes is a small amount of venom to achieve this effect and kill 30-40% of people who contract tetanus.
It is possible to induce resistance to tetanus by injecting a modified form of the toxin. The tetanus toxin is treated with heat or formalin to change its structure, so it can no longer affect the nervous system. The inactivated toxin is now known as tetanus toxoid. It retains enough of its structure that using it for tetanus immunization will induce an immune response and prevent the occurrence of the disease, if the person becomes infected with the bacteria.
Tetanus toxoid was first developed in the 1920s. It was used to immunize American forces during their service in World War II. Because the vaccine is based on tetanus toxoid and not on a live organism, the immune response tends to wear off over time. It is important for adults to get booster shots every 10 years to maintain a resistance to tetanus. Recently in the United States, most cases of tetanus have been found in adults 50 years of age and older.
Immunization with tetanus toxoid is almost completely effective in inducing resistance to tetanus. If a person hasn’t kept up with their booster shots and contracts tetanus, however, it’s possible to die from the disease. It is standard medical practice to treat patients with soiled wounds with a tetanus shot, but it takes several weeks for the body to develop antibodies to the toxoid. Tetanus can kill a person in the time it takes for the vaccine to take effect.
Starting at six weeks old, babies are now strongly recommended to get vaccinations for tetanus, along with many other diseases. Vaccines for these conditions have been developed so that one shot can deliver the substances to cause resistance to multiple diseases, although a series of shots are required. Commonly, tetanus toxoid is combined with diphtheria toxoid. Also included is the pertussis vaccine, also known as whooping cough. This series of vaccines can also be combined with vaccines for polio, hepatitis B and Hib, a form of influenza B.
The side effects of tetanus toxoid are usually minimal. Adults who receive tetanus toxoid vaccination usually have only localized, non-severe reactions. Symptoms to watch out for in children include seizures, fevers above 103°C, vomiting, seizures, or swollen glands in the armpits, among others. For children receiving the combination vaccines, seizures are extremely rare, with one in 39.4 children developing a high fever. The rare fever is thought to be due to the pertussis vaccine, and the child is thought to still have immunity to tetanus and diphtheria.
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