January 11, 2022 Author : Liliana Beirão Tetanus is a serious infectious disease : It is caused by a bacterium, the bacillus Clostridium tetani ; It can affect people of any age; It may be cause of death; The prevention of this disease is done by vaccination; The tetanus vaccine is part of the Portuguese national vaccination program. Vaccination starts in babies and regular boosters should be given throughout life. Despite the progress achieved with universal vaccination, in Portugal, cases of tetanus continue to be recorded, especially in people who have not been vaccinated or who do not receive boosters with the indicated regularity. How do you get tetanus? Tetanus is not transmitted from person to person. The bacterium Clostridium tetani that causes tetanus lives in the environment, mainly in soil and manure, in the form of spores, which are very resistant and survive for many years. It enters the body through skin wounds . Wounds that have the following characteristics are at increased risk of contagion: Punctiform wounds ( eg by nails, thorns or bites); Wound made by foreign bodies ( eg wood splinters); Extensive wounds, with skin and soft tissue damage ( eg burns); Wounds contaminated with soil or manure; Wounds with clinical evidence of infection or with dead tissue; Open fractures. Once in the body, Clostridium tetani produces neurotoxins (toxins that reach the nervous system) that alter the function of the nerves responsible for muscle contraction. From infection to symptoms (incubation period) an average of 10 days pass. Symptoms Tetanus is characterized by painful, involuntary muscle contractions (spasms) and muscle stiffness . The diagnosis is essentially clinical, and the disease can have several forms of presentation : Muscle contractions start in the neck and lower jaw region and may imply difficulty in opening the mouth and swallowing. The disease can progress to the shoulders, face, abdomen, and limbs, which suffer spasms, sometimes triggered by stimuli such as noises or others, and which last for a few minutes. Muscle spasms can cause deformities, for example an arched back or the appearance of a strange smile. In more advanced disease, there are changes in blood pressure, heart rate, excessive sweating, and fever. Other forms of the disease are localized tetanus , where muscle spasms are localized to the wound, and cephalic tetanus, where there is weakness of the facial muscles and spasms of the jaw muscles. Both can progress to generalized tetanus. Complications Tetanus can give rise to several complications , including: Tightening of the vocal cords (laryngospasm); Breathing difficulty associated with neck muscles stiffness; Fractures; Pulmonary embolism and pneumonia; Respiratory failure, due to spasm of the muscles involved in breathing and blockage of the airways, which is the most common cause of death from tetanus. Prevention Tetanus is prevented by vaccination. Get vaccinated . The Portuguese national vaccination program includes a vaccine that must be given at 2, 4 and 6 months of age. Boosters are then given at 18 months, 5, 10, 25, 45, 65 years and then every 10 years. It is also given with each pregnancy. People who recover from the disease do not develop natural immunity and can become infected again, so they should be vaccinated. On the other hand, this is a vaccine that does not give the so-called herd immunity – only those who made the vaccine are really protected . Proper skin wound care is also an important preventive measure. When in doubt, always seek medical attention. Meet the general and family medicine clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
