Most of us have been asked at our doctor’s office when we last had a tetanus shot.
In my most recent column, I wrote about abrasion and laceration injuries and mentioned the need to get a tetanus shot if necessary.
But when to get it, and just what is tetanus? The answer to the second part of that question is that tetanus is a severe disease caused by a toxin produced by the bacteria Clostridium tetani, which produces stiffness and spasms of skeletal muscles. It often begins in the muscles of the jaw, hence the name “lockjaw.” Years ago, people could die from tetanus because of the jaw locking, leaving them unable to eat or breathe.
Fortunately, in this age of modern medicine, tetanus infections can be successfully cured.
The tetanus germ is actually quite fragile. It cannot live in the presence of oxygen and does not survive well outside the human body. It does, however, produce spores that are extremely resistant to adverse conditions. These spores are widely distributed in soil and in the intestines of many domestic and farm animals. The spores can also be found on skin surfaces as well as on many inanimate objects.
The tetanus germ itself is not harmful, but it produces one of the most potent poisons known. This toxin is what causes the muscle spasms. Tetanus is not contagious from person to person, and antibiotics are ineffective, as they have no effect on the harmful toxin.
The tetanus bacterium enters the body through a wound which might be major or minor. The incubation period ranges from three to 21 days, and symptoms usually are observable within days. The deeper the wound, the less oxygen is present, allowing the tetanus spores to proliferate, spreading the toxin throughout the bloodstream.
Tetanus may follow puncture wounds, especially by stepping on a nail. A rusty nail is only slightly more dangerous than a non-rusty nail, and only because its surface is rougher and a little more likely to harbor germs. Burns, bites and even minor scratches can also lead to tetanus. Occasionally, the victim might not even recall a preceding injury.
Tetanus immunization came of age during World War II. Tetanus fatalities fell from thousands per year to just 20 cases, as of the last report in 2003. Almost all reported cases of tetanus are in those who have never been vaccinated or those who were properly vaccinated but have not had a booster in the preceding 10 years.
Routine tetanus immunization begins after birth at 2 months and is continued with a series of four doses with a booster at about 5 years of age, prior to entering school. From then on, a booster is needed every 10 to maintain adequate protection.
Receiving a booster sooner than necessary is not harmful. Better safe than sorry.
Tetanus vaccination is almost 100 percent effective and, unlike the old horse serum used years ago, the new variety being used rarely causes serious reactions. The most common problem for some after receiving the tetanus shot is soreness, with occasional redness and swelling around the injection site. This will resolve on its own and is not an allergic reaction.
If you have an open wound:
- Clean the wound appropriately.
- Get a tetanus vaccination as soon as possible if: You’ve never had one before; If the wound is very dirty and deep and your last booster was more than five years ago; If the wound is relatively clean and minor and your last booster was more than 10 years ago.
- Have your health care provider keep you updated with 10-year booster immunizations, even during a routine office visit.