Many people are very familiar with the tetanus vaccine, but do you know when you should have the injection? Cases of tetanus in developed countries are quite rare due to the high percentage of vaccinated individuals. This practice is extremely important, as there is no cure for this infection which is caused by a bacterial toxin found in soil, dirt and animal feces. This bacterium produces spores that are very difficult to kill because they are resistant to both heat and many drugs and chemicals. Tetanus affects the nervous system and causes painful muscle contractions, especially in the neck and jaw; it also hinders breathing, so it is potentially fatal. For all these reasons, it is important to understand when you should get the vaccination.
Steps
Part 1 of 3: Knowing when to Inject
Step 1. Get a booster injection after some injuries
Toxins from the bacterium usually enter the body through a break in the skin caused by a contaminated object. If you have suffered one or more of the following injuries that make you susceptible to infection, you should have a booster vaccine. Here are what the injuries are:
- All wounds contaminated with dirt, dust, horse manure.
- Point wounds. Among the objects that cause this type of injury we remember: splinters of wood, nails, needles, glass, animal and human bites.
- Burns. Second degree (which partially involve the thickness of the skin or have blisters) and third degree (which affect all skin layers) place the victim at a more serious risk than first degree (superficial) burns.
- Crushing injuries that damage tissues due to strong compression between two heavy objects. This type of injury also includes those caused by a heavy object falling on a part of the body.
- Wounds with necrotic tissue, i.e. dead. In this case the area does not receive blood and becomes a breeding ground for infections (in addition to the fact that the tissues are severely damaged). For example, parts of the body affected by gangrene (dead tissue) are at risk of infection.
- Injuries in which foreign bodies remained. When a foreign object remains in the body, such as splinters, glass fragments, gravel, and so on, there is a greater risk of infection.
Step 2. Know if it's time to get the vaccine
If you've never had your first set of tetanus injections (first round of vaccination) or don't remember exactly when you got your last booster, then you should get the vaccine. If you have injured yourself, you may be wondering if you should have the booster injection. The answer is yes if:
- The injury was caused by a "clean" object, but your last tetanus shot was over 10 years ago.
- The injury was caused by a "dirty" object and your last injection was over 5 years ago.
- You are not sure if the object that hurt you was "clean" or "dirty" and you haven't been vaccinated for over 5 years.
Step 3. Get the injection while pregnant
To be able to transfer the antibodies to the baby, you should get vaccinated between the twenty-seventh and thirty-sixth week of gestation.
- Your gynecologist will likely recommend the inactivated Tdap vaccine (Tetanus, Diphtheria and Pertussis) during the third trimester of pregnancy.
- If you have never been vaccinated before and did not have the injection during gestation, you should do so immediately after giving birth.
- If you get a cut with a dirty object or wound during pregnancy, you probably need to get a recall.
Step 4. Get vaccinated
The best way to "treat" tetanus is to prevent the disease from developing. Most people do not experience severe vaccine reactions, but there are some mild symptoms that are fairly common. These include mild localized swelling, tenderness and redness at the injection site which disappear spontaneously within 1-2 days. Don't be afraid to make another call; there is generally no problem if you don't wait 10 years between vaccinations. There are many products for tetanus vaccination on the market and they are:
- DTPa: The diphtheria, tetanus and pertussis vaccine is given to infants at 2, 4 and 6 months of age and then repeated between 15 and 18 months. DTPa is very effective for young children who will be undergoing another cycle at 4 and 6 months.
- Tdap: Over time, protection against tetanus decreases, so older children need a booster injection. This vaccine contains a full dose of inactive tetanus bacterium and small amounts of pertussis and diphtheria bacteria. All individuals between 11 and 18 years of age are advised to undergo this treatment, preferably around 11-12 years of age.
- Td: if you are an adult, get a Td injection (tetanus and diphtheria) every 10 years to stay protected. Since some individuals have a low level of antibodies after 5 years, you should have a booster dose if you have gotten a deep wound with a contaminated object and it has been more than 5 years since the last vaccine.
Part 2 of 3: Learn and Recognize Tetanus
Step 1. Learn which categories are at risk and how the disease spreads
In almost all cases, tetanus develops in individuals who have never been vaccinated or in adults who have not guaranteed their immunity with the 10-year booster. The infection does not spread from one person to another, so it is different from all other diseases that are fought with preventive vaccination. Tetanus contracts when bacterial spores enter the body, usually through an open wound, and the powerful neurotoxins cause muscle spasms and stiffness.
- Complications resulting from a Clostridium tetani infection are worse among patients who have never received the vaccine or adults in industrialized countries who have not followed the immunization protocol correctly.
- The risk of tetanus also increases after a natural disaster, especially in developing countries.
Step 2. Check your risk factors
As soon as you injure yourself or suffer trauma, clean and disinfect the injury. If you wait more than 4 hours to disinfect a new wound, then you increase the risk of contracting tetanus. This procedure is particularly important in cases of puncture wounds, because germs and dirt have penetrated deeply, in an environment conducive to the proliferation of bacteria.
Check if the object that hurt you is clean or dirty, to decide if a recall is worth it. Any object contaminated with earth, dust, saliva, faeces or manure is considered "dirty"; in the other cases we speak of a "clean" object. But remember that you can't know for sure if an item is contaminated or not
Step 3. Pay attention to the symptoms
The incubation period for tetanus varies from 3 to 21 days, but on average, symptoms appear around the eighth day. The severity of the disease is determined on a scale ranging from grade I to grade IV. The later the symptoms appear, the less intense the disease should be. Common symptoms of tetanus (in the order they appear) are:
- Spasms in the jaw muscles
- Stiffness in the neck;
- Difficulty swallowing (dysphagia);
- Stiffness of the abdominal muscles.
Step 4. Recognize the other symptoms of tetanus infection
The diagnosis, in general, is based only on the observation of the symptoms. There are no blood tests that can detect the presence of the bacterium, so you have to be vigilant about the body's reaction. The person has a fever, sweats, is hypertensive, and has a rapid heartbeat (tachycardia). Be aware that there can be complications, including:
- Laryngospasm or spasm of the vocal cords that make breathing difficult
- Bone fractures;
- Convulsions;
- Abnormal heart rhythm
- Secondary infections such as pneumonia due to prolonged hospitalization;
- Pulmonary embolism, presence of blood clots in the lungs;
- Death (in 10% of cases the disease is fatal).
Part 3 of 3: Treating Tetanus
Step 1. Go to the emergency room
If you think or just suspect that you have contracted the infection, you should go to the hospital immediately. This is an emergency and you will be hospitalized because tetanus has a high death rate (10%). At the hospital, you will be given an injection of tetanus antitoxin, such as immunoglobulins, which will neutralize any toxins that have not yet bound to your nerve tissues. The wound that allowed access to the bacterium will be carefully disinfected and you will be vaccinated to prevent future infections.
Clostridium tetani infection does not make you immune for the future, while the vaccine can protect you
Step 2. The doctor will decide the type of therapy you will need to follow for your specific case
There are no blood tests to diagnose tetanus, so laboratory tests are completely useless for evaluating the disease. For this reason, no doctor chooses a wait-and-see approach, but prefers to attack the infection immediately even in cases where there is only the suspicion of contagion.
Doctors base their diagnosis mainly on symptoms and evident clinical signs; the more serious the situation, the quicker the intervention
Step 3. Treat the symptoms of tetanus
Since there is no cure for this condition, treatments are limited to soothing the symptoms and managing the complications that may arise. You will be given intravenous or oral antibiotics in combination with medications to control muscle spasms.
- Medicines that are used for spasms include sedatives from the benzodiazepine group, such as diazepam (Valium), lorazepam (Tavor), alprazolam (Xanax) and midazolam.
- Antibiotics are generally not effective against tetanus, but they are prescribed to prevent Clostridium tetani from reproducing and to slow down the release of toxins as a result.
Advice
- There are vaccines against tetanus that also protect against diphtheria and pertussis (Tdap) or only against diphtheria (Td). Both vaccines last 10 years.
- The date of your last tetanus vaccine recall should be recorded on your vaccination certificate, of which you should have a copy (if not, request it from the relevant ASL).
- If you are at risk of getting the infection, do your homework to know the signs and complications of tetanus. The spasms can become so severe that they interfere with normal breathing, while the convulsions reach such violence that they can break the spine or long bones.
- It's always better to be safe than sorry - if you're worried about getting tetanus, get vaccinated.
- A couple of rare diseases cause symptoms similar to those of tetanus. Malignant hyperthermia is an inherited disease that causes rapid onset of fever and severe muscle contractions when the patient is under general anesthesia. Stiff man syndrome is an extremely rare condition that affects the nervous system and causes periodic muscle contractures. Symptoms begin to manifest around the age of 45.
