TETANUS

the tetanus bacillus

 

Tetanus is an often fatal infectious disease caused by the toxigenic strains of the tetanus bacillus. Tetanus is a devastating disease in developing countries and has not yet entirely disappeared from industrialized countries.

Symptoms of tetanus

  • The bacterium penetrates the body through lesions (e.g., soiled wounds, open fractures, chronic ulcers…) or as a result of medical acts performed under insufficient aseptic precautions.
  • Following an incubation period of four to 21 days, tetanus most often presents as a generalized spastic disease. Contractions of the jaw muscle (or trismus) are a characteristic feature and are followed by spasms of the back muscles (opisthotonos) and sudden generalized convulsions.
  • In the absence of treatment, the outcome is almost always fatal, particularly in the very young or the elderly.
  • Even after appropriate treatment, tetanus-related mortality remains high.

Epidemiology and vaccination against tetanus

  • Tetanus bacillus is ubiquitous and present in the soil in the form of highly resistant spores. Its reservoir can thus not be eliminated, but vaccination is a very effective weapon in the prevention of the disease.
  • In 2002, over 200,000 tetanus-related deaths were estimated to occur worldwide, of which approximately 180,000 were due to neonatal tetanus. (26)
  • Tetanus vaccines are based on tetanus toxoid, and are usually combined with other valences (e.g., diphtheria, pertussis, polio, Hib…).

References:

26 - Tetanus vaccine. WHO position paper. WER 2006, 81:197-208: