Tetanus and Tetanus vaccination

With the arrival of antibiotics in the early twentieth century, we quickly forgot that any break in our protective layer of skin could be fatal.  Even today, people still die from Tetanus. This is a disease caused by a bacterium, Clostridium Tetani, which is found everywhere in nature. Tetanus spores  can survive for up to 40 years in soil. If the spores get under the skin, they “hatch” and start to multiply. After 7 to 21 days, the bacteria produce a poison (neurotoxin) which affects the nervous system causing muscular spasm. “Lockjaw”, the common name for tetanus, develops when the toxin affects the facial muscles. Even with treatment, about 10% of people who develop tetanus will die.

The spores must be introduced under the skin so the most dangerous wounds are deep penetrating wounds. Everyone is fearful from standing on a “rusty nail”. The rust is not the issue – it is the fact that a dirty instrument has penetrated the skin and may have introduced tetanus spores deep into the tissues. A dirty needle, a bite from a pet or a rose thorn might do the same thing!

Tetanus Vaccine

Now, for the good news. C.Tetani are quite sensitive to antibiotic treatment and patients who develop tetanus can be treated. Even better news is that the condition is completely preventable with a vaccine.

Children who receive their routine vaccinations at 2, 4 and 6 months have tetanus vaccine included in the mix. These three primary doses give protection for at least five years. Children, at the time they start school, are recommended to have a booster shot and this also includes tetanus. This will stretch the immunity to tetanus by at least a further 10 years to age 15 years. Teenagers, about the time they start secondary school, are recommended to have a final booster shot (but this one is often forgotten).  This fifth vaccine will give full protection for at least another ten years and indeed probably for life.  People embarking on international travel, especially to places with poor medical services, are recommended to have a booster every ten years.

Tetanus shots

It is important to understand that the “tetanus shot” is a vaccine – in other words it stimulates the body’s own immune system to recognise and attack any C.tetani it may come into contact with. The practice nowadays is to administer a dose of vaccine to any patient with a potentially infected wound, especially if there is any uncertainty about their vaccine status. After injury vaccination may be administered anytime during the days following injury. All wounds should be washed thoroughly with clean (boiled) water and if possible a mild antiseptic solution (eg. Savlon).