Tetanus, or lockjaw is a serious, sometimes fatal infection caused by Clostridium tetani bacteria. Spores of the bacteria C. tetani live in the soil dust and animal manure, but also exist virtually anywhere around the world. In the spore form, C. tetani may remain inactive in the soil, but it can remain infectious for more than 40 years. Once introduced into the body, the bacteria produce a toxin that affects the brain and nervous system. As the infection progresses and the toxin continues to affect the nervous system, patients will experience stiffness in the jaw muscles and other muscles. Tetanus is a global problem occurring in un-immunized people and can ultimately be fatal in 20% of infections.
Tetanus is usually spread when the bacteria make its way into the body of a human through a skin lesion, usually a puncture wound or a skin cut. Deeper cuts are ideal environments for infection because the bacteria thrive and can multiply more effectively in places that contain little or no oxygen. The incubation period usually takes a week, but it varies from 3 to 21 days. Once inside, the bacteria multiply rapidly and release a neurotoxin (poison that affects the nervous system) known as tetanospasmin. Once tetanospasmin enters the bloodstream it rapidly spreads throughout the body. At that point the patient will begin experiencing tetanus symptoms.
Other ways tetanus infections occur:
- Abrasions and lacerations
- Animal bites
- Skin burns
- Tattoos that are performed with unsterilized equipment
- Injecting drugs with dirty needles
- Body piercing performed with dirty equipment
Tetanospasmin interferes with the signals sent from the brain to the nerves in the spinal cord, and then on to the muscles, causing muscle spasms and stiffness. Once in the blood stream, the neurotoxin interferes with nerves that control muscle movement. Tetanus often begins with mild spasms in the jaw muscles (lockjaw). The spasms also affect the chest, neck, back, and abdominal muscles. Back muscle spasms may cause arching which is known as opisthotonos. Other times the neurotoxin will affect the muscles that help with breathing and cause spasms and lead to breathing problems. Powerful contractions of muscle groups can cause fractures and muscle tears. This is called tetany.
Other symptoms include:
- Hand or foot spasms
- Excessive sweating
- Uncontrolled urination or defecation
- Swallowing difficulty
Diphtheria is a very contagious and potentially life-threatening infection. It can attack the nerves and heart and leave you with severe, life-long complications. Diphtheria is a serious risk for travellers, particularly in Eastern Europe where many people are not vaccinated.
Diphtheria is caused by Corynebacterium diphtheriae, a bacterium. The bacterium produces a toxin that is carried in the bloodstream. Diphtheria bacteria live in the mouth, nose, throat, or skin of infected persons and it spreads from person to person very easily. A traveller can get Diphtheria by breathing in Diphtheria bacteria after an infected person has coughed or sneezed. People also get Diphtheria from close contact with discharges from an infected person’s mouth, nose, throat, or skin.
Symptoms include a sore throat and mild fever, difficulty swallowing, swollen lymph glands. If you are travelling to any part of the world where Diphtheria is endemic, especially if you are going to be in close quarters, you are at high risk of contracting Diphtheria. Diphtheria is easily preventable with the Tetanus/Diptheria or Tetanus/Diphtheria/Pertussis (Whooping Cough) vaccine.
There are several options for vaccination against these diseases. Although tetanus treatment exists, it is not uniformly effective. The best way to protect yourself from tetanus is to get vaccinated. Age and immunization history govern which is right for you and when you need them. Be sure to discuss the options with your Passport Health Travel Medicine Specialist.
Both our Clinic and Mobile Unity stock the Tetanus Diphtheria and Tetanus Diphtheria and Pertussis vaccinations.
Tetanus can occur anywhere in the world in inadequately vaccinated persons. Diphtheria and Pertussis (Whooping Cough) are more frequent in parts of the world where vaccination levels are low. If you are a traveller you should receive the Tetanus Vaccination.
So, if you are wondering, “What travel shots and vaccinations do I need?” or “Where do I get the Td and Tdap Vaccines?” schedule an appointment with your local Passport Health travel clinic.