Dear Readers

Marvin L. works on a farm in the hills of St Andrew. His friend, another farm worker, died from tetanus (lockjaw) over a year ago after getting cut on his foot. Marvin has since received an inoculation against tetanus but remains very concerned about contracting this illness.

He says that the cut his now-deceased friend received was "no big thing". It was small and didn't give any trouble, yet weeks later, his friend was a dead man. Marvin asks Lifeline how easy it is to get lockjaw and what makes it deadly.

Marvin is still grieving the loss of his friend. It is often difficult to understand sudden, unexpected death, and death from tetanus is now much more rarely seen than a decade ago.

more susceptible

Tetanus, also called lockjaw, occurs after the body becomes infected with the bacterium clostridium tetanus. This germ is found in dirt, soil and manure. It enters the body through a wound, and small wounds can be even more susceptible than large ones. The germ produces a toxin (a poison) that travels to the nervous system causing severe muscle spasms and stiffness of the body. After the germ enters the host's body, it can take from one day to about two weeks' incubation before the symptoms occur.

Tetanus is not often seen these days because protection against this germ is one of the routine immunisations given during childhood. Usually, after adequate immunisation, active immunity is present for about 10 years. This is why a tetanus booster is often given to an adult who attends a physician or clinic for care of any cut he or she has received. A tetanus prophylactic is usually given as a part of wound management, especially if the wound is a small puncture wound or a crush wound.

Tetanus toxin should be given once the person has not received this shot within the past five years.

There is no natural immunity to tetanus, even after having contracted the illness. This is why regularly spaced inoculations are necessary to protect all age groups. These shots are particularly important for people who work in the soil or with sharp implements. People who have never been immunised may require more than just the tetanus toxic shot if they have been injured. If they are at high risk, they should also be given passive immunisation with tetanus immune globulin at the initiation of medical management.

heals before any symptoms

The wound through which the tetanus germ enters the body often heals before any symptoms of tetanus appear. This illness is defined by muscle rigidity and spasms. This can be life threatening. It requires hospitalisation to obtain very close medical supervision. To avoid this trauma, it is a very good idea to see a doctor when stuck by a nail, stabbed with a lead pencil, or bitten by a dog or cat, as these small puncture wounds are the ones which give the worst trouble with a tetanus injection.

Often, physicians will prescribe antibiotics to prevent the tetanus germ from spreading and causing any illness at all. Sometimes, tetanus can develop even when the affected person is unaware of having a cut on the body. When symptoms of tetanus occur, a physician must be seen immediately.

Tetanus always requires treatment in hospital and involves the administration of antibiotics, pain killers, muscle relaxants and nutritional support.

Any injury which breaks the skin, especially with a puncture wound, should immediately be washed with plenty of water diluted with hydrogen peroxide or betadine.

Write to:

Lifeline

PO Box 1731

Kgn 8

AJM