Dear Doctor;

Is tetanus treatable? How can one know that he has been infected so as to seek early treatment? Can someone who was infected in childhood be infected with tetanus in adulthood? What are the risk factors?

Musoni, Nyamirambo. 

Dear Musoni, 

In this era of antibiotics, tetanus is entirely treatable, the only thing needed is early initiation of treatment. The earliest sign of a typical tetanus infection is difficulty in opening the mouth, what is known as ‘lock jaw’. This may progress to stiffness of the limbs and convulsions. Left untreated, a person can die of respiratory failure due to paralysis of respiratory muscles.

One infected in childhood and even vaccinated as a child can develop infection as an adult if microbes gain entry in the body. This happens because one time infection does not provide life long immunity as in case of viral infections. 

Tetanus occurs due to infection by a tiny microscopic germ called Clostridium Tetani. This remains in dust, manure, soil, among others. surface and environment, and gains entry in the body through wounds contaminated with mud, among others. Pricks and cuts by contaminated needles, scissors, among others. tools are other sources of infection. It can also occur  due to bites by dogs, snakes, etc. animals. After the microbes enter the body, a neurotoxin is released which causes muscular stiffness and paralysis. Disease can develop from two days to three weeks after exposure.  Diagnosis is made easily on physical features and treatment is by antibiotics, including penicillin and metronidazole. Anti tetanus serum  given  immediately within two to three days of development of symptoms helps in aborting the disease and curing it.

Prevention consists of immediate cleaning of a wound with antiseptic solution and injection  of  anti tetanus toxoid after inflicted with a soiled wound which carries risk of developing tetanus. High risk groups are given booster doses of tetanus toxoid to prevent infection.