Although tetanus is a serious and potentially fatal infection, it is entirely preventable and should not be a major threat to the health of individuals today. This is due to an effective vaccination available that provides effective protection from the bacterial infection.
The prevention of tetanus is particularly important because it is difficult to treat when someone is already infected with the spore-producing bacteria. Treatment usually occurs in a supportive care environment, with symptomatic medications to control muscle spasms, antibiotics to treat the bacteria and wound management. However, approximately 20% of reported cases are fatal, which explains why prevention is of utmost importance.
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Vaccination
The vaccine is highly effective and almost all cases of tetanus occur in individuals who have not been vaccinated in the preceding ten years.
It works well as a preventative shortly following the immunization – up to 5 years – and slowly decreases in efficacy after this time. For this reason, it is recommended that people be vaccinated at least once every 10 years.
Immunization schemes
Most developed nations in the world have a set immunization scheme for children to help protect them from dangerous infectious diseases, such as tetanus.
Young children are usually given standard tetanus vaccinations along with protection against other infectious diseases such as diphtheria and pertussis during the first months and years of life (2 months, 4 months, 6 months, 18 months, 4 to 6 years). A booster shot is then required around the age of 14 to 16, and every ten years following this time throughout adulthood to minimize the risk of tetanus.
It is important to be aware that patients may need additional care, even if they have been vaccinated in the past 10 years, particularly if they have a deep or dirty wound.
Additionally, most individuals who are traveling to areas when tetanus infections may be more common should be advised to have their immunity status up to date.
Tetanus, Diptheria and HPV vaccination
Wound management
It is important the all wounds that may possibly be infected with Clostridium tetani bacteria are adequately managed to reduce the risk of the infection spreading and leading to tetanus.
All wounds should be cleaned thoroughly by rinsing them with clean water and washing the area surrounding the wound with an appropriate agent. Deep and dirty wounds require more attention and may require a booster vaccination to prevent the spread of tetanus.
The best course of action depends on the current vaccination status of the individual.
- People with minor, clean wounds generally do not need a booster shot, provided they have been vaccinated within the last 10 years.
- People with minor, clean wounds that have not been recently vaccinated (within 10 years) should be given a booster shot to provide adequate protection.
- People with deep or dirty wounds may need an additional booster shot if they were last vaccinated more than 5 years ago.
- People that have not been vaccinated, or cannot recall the date of their last vaccination, may need tetanus immunoglobulin, in addition to the vaccination.
Minimizing situations that could lead to wounds and the possibility of contracting tetanus is also important to consider in the prevention of the disease. For example, when participating in sports that involve violent contact with the ground such as skating, it is recommended to wear knee and elbow pads. Likewise, wearing shoes when walking outside can stop injuries due to stepping on sharp, dirty objects.
References
Further Reading
Evidence from Malawi: Typhoid conjugate vaccine provides protection for up to four years