Tetanus


Tetanus

Description of tetanus

Tetanus is an infectious disease caused by the bacteriumClostridium tetani (or its toxin) which gets into the body open wound, whereby there is clogging bacteria blow into the blood.

It is a disease manifested by generalized seizures (whole-body) and dysregulation of the internal organs. Nowadays it is a very rare disease, mainly due to mandatory vaccination of children and adults. 3 -10 indicate acute cases annually, mostly in immunosuppressed individuals (mostly elderly).

Mortality tetanus but high, ranging between 10-50%, with the most serious forms of almost 100%. Severity depends on the form of the disease, the immune status of the affected and infectious dose (the amount of bacteria, or toxins that the body gets infected).

It is also important to say that this is not a disease transmitted from person to person.

 

Causes of tetanus

Infection typically occurs when external injuries deeper structures (subcutaneous tissue, muscle), when the wound gets the dirt out of the country (the land). Visible pollution, however, not a requirement. Tetanus bacteria are among the anaerobic bacteria form spores. In bacteria, spores are actually a kind of cocoon in which the bacteria closes under adverse conditions. The problem is that these disputes are able to survive for tens to hundreds of years and are very resistant to any external influences.

Bacteria reach the ground with the excrement of animals in the intestines live as the normal intestinal flora. These are mainly horses (hence the greater the risk of infection from soil fertilized), but also for some people it can be demonstrated in the intestine.

The soil can then create resistant spores. They themselves are not dangerous, but the bacterium is capable, if external conditions favorable to return to its original, so-called. Vegetative state. In this state, although very sensitive to the surrounding environment (pH, oxygen, nutrients, etc.) but also produce a very potent neurotoxin (poison affecting the nervous system).

It is absorbed into the blood and gets to the nerve endings on the so-called. Neuromuscular griddles. These are places where the transmission of nerve impulse to the muscle fibers. From here then travels along nerve fibers of the central nervous system, the nerves affecting the motor (motive) system. The toxin then blocks the nerves substance responsible for the control neurotransmission. Being blocked occurs uncontrolled muscle stimulation, which causes the formation of the convulsions.

Among the rare resources infections are spread from the colon or from the vagina.

 

Risk factors tetanus

Whereas it is in our country tetanus immunization required is the greatest risk factor to be considered is the absence of vaccination. Normally tetanus vaccinated soon after birth, in several successive doses.

The first four benefits are part of the hexa (diphtheria, tetanus, whooping cough – pertussis, Haemophilus influenzae B, polio, viral hepatitda B).

The first dose is given between 13 and 16 weeks after birth, the second a month after the first (17th to 20th week), the third month after the second dose (21 to 24 a week). Half a year after the third dose is administered dose fourth. Between 5 and 6 years of age there is a booster when simultaneously with tetanus přeočkovává diphtheria and whooping cough. Separately, then vaccination against tetanus is applied between 14 and 15 years of age and revaccination should be every 10 to 15 years.

To ensure that the child has not been vaccinated must be very serious reasons (serious disorders of the immune system), in other cases, parents (if the child is immunized refused) expose the child to a high risk of infection both tetanus, but also other diseases, which is then very difficult to treat and often lead to death or irreversible damage to the affected organism.

Furthermore, the problem may occur when one forgets the booster. This problem occurs mainly in older people, so I would like to emphasize that the date of the last booster had ever been issued or registered so that it can be checked regularly. In old age because the immune system loses its strength, so it is more than important to adhere to these terms.

Among other risk factors, then it is irresponsible approach to injuries, lack of toilet wounds,especially contaminated soil at deeper injuries then non seeking medical assistance.

Risk factors obviously include intravenous drug use where needles are not sterile and there is thus a potential risk of infection from contaminated needles. And not only the risk of tetanus infection …

 

Preventing tetanus

The only effective prevention is vaccination. Without it, a person exhibits a high and mostly unnecessary risk of fatal diseases. Do not fidget on weekends in the beds or wounds spotlessly clean without the proper immunization really is not enough. Although this reduces the risk of contact with the bacteria, but that’s about it. In this latter case there is a danger that the person concerned will experience very unpleasant and painful condition that can lead to death and that experienced in full consciousness. And it must be added unnecessarily.

Of course it is necessary to mention the thorough disinfection of injuries and if necessary a deeper wounds seeking medical attention. That usually in such cases (according to the doctor’s judgment), in addition to professional wound care is also in single doses of antibodies against tetanus.

 

Signs and symptoms of tetanus

There are several possible forms of the disease that depends on the immune status of the organism to infectious dose. In the case of minor forms (among them is the longest time from infection to onset of symptoms) is not a course so severe cramps and they occur only rarely.

In moderately severe forms, spasm, but mostly there is no impairment of the respiratory system (respiratory muscles).

In the case of the most severe forms occur all of the following symptoms in quick succession, and the disease is coming to respiratory insufficiency with a high risk of death (50 to 100%, depending on age of the higher mortality rate among children and the elderly).

The disease manifests itself mainly to the increased stiffness of muscle spasms. They can occur as clonic spasms (muscle twitching) and tonic (muscle spasms or whole groups). From the beginning they may not be accompanied by pain, but which has been added to seizures.

The first symptoms are usually on facial muscles. , Spasm of jaw muscle, which in turn does not allow opening of the mouth (trismus). Further picked spasms of facial muscles (ie. A sardonic smile). There are often also dysphagia.

Subsequently added generalized muscle spasms. And especially the abdomen, neck and back pain, which occurs when the body is stretched to křečovitému reclining (opistotonus). Spasms can be triggered by external stimuli banal such as touch or sound stimuli. At this stage, there may be convulsions vital larynx muscle or diaphragm. In the event of impairment of these muscles leads to dyspnea with subsequent risk of suffocation.

Seizures are extremely painful, increases the temperature and significant perspiration.Unfortunately, there is no disturbance of consciousness, so the person perceives this whole process. If the latter symptoms occur within 24 hours after the beginning of infection, the prognosis is extremely unfavorable.

If you therefore get symptoms such as fever, sweating and convulsions (especially in the first phase of the face), following previous injuries (particularly contaminated soil), it is appropriate to seek medical help immediately. These symptoms occur when there is an infection, usually about one week (but also shorter or longer period) after injury. In case the disease begins to manifest previously demonstrated to infect aggressive strains and diseases have worse overall prognosis.
The prognosis of this disease is a serious but always !!!

 

treatment of tetanus

Treatment is repeated doses of antibody against tetanus toxin. Next, it must be treated surgically and carefully check the wound, from which it began to spread of infection. At the surgically created such conditions in order to make the best of tissue oxygenation. Bacteria are very sensitive to oxygen and kills them. Possibility is the use of a hyperbaric chamber.

Other methods include respiratory support (assisted ventilation) in the case of disability larynx, doctors may perform a tracheostomy (a surgical opening of the trachea at the front of the neck with the introduction of the tube, which air flows).

The treatment of cramps include the administration of muscle relaxants (drugs for muscle relaxation) and sedatives (tranquillizers).

As a supportive treatment, in view of the fact that it is a bacterium, antibiotics are administered.Secondly help to prevent the further propagation tetanus bacteria, but also other potential other bacteria which may occur in the organism and disease progression complicate.

The treatment lasts for 2 (with the lightest forms) – 6 weeks if treatment is working optimally, there are retreats muscle stiffness and overall improvement.

 

complications of tetanus

Complications are primarily late disease manifestations, thus choking (asphyxia) can further generalized convulsions in fractures, especially vertebral (compression fractures), but also of other bones.

And the risk of rupture of muscles and tendons. Further risk during treatment risk for developing pneumonia (pneumonia).

During repeated convulsions is the risk that the muscles most affected cramps. The damaged parts of your muscles then die, and their decay products that get into the blood, can clog the kidneys (depending on the extent of muscle damage), then there is a risk of kidney failure.

Very serious complication of the disease is cardiac arrest.

Other names: tetanus, lockjaw

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