David Perlstein, MD, MBA, FAAP
Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Tetanus facts
- What is tetanus?
- Where do tetanus bacteria grow in the body?
- How does the tetanus toxin cause damage to the body?
- What is the incubation period for tetanus?
- What is the course of the tetanus disease? What are the symptoms and signs of tetanus?
- What is the treatment for tetanus?
- How is tetanus prevented?
- What is the schedule for active immunization (tetanus shots)?
- What are the side effects of tetanus immunization?
- What is passive immunization (by way of specialized immunoglobulin)?
What is the incubation period for tetanus?
The incubation period between exposure to the bacteria in a contaminated wound and development of the initial symptoms of tetanus ranges from two days to two months, but it's commonly within 14 days of injury.
What is the course of the tetanus disease? What are the symptoms and signs of tetanus?
During a one- to seven-day period, progressive muscle spasms caused by the tetanus toxin in the immediate wound area may progress to involve the entire body in a set of continuous muscle contractions. Restlessness, headache, and irritability are common.
The tetanus neurotoxin causes the muscles to tighten up into a continuous ("tetanic" or "tonic") contraction or spasm. The jaw is "locked" by muscle spasms, giving the name "lockjaw" (also called "trismus"). Muscles throughout the body are affected, including the vital muscles necessary for normal breathing. When the breathing muscles lose their power, breathing becomes difficult or impossible and death can occur without life-support measures (mechanical ventilation). Even with breathing support, infections of the airways within the lungs can lead to death.
What is the treatment for tetanus?
General measures to treat the sources of the bacterial infection with antibiotics and drainage are carried out in the hospital while the patient is monitored for any signs of compromised breathing muscles. Treatment is directed toward stopping toxin production, neutralizing its effects, and controlling muscle spasms. Sedation is often given for muscle spasm, which can lead to life-threatening breathing difficulty.
In more severe cases, breathing assistance with an artificial respirator machine may be needed.
The toxin already circulating in the body is neutralized with antitoxin drugs. The tetanus toxin causes no permanent damage to the nervous system after the patient recovers.
After recovery, patients still require active immunization because having the tetanus disease does not provide natural immunization against a repeat episode.
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