Tetanus (tetanus)

In general, tetanus is given little or no attention, as a reliable and effective tetanus vaccine is available. But be honest: Do you know your tetanus vaccination status? Many have to deny this question. Tetanus is a serious, often fatal, bacterial infection characterized by typical muscle spasms. After all, even today, up to 25 percent of the cases in Germany are fatal. That's why tetanus vaccination is one of the most important vaccines.

What is tetanus?

Tetanus is an infectious disease that can infect your virus anywhere in the world. Because of the consistent vaccination, tetanus has become very rare in Germany. If the vaccine protection is no longer guaranteed, the risk should not be underestimated.

Colloquially, tetanus is sometimes equated with blood poisoning (sepsis). Although in both cases bacteria are the trigger, these are different diseases.

Bacterial infection with Clostridium tetani

The tetanus pathogen is a bacterium, namely Clostridium tetani, which is found in the soil, dust, in human or in animal excretions (especially of horses). The spores occur everywhere in the soil, can survive in the soil for years and multiply, especially in low-oxygen environment.

If, for example, you injure yourself in the gardening by a wood splinter, sharp-edged stones in the garden soil, a nail or thorns, the bacteria can get into the body. Even small to very small wounds, barely visible "minor injuries" such as scratches or stings, can be dangerous.

In wounds with inadequate oxygen supply, the germs multiply quickly. The bacterium excretes one of the strongest toxins, a so-called toxin. This means that it is not the bacteria themselves but the poison they produce that unfold their harmful effects in the organism.

Tetanus: recognize symptoms

As the inflammation spreads, the poison of the bacteria may spread throughout the body. It passes through the bloodstream or along the nerves to the brain. There it inhibits certain areas of the brain, so that after an incubation period of 3 days to 3 weeks (rarely longer), the first signs of tetanus may occur:

  • Tingling and numbness in the area of ​​the injury
  • Headache and dizziness
  • languor
  • Muscle aches
  • unrest

Typical symptoms are muscle spasms. The cramps begin on the face (including the jaw and neck muscles) and then spread to the whole body. Other symptoms of tetanus include:

  • high fever
  • Chills and sweats
  • confusion
  • accelerated breathing
  • fast heartbeat
  • Fluctuations in blood pressure and circulation

Course: Tetanus can be fatal

Later, the very painful cramping - with fully preserved consciousness - spreads to virtually all the muscles of the body, the limbs are usually spared.

It comes to the so-called jaw clamp (trismus), which gives the sufferer a grinning facial expression. Spasms of the swallowing and breathing muscles lead to life-threatening asphyxia and in many cases end in death. In addition to respiratory distress, heart failure in tetanus is a possible cause of death.

In addition, cramping can put excessive strain on the spine, causing fractures of the vertebrae and permanent damage to the spine.

The effect of the poison can last four to twelve weeks. Early therapy improves the prognosis. But even with intensive care tetanus is lethal in 10 to 25 percent of cases.

Wundstarrkrampf: How is the diagnosis?

Often, the doctor can already diagnose tetanus because of the characteristic muscle cramps, especially if there is no adequate vaccine protection. Furthermore, a blood sample can be taken for diagnosis and tested for the toxin - however, a lack of the toxin in the blood is not certain evidence that it is not tetanus.

Treatment of tetanus

There is no special therapy for the poison of clostridia. The treatment is primarily aimed at stopping the further spread of the bacterium in the body, neutralizing the toxin and relieving the symptoms.

The wound is thoroughly cleaned, sometimes it is also surgically cleaned (cutting out soiled wound areas) and treated as open as possible, so that oxygen gets to the wound and prevents the spread of the bacteria. Even high-dose antibiotics can help stop the spread of bacteria in the body.

In addition, antiserum (tetanus immunoglobulin) is administered to make the poison ineffective. Also, a tetanus vaccine can help: Even if there is still a vaccine protection, the booster vaccine can be administered to activate the immune response of the body faster.

Muscle relaxants (muscle relaxants) and tranquilizers are used to alleviate the symptoms. In addition, the person affected is protected from external stimuli such as light and noise, as these can trigger muscle spasms.

Prevent tetanus

After an injury, any foreign bodies must always be removed first, then disinfect the wound with iodine or alcohol. This is especially true for small and smallest wounds. Deep wounds should not be closed, so that sufficient oxygen can reach the wound area.

For large wounds that have become contaminated or insufficiently vaccinated, a doctor should be consulted to take the precautions described above. For larger, dirty wounds, a tetanus vaccine is also refreshed preventively even if there is still vaccine protection, but the last vaccination was more than five years ago.

Safe protection against tetanus is always provided by vaccination. This vaccine is well tolerated and the protection rate is nearly 100 percent

Vaccination protects against tetanus

Although there is a reliable vaccine against tetanus, many people no longer have adequate vaccine protection. Risk groups are mainly the elderly, the chronically ill or people with skin diseases.

If the body has too little antibody in the blood when it is infected with the bacteria, it can often no longer manage to fight the pathogens. The infection then spreads throughout the organism. Security about the current vaccination status can give the family doctor or a well-managed vaccination certificate.

Tetanus: How often do you vaccinate?

The tetanus primary vaccination consists of four partial vaccinations in children:

  • Primary vaccination in infancy (with 2 months)
  • 2nd vaccination with 3 months
  • 3rd vaccination with 4 months
  • 4. Vaccination at 11 to 14 months

The first refresher is recommended for children aged 5 to 6 years, then again at the age of 9 to 17 years.

In adults who have not received a primary vaccination as a child, the primary vaccination consists of three vaccinations given at intervals of 4 weeks and 6 to 12 months.

The protection is valid for ten years and then has to be refreshed by a new vaccination.

The vaccine against tetanus is also available as a combination vaccine, so that the syringe can also be given together with the vaccine against diphtheria, whooping cough (pertussis) and / or polio (polio).

Who travels abroad or undertakes a long-distance travel, should be vaccinated against tetanus. All vaccinations should be registered in the vaccination certificate so that you always know your vaccination status.

Side effects of tetanus vaccination

The tetanus vaccine is usually very well tolerated, but it may come to (possibly painful) redness or swelling at the injection site. Also, in rare cases in the first few days to general side effects of vaccination can occur, such as:

  • fatigue
  • Muscle aches
  • Gastrointestinal problems
  • increased body temperature and shivering

Side effects such as allergic skin or respiratory reactions are very rare in tetanus vaccination (less than 1 in 1, 000 people affected). Occasionally there have already been diseases of the nervous system. A tetanus disease can not be induced by the vaccine because the vaccine contains the harmless bacterial toxin.

Sources and further information

  • Robert Koch Institute (RKI): Tetanus
  • Robert Koch Institute (RKI): recommendations of the Standing Vaccination Commission
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