Tetanus (lockjaw)

Introduction

Tetanus (lockjaw) is caused by toxins produced by a bacteria found in soil that can contaminate cuts and wounds. Tetanus may cause widespread muscle stiffness, muscle spasms and breathing difficulties. Tetanus is uncommon in Australia due to the widespread use of the tetanus vaccine.

Tetanus bacteria live in soil, dust and manure. Infection occurs when bacteria enter the body through a break in the skin. Tetanus symptoms include:

• muscle spasms that begin in the jaw and neck
• inability to open the mouth (lockjaw)
• swallowing problems
• breathing difficulties
• painful convulsions
• abnormal heart rhythms.

Serious and potentially lethal complications include:

• suffocation
• respiratory failure
• pneumonia
• hypertension
• heart attack.

Symptoms occur between three days and three weeks after infection. Most cases occur within 14 days. Generally, if symptoms appear quickly, the infection is severe.

Anyone who has not been immunised against tetanus is at risk, in particular:

• people who work with soil, horses, or in dusty environments
• intravenous drug users
• Australians travelling overseas to parts of Asia, South America or Africa
• people who have high-risk wounds are more likely to be infected with tetanus bacteria.

High-risk wounds

Some wounds are more likely to encourage the growth of tetanus bacteria, including:

• compound fractures
• burns
• animal bites
• any type of penetrating wound, such as from a rusty nail or rose thorns
• wounds contaminated with soil, manure or foreign objects like wood fragments.

Diagnosis is usually made by physical examination and taking medical history, including information about immunisation. It is difficult to confirm a diagnosis through laboratory tests.

Tetanus is a life-threatening disease and sometimes, death will occur, even with prompt medical attention.

Treatment for tetanus includes:

• antitoxins to neutralise any tetanus toxin
• hospitalisation
• anti-convulsive medications
• antibiotics
• life support (if a child has severe breathing problems)
• vaccination.

Seek medical advice for dirty wounds/wounds where the skin has been penetrated. Doctors may advise a tetanus booster shot, depending on how long since the last tetanus dose.

In NSW, the tetanus vaccine is available in a combined immunisation that also contains vaccines against other serious and potentially fatal diseases. For the treatment of a tetanus-prone wound, the doctor/nurse will administer a dose of diphtheria and tetanus vaccine.