Tetanus is a severe disease caused by a neurotoxin which is produced by Clostridium tetani bacteria. Transmission occurs when spores are introduced into the body, most often through wounds. Tetanus is not spread from person to person.
The toxin produced by the bacteria cause a number of different symptoms including spasm of facial muscles e.g. “lock jaw”.
People of all ages can acquire tetanus infection, but it is particularly common and serious in newborn babies. Early diagnosis and treatment for tetanus can be life-saving.1
Clostridium tetani spores are present in the intestine of most mammals (including horses, sheep, cattle, dogs, cats, rats, guinea pigs and chickens). They are passed into soil via faeces.
The disease is spread when material containing tetanus spores contaminates a wound. In anaerobic conditions the spores germinate and a toxin is produced. The toxin travels throughout the body via the blood, causing symptoms.
Risk of tetanus is higher in:
Wounds considered to be a high risk for tetanus are those that show one or more of the following:
Although C.tetani is found worldwide, tetanus infections are rare in developed countries. In developing countries tetanus is predominant in neonates and children, due to inadequate immunisation and poor local medical practice.
An estimated 12476 cases of tetanus occurred globally in 2017. Between 2011–2016, 72 600 deaths globally were attributed to tetanus.2
The incubation period for tetanus is on average 7-21. If left untreated, the symptoms can get worse over the following hours and days. The shorter the incubation period, the worse the severity of the disease. The incubation period of neonatal tetanus is 3-10 days.
Symptoms of tetanus include:
Complications of tetanus infection may include:
If tetanus is suspected seek medical attention as soon as possible.
Tetanus requires hospital admission and possible treatment may include:
Management of tetanus prone wounds:
Effective vaccination is available and all travellers should be immunised regardless of age. Travellers should be up to date on their tetanus immunisation (regardless of their age). They should be aware of the risk of accidents while travelling.
It is important to seek urgent medical attention in the case of a tetanus prone wound as thorough cleaning of the injury is essential and further vaccine/immunoglobulin may be recommended.
Tetanus infection does not confer immunity; immediate vaccination (inactivated tetanus toxoid) is too slow to address a current infection. Antibiotics for prophylaxis against tetanus in wound management are not recommended. They are only given for an active infection.1
Travellers should consider getting vaccinated against tetanus if:
A total of 5 doses of vaccine at the appropriate intervals are considered to give satisfactory long-term protection. The UK schedule for primary immunisation is as follows:
Those who miss a dose need to resume the schedule but do not need to have repeat doses. There should be a minimum for one month in between doses of the vaccine.
The UK schedule for reinforcing immunisation is as follows:
For travellers to areas where medical attention may not be accessible and whose last dose of a tetanus-containing vaccine was more than 10 years previously, a booster dose should be given prior to travelling, even if the individual has received five doses of vaccine previously. This is in case immunoglobulin is not available should a tetanus-prone injury occur.
Travellers who have never had a tetanus vaccination before are advised to have as many of the 3 initial doses as possible before travelling, ensuring sufficient time between each dose. The completion of the full course is advised upon return.5
This information is taken from trusted third party websites, NaTHNaC (Travel Health Pro) and EMIS (Patient info) and use of all information has been licenced under the Open Government. Licence http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/
Although the materials are being used/replicated under the provisions of the Open Government Licence this in no way represents endorsement of Traveljab.co.uk by NaTHNaC, Emis, Public Health England, the NHS or the Department of Health and Social Care.