Tetanus Health Article

Treatment

Treatment may include:

• Antibiotics, including penicillin, clindamycin, erythromycin, or metronidazole (metronidazole has been most successful)
• Bedrest with a nonstimulating environment (dim light, reduced noise, and stable temperature)
• Medicine to reverse the poison (tetanus immune globulin)
• Muscle relaxers such as diazepam
• Sedatives
• Surgery to clean the wound and remove the source of the poison (debridement)

Breathing support with oxygen, a breathing tube, and a breathing machine may be necessary.

Expectations (prognosis)

Without treatment, one out of four infected people die. The death rate for newborns with untreated tetanus is even higher. With proper treatment, less than 10% of infected patients die.

Wounds on the head or face seem to be more dangerous than those on other parts of the body. If the person survives the acute illness, recovery is generally complete. Uncorrected episodes of hypoxia (lack of oxygen) caused by muscle spasms in the throat may lead to irreversible brain damage.

Complications

• Airway obstruction
• Respiratory arrest
• Heart failure
• Pneumonia
• Fractures
• Brain damage due to lack of oxygen during spasms

Calling your health care provider

Call your health care provider if you have an open wound, particularly if:

• You are injured outdoors.
• The wound has been in contact with soil.
• You have not received a tetanus booster (vaccine) within 5 years or you are not sure of your vaccination status.

Call for an appointment with your health care provider if you have never been immunized against tetanus as an adult or child, if your children have not been immunized, or if you are unsure of your tetanus immunization (vaccine) status.

Prevention

Tetanus is completely preventable by active tetanus immunization. Immunization is thought to provide protection for 10 years. Studies of soldiers suggest that good protection persists up to 12 years after the last immunization.

In the United States, immunizations begin in infancy with the DTaP series of shots. The DTaP vaccine is a "3-in-1" vaccine that protects against diphtheria, pertussis, and tetanus. It is a safer version of an older vaccine known as DTP, which is no longer used in the U.S.

Td vaccine or Tdap vaccine is used to maintain immunity in those age 11 and older. Tdap vaccine should be given once, prior to age 65, as a substitute for Td for those who have not had Tdap. Td boosters are recommended every 10 years starting at age 19.

Older teenagers and adults who have sustained injuries, especially puncture-type wounds, should receive booster immunization for tetanus if more than 10 years have passed since the last booster.

Thorough cleaning of all injuries and wounds and the removal of dead or severely injured tissue (debridement), when appropriate, may reduce the risk of developing tetanus. If you have been injured outside or in any way that makes contact with soil likely, contact your health care provider regarding the possible risk for tetanus.

Many people believe injuries caused by rusty nails are the most dangerous. This is true only if the nail is dirty as well as rusty, as is usually the case. It is the dirt on the nail, not the rust, that carries the risk for tetanus.