2015-09-01

Tetanus- A distant but not eliminated danger

Tetanus- A distant but not eliminated danger

Tetanus is most likely the most widely accepted of the immunizations, and so more people are immunized against the disease tetanus than any other, and so we are likely to never see someone with it.

And yet a recent report on tetanus in India is a reminder that this illness is not yet gone, and that the only reason we do not see many cases is that so many of us are immunized against it.

http://www.nytimes.com/2015/09/01/health/india-virtually-eliminates-tetanus-as-a-killer.html?_r=0

Tetanus comes from a Greek word meaning stretch because the hallmark of the infection are extreme muscle spasms that literally stretch the body.  The muscles remain in intense spasm for 3-4 weeks, and full recovery can take months.  The toxin the tetanus bacteria makes is considered one of the most poisonous substances known in nature.  

Tetanus is a very unusual infection for several reasons:
  • The germ is a bacteria that does not really invade or attack the body like nearly all other bacterial infections.
  • The germ simply grows a bit in a cut and then produces a toxin.
  • The toxin forces the body's muscles into extremely painful and constant spasm, to such an extreme extent that the jaw, along with all other muscles, is locked into a tensed position, hence the nickname lockjaw.
  • Unlike nearly any other infection, the germ goes dormant outside of living bodies, and turns into a spore that can rest out in the world for many, many years.   Much of the earth has tetanus spores on the surface of land.  Tetanus spores are found in every country, and even in the air of clean spaces.
The report from India dramatically demonstrates that tetanus only becomes rare when nations immunize most of their children against it.   

Before worldwide immunization work succeeded, there were about 800,000 newborns died every year from neonatal tetanus.  Newborns are especially susceptible if their mothers are not immune and if their cords are not clean.

The advent of higher immunization rates has dropped the number of newborns dying from tetanus to 50,000 per year.  India has achieved a 95% immunization rate and has seen newborn tetanus nearly disappear.

BOTTOM LINES
  • The key message from this story is that tetanus is a terrible and deadly disease that we no longer see only because of tetanus immunizations.
  • The many years of immunization against tetanus in the US has done nothing to clear our land from very widespread tetanus spores.
  • There is nothing to stop tetanus from occurring in unimmunized infants, children, and adults.
  • Finally, the story of India dramatizes how tetanus occurs when immunization rates are low, and disappears when they rise.
  • So, we do urge all infants to get immunized, the risk of developing tetanus begins at birth, and never goes away, unless immunization occurs.
To your health,
Dr. Arthur Lavin






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