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Tetanus: Dr. Zubaida Aimal

Tetanus is caused by Clostridium tetani bacteria, which produces a toxin that causes painful muscle spasms. It is commonly transmitted through wounds contaminated with soil or dust. The document discusses the epidemiology, symptoms, types, prevention through vaccination, and treatment of tetanus. Prevention involves keeping wounds clean, active immunization through vaccines like DPT and TT, and passive immunization with antibodies in certain cases. Vaccination of women of childbearing age and pregnant women is especially important to prevent neonatal tetanus.

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67 views31 pages

Tetanus: Dr. Zubaida Aimal

Tetanus is caused by Clostridium tetani bacteria, which produces a toxin that causes painful muscle spasms. It is commonly transmitted through wounds contaminated with soil or dust. The document discusses the epidemiology, symptoms, types, prevention through vaccination, and treatment of tetanus. Prevention involves keeping wounds clean, active immunization through vaccines like DPT and TT, and passive immunization with antibodies in certain cases. Vaccination of women of childbearing age and pregnant women is especially important to prevent neonatal tetanus.

Uploaded by

khanmoin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

TETANUS

Dr. Zubaida Aimal


MBBS, MPH(UK), MScPH (EU)
Assistant professor
Department of Community Medicine
Army Medical College
TETANUS
 Acute disease induced by exotoxin of
Clostridium Tetani.
 Muscular rigidity
 Persists throughout illness punctuated by
painful paroxysmal spasm of the voluntary
muscles:
 Masseter (trismus or lock-jaw)
 Facial
 Backand neck
 Lower limbs and abdomen
EPIDEMIOLOGICAL
DETERMINANTS
 Agent Factors
 Host Factors
 Environmental & Social Factors
 Mode of Transmission
 Incubation Period
AGENT FACTOR
 Agent: Clostridium Tetani: Gram positive
anaerobic spore-bearing anaerobe
 Reservoir of infection: Soil & Dust
 Exotoxin: Tetanosporin. lethal toxicity
 Period of Communicability: not transmitted
from person to person
RESERVOIR OF INFECTION
 Vegetative form are found in herbivorous
animals : horses, cattle sheep, goat etc
 Soil is reservoir of Tetanus spores
 Organism are excreted and are converted
into spores, they are disseminated widely
by wind and are found everywhere in:
 Soil, dust, objects etc
HOST FACTORS
 Age:
 Common in 5-40 years & Infants
 Gender: Males > females
 Rural-Urban differences: Rural > Urban
 Occupation: Agriculture workers
 Immunity:
No age is immune unless protected by previous
immunization.
Herd immunity does not protect against tetanus
INCUBATION PERIOD
 6– 10 days
 Maybe as short as 1 day or as long as several
months
ENVIRONMENTAL FACTORS
 Unhygienic customs and habits i.e
application of dust & animal droppings to
wounds
 Unhygienic delivery practices i.e using
unsterilized blade for cutting umbilical cord
 Ignorance of infection
 Lack of primary health care services
 Tetanus decreased in developed world-
urbanization,industrialization and
mechanization
MODE OF TRANSMISSION
 Contamination of wounds
with tetanus spores
 pin prick, injury
 skin abrasions
 Burns
 Human bites, animal bites,
 Unsterile syringes,
unsterile division of
umbilical cord
 Otitis media, chronic skin
ulcers, eye infection etc
TYPES OF TETANUS
 Traumatic
 Puerperal
 Otogenic
 Idiopathic
 Tetanus Neonatorum (8th day disease)
NEONATAL TETANUS
 Newborn apparently normal at birth
 Fever after 3-4 days
 Stops taking feed from 5th day, develops
convulsions from 6th day and most children
die on 8th day.
PREVENTION
 Active Immunization
 Passive Immunization
 Active & Passive Immunization
 Antibiotics
ACTIVE IMMUNIZATION
 Diphtheria, Pertussis,
Tetanus (DPT)
At 6, 10 and 14
weeks

 Pentavalent
vaccine given EPI
 At 6, 10 and 14

weeks
SCHEDULE OF TETANUS TOXOID (WHO)
FOR WOMEN OF CHILD BEARING AGE

 TT1: During child bearing age


 TT2: Four weeks after TT1
 TT3: Six months after TT2
 TT4: One year after TT3
 TT5: One year after TT4 or during next
pregnancy
SCHEDULE OF TETANUS TOXOID FOR
PREGNANT WOMEN

• TT1 – As early as
Two possible (first contact)
doses • TT2 – 1 month after
require TT1
d • (preferably before 3
weeks before deliver)
PASSIVE IMMUNIZATION
 Human Tetanus Hyperimmunoglobulin:
 250 IU for all ages
 Protection for 30 days

 Anti tetanus Serum (ATS):


 Ifhuman anti-toxin is not available, ATS can be given
 Can cause severe reaction
ACTIVE & PASSIVE IMMUNITY

 Indicated for unimmunized persons


 Human Ig:
250 IU in one arm
 Tetanus Toxoid
0.5 ml in other arm or gluteal region
Followed by another dose of TT, 0.5 ml after
6 weeks
Third dose of TT , one year later
ANTIBIOTICS
 Penicillin (Benzathine Penicillin)
 Single I/M
 Dose of 1.2 mega units
 Kills any vegetative form of tetanus bacilli but
does not kill spores.
PREVENTION OF NEONATAL TETANUS

 Tetanus Toxoid
Inchildhood
Women of child bearing age
Pregnant women
 Clean Delivery Practices
 Training of traditional birth attendants?
PREVENTION OF NEONATAL
TETANUS
 Infants born to mother who have not
received 2 doses of TT are exposed to risk of
Tetanus
 Injection of antitoxin * 750 IU* within 6 hours
of birth
NATAL CARE
 Emphasis is made on cleanliness.
 Remember the

C
NATAL CARE
Clean hands & fingers
Clean surface for delivery
Clean cutting & care of the
cord
Clean tie of card with no
application on stump
Clean birth Canal-by avoiding
harmful practices.
PREVENTION OF TETANUS AFTER
INJURY
 Wounds thoroughly cleaned
 Removal of any foreign body, soil, dust etc
IMMUNITY CATEGORY OF TETANUS

 A
Has had complete course of TT or booster dose
within the past 5 years
 B
Has had complete course of TT or booster more
than 5 years ago & less than 10 years ago
 C
Has had a complete course of TT or booster
more than 10 years ago
 D
Has NOT had complete course of TT or
immunity status is not known
WOUND CATEGORIES
 All wounds receive surgical toilet
A. Wound less than 6 hours old, clean, non-
penetrating and with negligible tissue
damage.
B. Other wounds
Wound less than 6 hours old, clean, non-penetrating and with negligible tissue damage.

 Immunity Category  Treatment


 A  Nothing more required
 B  TT 1 dose
 C  TT 1 dose
 D  TT complete course
OTHER WOUNDS
 Immunity Category  Treatment
 A  Nothing more required
 B  TT 1 dose
 C  TT 1 dose + Human T Ig
 D  TT complete course + Human T Ig
ANY QUESTIONS?
THANK YOU

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