Tetanus and tetanus shot

Tetanus is a disease that is still rare in the Netherlands, thanks to the tetanus shot or the national vaccination. On average, 100 people used to die from tetanus every year, now 5 people die every year. Most people who die from it are unvaccinated children or adults.

What is tetanus?

Tetanus is a serious disease caused by the bacterium Clostridium tetani. This rod-shaped bacterium is common in the Netherlands in soil, street dirt and horse manure. The bacteria can also be found in the gastrointestinal tract of animals. The bacterium prefers to develop in an oxygen-poor environment and is heat sensitive. The spores of the bacteria are spread in manure and in the soil. The spores are also abundant in street dirt.
The bacteria can enter a wound, for example during a fall on the street. The bacteria can also penetrate the skin in burns. A miscarriage or an ear infection with discharge from the ear is also a cause. The bacteria produces a strong poison called tetanus toxin. This poison spreads through the blood and lymph throughout the body. The disease is currently referred to as tetanus. Tetanus can be fatal: the risk of death is up to 100 percent.

Street dirt, soil or an animal bite

The bacterium Clostridium tetani is mainly found in street waste and in the soil. Horse manure used to be notorious for this bacteria. This is because the bacteria reside in the gastrointestinal tract of animals. Because horse and carriage used to be a normal use on the streets, streets were often full of contaminated horse manure. Horses are sensitive to this bacteria. They can be carriers of the bacteria through the gastrointestinal tract, but they can also be infected with the bacteria through a wound. In the latter case, the horse itself also becomes ill. Nowadays almost all horses have been vaccinated against this bacterium.
Other sources of infection through animals include the bite of a dog, scratching by a cat, the bite of a wild animal such as a rabbit, a fox or another animal. In general, domesticated pets that stay mainly indoors are less likely to carry the bacteria.

Tetanus shot or injection

In the Netherlands, vaccination against tetanus is standard practice. This is included in the national vaccination programme. Children up to 1 year old are vaccinated with the DPTP vaccine (diphtheria, whooping cough, tetanus and polio). Children aged four and nine are vaccinated again against tetanus using the DTP vaccine (diphtheria, tetanus, polio). The vaccination provides protection for up to 15 years. It is generally assumed that people up to 24 years old are fully protected against tetanus provided they have had the national vaccinations. For people aged 25 and over, a vaccination is administered if there is an injury that requires medical care. If the last vaccination was more than ten years ago, an Anti Tetanus Serum (ATS) and toxoid are administered. If the last vaccination was between 1 and 5 years ago, only a toxoid is administered. This varies per region.
A toxoid provides immunity fairly quickly after administration because the active substance is introduced. An Anti Tetanus Serum is the dead substance. This ensures that the body itself produces an antibody.

Symptoms and treatment of tetanus

Anyone who has contracted tetanus will show a number of symptoms. First, stiffness will occur near the wound. This stiffness continues to spread to other parts of the body. External factors can cause muscle cramps such as cold, touch or sounds. Muscle stiffness occurs in the jaws, also called jaw cramps. Swallowing complaints and breathing problems then occur. All the muscles become so tense that the patient is sometimes pulled backwards because the back muscles cramp. This entire process takes approximately 4 to 6 weeks. The patient remains conscious. High fever may occur, sometimes even hyperthermia. Broken bones and cardiac arrhythmias may occur. If tetanus is not treated, the risk of death is high. With proper treatment, the chance of death is 20 to 40 percent. This indicates that tetanus is a very dangerous disease that cannot always be cured even with proper treatment. Vaccination is therefore very important.