While most horror movies show you a beast with mouth wide open and frightening teeth, actually a Lockjaw is a much more terrifying experience especially if it was caused by Tetanus. Tetanus bacteria are ubiquitous, lurking mainly in soil dust and manure. Once introduced through a skin cut, Tetanus spores will find receptive environment to turn back to active bacteria that secret the Tetanus toxin. This poison travels upstream along the nerve fibers till it reaches the central nervous system.

If the first thing that jumped to your minds when we say nerves is those tiny cords giving Go-Go signals to your muscles, think again. Actually, the Go-Go signals are only part of the story and the Stop-Stop signals that are transmitted by the nerves are as important. Tetanus poison allows the flow of Go signals but blocks the Stop signals from flowing. Unfortunately, to the Tetanus patient this means mayhem, where his muscle will continue to contract after an initial Go signal without receiving the finishing of action Stop signal.

Symptoms:

– Locked jaw

– Stiffness of the neck

– Difficulty swallowing

– Rigidity of the chest, arms and legs muscles

All these uncontrollable muscle contractions will lead to:

– Fever

– Elevated blood pressure

– Rapid heart rate

– Diffuse sweating

The unopposed muscle contractions can be severe enough to break some bones; the involvement of swallowing muscles makes drooling part of the disease picture with inability to swallow even patient’s own saliva. The heart as a muscle is spared from the effect of Tetanus, but respiratory muscle are affected, giving the patient sensation of inability to breathe while gurgling on his accumulating mouth secretions. Tetanus doesn t offer permanent immunity due to the extreme potency of the Tetanospasmin poison. Treatment depends on giving Tetanus Toxoid, better yet don’t wait too long to receive the tetanus vaccine because you will never know when you will meet that rusty nail or dirty splinter of glass.

Tetanus vaccine is given at 2, 4 and six months of age with booster shots at one and a half and four years of age. 9] The center for disease control recommends that adults receive a booster vaccine every ten years.

Written by Dr. Ammar Al Hakim, Pediatric consultant