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Tetanus and the Traveler

tetanus information for travelers
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I used to think of tetanus as the disease of rusty nails and locked jaws. Turns out, I didn’t know crap about the disease.

While it’s true that early stages of infection with tetanus bacteria can cause spasms in the jaw muscles, the whole rusty nail thing is a bit overdone. But we’ll get to that in a second.

What is tetanus?

Tetanus is a bacteria that can cause a nasty infection in humans. It is fatal in some cases, but often patients recover with a treatment regimen. What’s more, the disease can be effectively prevented through vaccination (in first world countries, vaccinations are considered routine).

How do you get tetanus?

Spores of tetanus bacteria are found in soil and they are not limited to one part of the world — they are found everywhere. This is not a bacteria that can cause an infection by ingestion. The spores can cause an infection if they enter the body through an open wound. While it’s true that you can get tetanus from a rusty nail, this mode of infection is not exclusive. A rusty object may be more effective at delivering infection because it can cause a deeper wound and it because it is a good environment for harboring anaerobic bacteria (bacteria that thrive without oxygen) and tetanus falls into this category of bacteria. However, if the rusty nail has not been contaminated with soil containing spores, you are not at risk of tetanus infection.

What happens if you get it?

Tetanus is not a fun illness. The spores of the bacteria actually create a poison in the body, which goes on to block nerve signals that travel between the spine and the muscles of the body. This leads to violent spasms. Violent enough that they can actually tear muscles and in some cases, they can cause spinal fractures.

Diagnosis typically involves observation, medical history and a physical examination. There are no blood or spinal fluid tests that can be administered to confirm infection. Based on the examination, there are several options for treatment. Patients will often be given an antibiotic like metronidazole (yes, the same antibiotic that is often prescribed for amoebic dysentery). In addition, patients may receive muscle relaxers, sedatives, and possible further treatment depending on the severity. With treatment, less than 10% of cases are fatal. On the other hand, if treatment is not given, that percentage rises to 25%.

How can tetanus be avoided?

Yes, tetanus can be prevented. A highly effective vaccine is available. If offers at least 10 years of immunity (some studies have shown up to 12 years, but doctors still advise 10 years as the limit) after which point a booster shot is required for continued immunity. It is often considered part of a package of routine vaccinations that are given to children and then continued into adulthood. We mentioned some of these routine vaccinations in our piece on travel immunizations here.

There is simply no reason not to get this vaccine. It is effective, it is unlikely to produce side effects and it confers immunity for many years.

Do travelers have a particular risk of getting tetanus?

No, travelers are at no greater risk of getting tetanus. This bacteria is found worldwide and is not restricted to any one particular area. That said, if you are going to be spending a lot of time doing sports and other activities outdoors where you may come into frequent contact with soil, your risk may be somewhat elevated.

The bottom line is that this is a vaccine you should get without thinking twice. If you are an adult and can’t remember when you last had a booster, you should call up your doctor and check on your immunization records to find out.

Photo credit: flickr user myheimu

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