Tetanus
Cause
The bacterium Clostridium tetani.
Transmission
Tetanus is acquired through exposure to the spores of Clostridium tetani, which are present in soil worldwide.
Nature of the disease
The disease is caused by the action of a potent neurotoxin produced by the bacterium (e.g. when present in dirty wounds). Clinical symptoms of tetanus are muscle spasms, initially of the muscles of mastication causing trismus or “lockjaw”, which results in a characteristic facial expression – risus sardonicus. Trismus can be followed by sustained spasm of the back muscles (opisthotonus) and by spasms of other muscles. Finally, mild external stimuli may trigger generalized, tetanic seizures, which contribute to the serious complications of tetanus (dysphagia, aspiration pneumonia) and lead to death unless intense supportive treatment is rapidly initiated.
Disease burden
Wounds can become infected with the spores of Clostridium tetani anywhere in the world.
Risk for travellers
Every traveller should be fully protected against tetanus. Almost any form of injury, from a simple laceration to a motor-vehicle accident, can expose the individual to the spores.