Tetanus, which is preventable through immunization (tetanus immune globulin), affects the nervous system and can be fatal. Generalized tetanus is the most common kind, but it can be localized, affecting only the part of the body where the infection entered. In most cases, however, the infection spreads throughout the entire body when bacteria from an infected wound is released into the bloodstream, particularly if a wound is deep or dirty. Generally referred to as lockjaw, the bacteria naturally lives in the intestines of humans and animals where it does not cause disease. The bacteria is also found in soil, animal feces and manure, where it can cause problems if an injury becomes contaminated.
Onset of Symptoms
Tetanus symptoms can appear anytime between five days to 15 weeks after a cut or deep puncture injury occurs. However, the incubation period is normally between three days to three weeks. Diagnosis is usually based on physical symptoms. There are no laboratory tests available that accurately detect the disease. The toxin spreads to the nerves as bacteria from an infected wound is released into the bloodstream. If the disease is localized, a person may experience pain or tingling at the site where the infection began.
Bacteria spores produce a toxin that affects the body’s central nervous system. The toxin prevents the release of an amino acid known as glycine, which contributes to muscle movement. Jaw, face and neck stiffness are among the first symptoms to present. Locking of the jaw leads to difficulty opening the mouth and swallowing and can eventually lead to respiratory muscle paralysis. Other symptoms of the disease may include diarrhea, bleeding into the bowels, headache, fever, sore throat, chest pain and sensitivity to touch.
The disease is progressive with symptoms eventually affecting the muscles in the arms and legs, causing pectoral and calf muscles to become rigid. Muscle spasms can cause the abdomen to tighten, the head to tilt and the spine to arch backwards if spasms spread to the back. This particular symptom is common in children with tetanus. Spasms can affect the neck, back, abdominal muscles and respiratory muscles in the chest, the latter of which can constrict the airways, causing airway obstruction and acute asphyxia or suffocation.
Complications From Symptoms
Tetanus symptoms can contribute to complications such as difficulty breathing, injury to the spine or broken bones caused by severe, convulsive muscle spasms, rapid heart rate and elevated blood pressure. Secondary infections frequently occur because of long hospital stays in intensive care throughout recovery, increasing a person’s exposure to hospital-borne infections.
Symptoms That Cause Death
While the exact cause of how tetanus causes death is unknown, there are many different theories. Symptoms of tetanus have been known to cause death by contributing to cardiac arrest, kidney failure, blood poisoning and suffocation due to muscle spasms. Death may also be caused by exhaustion brought on by repeated, uncontrollable muscle contractions. In cases when death occurs early on in the disease, anoxia is often attributed as the reason. Anoxia is a consequence when not enough oxygen is being delivered to the tissues and organs in the body even though blood is circulating. The condition can be brought on by suffocation, which can be caused by symptoms of tetanus.
The earlier the symptoms of tetanus appear, the greater the chance of death from related complications. The incubation period for the disease is longer if the wound affects a part of the body farther away from the central nervous system. Even though people have a tendency to relate tetanus to the puncture wound from stepping on a rusty nail, any cuts, abrasions, animal bites or simple lacerations can become infected with the bacteria. Even tattoos, body piercing, burns, abortion and dental infections put a person at risk for symptoms of the disease. A report issued by the Centers for Disease Control and Prevention shows that about 20 percent of the cases of tetanus reported in the United States end in death. Of the reported number, 60 percent of the cases occurred among individuals older than 40. Most people who die from tetanus are age 50 and older.