Registered nurse Sarah Hollingsworth provides a tetanus shot to a first responder in tornado-ravaged Tuscaloosa

Tetanus: no fun

You do not want to get infected with tetanus. The disease, which used to kill about 40 to 50 Canadians a year in the 1920s and ’30s, is now only rarely reported. In recent years, Canada has seen, on average, only a couple of cases a year. But doctors who have seen what tetanus does do not forget it.

You do not want to get infected with tetanus.

The disease, which used to kill about 40 to 50 Canadians a year in the 1920s and ’30s, is now only rarely reported. In recent years, Canada has seen, on average, only a couple of cases a year.

But doctors who have seen what tetanus does do not forget it.

The bacteria multiply and start producing toxins that force muscles into painful contractions. One of the first places where those contractions take hold is in the muscles of the jaw — that’s where tetanus’s other name, lockjaw, comes from. Patients are racked with spasms.

It can take weeks and even months for the toxins to break down and the muscles to release, if they do. Between 10 and 20 per cent of tetanus cases die.

Infectious diseases specialist Dr. Allison McGeer vividly recalls the first time she saw a tetanus case. She remembers the date without needing to consult notes or a calendar. It was Nov. 1, 1981, and she was a medical intern, a doctor in training.

It was the first day in her medicine rotation and McGeer was in the emergency department. In walked a British man in his late 70s.

“He said ‘I think I have lockjaw,”’ McGeer recalls.

“Three hours later, he was intubated and paralyzed. And he stayed in the ICU until the end of February. I have absolutely no idea how he survived.”

The disease is caused by the bacteria Clostridium tetani, which are found in soil all over the world. The bacteria form spores, a hardy casing that helps them survive.

Because the bacteria are in soil, they are also in dust, so the spores can settle on objects like the thorns of a bush or a fence. Typical tetanus stories involve gardening, which is why health practitioners aggressively promote the shots around this time of year.

“Gardening is particularly bad because you have your hands in soil…. You’re more likely to injury your hands when you are gardening — which is why people focus on the gardening. Doing anything outside,” McGeer says.

People who haven’t been vaccinated but who have been exposed — or possibly exposed — are treated with tetanus immune globulin, tetanus antibodies taken from donated blood.

Treatment involves placing patients into induced comas to try to combat the spasms. Patients are also put on ventilators, machines that breathe for them.

“You sedate the hell out of them so they’re not awake, and then every once in a while you let the paralysis lift to see if they go into spasm. And if they go into spasm, you paralyze them again and you just wait,” McGeer says.

But the toxins wreak havoc on the rhythm of the heart. Victims can experience tachycardia — a rapidly racing heart beat — for hours on end. That can interfere with the circulation of blood, causing organs like kidneys to go into failure.

Dr. Ian Gemmill, the medical officer of health for the health unit that serves four counties in and around Kingston, Ont., has memories of a different tetanus case. In 1985, a man from his region was walking when he got knocked over by a cyclist. His face was abraded when it scraped the ground.

When emergency room staff treat skin wounds, they will often give tetanus vaccine, just to be on the safe side. But because this man had been in the Armed Forces, health professionals assumed he had had tetanus shots at some point in his life. He had not.

“It’s a very nasty death because one can’t breathe anymore, so you have to be intubated. And then it’s a question of whether or not that very tightly binding protein, which is paralyzing muscle, can be removed over time. Or can you keep the person alive long enough … before other complications lead to death?”

Fortunately, doctors in Canada these days don’t often have to struggle to keep tetanus patients alive, because a large proportion of the population has been vaccinated.

Tetanus is among the shots given in childhood.

It’s bundled in vaccines that protect against diphtheria, pertussis (whooping cough), polio and Hemophilus influenzae type B.

Any child who has had all his or her shots will be protected against tetanus. But that wouldn’t be true for children whose parents refuse to vaccinate them. Those children would all be at risk.

With some diseases, unvaccinated children are shielded to a degree because most children are vaccinated. Diseases like measles and chickenpox are much rarer these days because so many children can’t catch — and therefore don’t spread — these viruses. That’s a phenomenon called herd immunity.

But there is no herd immunity against tetanus, Gemmill notes. Because the source of infection is the environment, the only way an individual can be protected is if he or she is vaccinated.

Adults need tetanus booster shots every 10 years to maintain the needed level of protective antibodies. For adults, the vaccine comes in a serum that also protects against diphtheria and pertussis.

“Think about tetanus this time of year, especially if you’re a gardener or you’re working with your hands,” says Gemmill.

“Because that’s exactly the kind of person who might sustain a injury.”

Just Posted

Sylvan Lake council adopts waterfront plan

Sustainable Waterfront Area Redevelopment Plan to guide development for next 20 years

Two people die in Rocky-area collision

Rocky Mountain House RCMP investigate

RDC launches week of activities focusing on student mental health

Learners invited to join the discussion at #MakeSomeTimeRDC

Husky Energy walks away from its hostile takeover bid for MEG Energy

CALGARY — Husky Energy Inc. is walking away from its hostile takeover… Continue reading

Trudeau says politicians shouldn’t prey on Canadians’ fears

The Prime Minister was speaking at a townhall in Ontario

Teen vaping is an epidemic: US government

E-cigarettes are now the top high-risk substance used by teenagers, outpacing cigarettes, alcohol, marijuana

‘I never said there was no collusion,’ Trump lawyer says

President Donald Trump’s lawyer Rudy Giuliani says he has ‘never said there was no collusion’

Body of Canadian miner found after African kidnapping

Kirk Woodman’s body was discovered 100 kilometres from the site where he worked for Progress Mineral Mining Company in Burkina Faso

Canada’s Conners on his way to full PGA Tour card with fast start to 2019 season

Corey Conners was working on his putting last Friday when fellow Canadian… Continue reading

Canada’s Milos Raonic, Denis Shapovalov advance at Australian Open

MELBOURNE, Australia — Canada’s Milos Raonic and Denis Shapovalov have advanced to… Continue reading

Study finds more than half of food produced in Canada wasted

The study released Thursday is the world’s first to measure food waste using data from industry and other sources instead of estimates

AP Exclusive: A peek at how Disney resort shows are made

LAKE BUENA VISTA, Fla. — With excitement building over a new “Star… Continue reading

Justin Bieber’s ‘Steps to Stardom’ hometown exhibit makes plans for a book

STRATFORD, Ont. — Justin Bieber’s meteoric rise to pop stardom will be… Continue reading

Most Read