What is Clostridium tetani?
The bacterium Clostridium tetani occurs in the intestine of animals (especially herbivores) and of humans. The dangerous spores of the pathogen are widespread almost everywhere, for example in garden soil or road dust.
The bacterial spores occur mainly through deep and air-tight wounds, such as by stepping into a rusty nail in the body. But even the smallest skin lesions, such as a splinter of wood, can be a portal of entry for Clostridium tetani.
The source of infection for the so-called neonatal tetanus is the umbilical wound when the newborn is abled in unsterile conditions. The neonatal tetanus usually occurs only in developing countries and shows the highest lethality of all tetanus forms. The World Health Organization estimates that around 180, 000 babies worldwide die of tetanus. In Germany, fewer than 15 people suffer from tetanus per year.
A transfer from person to person is not possible. If the pathogen Clostridium tetani has penetrated the body, it takes a few days to two weeks, in rare cases a few months, until the first symptoms appear. The shorter the incubation period, the more severe the disease process.
Meaning & function
Under anaerobic conditions, ie lack of oxygen in the wound sprout the spores of Clostridium tetani, the bacterium multiplies and forms two very dangerous for the body toxins (toxins): tetanospasmin and tetanolysin. Through the bloodstream or through the nerves, the toxin tetanospasmin enters the spinal cord. There it causes hypersensitivity, increased reflexes and convulsions. The toxin tetanolysin damages the blood and the heart muscle.
As a result of this exposure to the toxins, various symptoms occur. At the beginning, those affected show more general symptoms such as headaches, backaches, muscle aches and fatigue. In addition, feelings of tension in the wound area, sensitivity to light and noise as well as an inner restlessness can occur.
In the case of mild disease progression, locally limited muscle stiffness occurs, especially in the jaw and neck area. However, there are no seizures.
For more severe infections with Clostridium tetani, the above-mentioned muscle rigidity in combination with a high fever first appears. These are followed by muscle spasms. First, masticatory muscles, the muscles of the tongue and the mimic musculature convulse. By the cramping of the facial muscles, the patients show the so-called malicious or devilish grin.
After that it comes to cramps of the neck muscles, the extremities and the abdominal muscles. Sick people usually freeze in an extended position. The cramps are triggered by even the slightest visual or acoustic stimuli.
During these very painful seizures, the affected persons are fully conscious.
Possible complications of an infection with Clostridium tetani are pneumonia, muscle tears, bone distractions and fractures (caused by seizures), as well as possible muscle shortening, joint stiffness and spinal curvature.
Death occurs either through asphyxiation caused by the paralysis of the tongue, pharynx, laryngeal or diaphragmatic muscles or by cardiovascular failure.
Despite the vaccine, 50% of all infections with Clostridium tetani are fatal in the severe form. Without vaccination, the lethality in the severe form is 90%. Crucial is the early administration of an antitoxin. The patients are receiving intensive medical care. With the help of tranquilizers, muscle-relaxing drugs and artificial respiration, the sufferers are to be relieved. If possible, place the patients in a soundproof and darkened room to prevent seizures.
The recovery after a Clostridium tetani infection has lasted only a few days in mild cases. In severe cases, convalescence can take several weeks to months. A disease with tetanus does not leave enough antibodies, so that a new disease is possible.
Possible protection against infection with Clostridium tetani is provided by a tetanus vaccine. In infancy and early childhood is usually a primary immunization, which must then be refreshed every 10 years. In particular, people over the age of 60 years should pay attention to their vaccination, as with increasing age the antibodies against the bacterium are broken down more quickly.