Tetnus and Lockjaw

Factual Questions
1

Ok… so while trying to untangle a large pile of rusty weed fabric staples today, I referred to said pile as “a big mess of lockjaw just waiting to happen”. However, this made me wonder:
(A) Are lockjaw and tetnus the same thing? I’m assuming they are
(B) What causes it? Isn’t tetnus caused by a virus? I think it is only because you can get a preventative tetnus shot which souns like an immunization to me which sounds like dead/weakened viruses
© What’s the rusty metal connection? Why would a virus hang out on oxidized ferrous material? And where did they hang out back in the Bronze Age?

“I guess one person can make a difference, although most of the time they probably shouldn’t.”

2

I think tetanus is common in soil, and rusty metal is often something that has been lying around in the dirt. It’s not the rustiness itself that causes it, but maybe that’s how the association got made.

3

A) Yep
B) It’s a bacterium, not a virus, and it is indeed common in the soil.
C) Just some WAGs: It’s not the rusty part that’s dangerous, but the puncture part. Tetanus germs do not like oxygen at all, and puncture wounds often seal back over, preventing exposure to air, which makes a fertile breeding ground. The “rusty” part is simply (again, just another WAG) that typically, it’s something (like a nail in a board) that has gone unnoticed for a long while, so it’s had time to rust. Most people upon seeing a case of lockjaw waiting to happen (like a nail sticking out of a board) would turn it over, drive it in or do something to lessen the chance of some unsuspecting person. A fresh nail would probably be just as dangerous.

4

Ahh Tetanus, one of the dread Clostridiums, that fun loving genus of strict anaerobic (no oxygen please) bacteria that brings us gas gangrene, botulism, nasty diarhea, and tetanus.

Lockjaw refers to the symptom of uncontrollable muscle contractions that this disease is so rightfully feared for. This bug is frequently found in the intestinal flora of, drum roll, farm animals; step on any nail that’s been hanging around the pen and you may innoculate yourself, deep in the muscle where oxygen is relatively scant with a spore that will reactivate and, if not stopped, cause you to bend up like a bow string and wish you were dead, which, of course, you soon will be. I’ve read that rare indivduals have survived with only a case of sore muscles, but that’s very rare.

As late as WWII, many soldiers died from contamination of wounds due to the proximity of horses and other animals.

5

“The causative agent of tetanus, Clostridium tetani, is an obligately anaerobic, endospore-forming, gram-positive rod.”

(It’s a bacterium.)

“It is especially common in soil contaminated with animal fecal wastes . . . the symptoms of tetanus are caused by an extremely potent neurotoxin (tetanospasmin) that is released upon death and lysis of the growing bacteria. It enters the central nervous system via peripheral nerves or the blood. An amount of tetanospasmin weighing as much as the ink in one period on this page could kill 30 people . . . The muscles of the jaw are affected early in the disease, which prevents opening of the mouth (lockjaw). . . Most people in the U.S.A. have received the DPT (diphtheria, pertussis, tetanus) immunization, which includes the tetanus toxoid that stimulates the formation of antibodies to fight tetanus toxin.”

(Aside): “The body produces antibodies called antitoxins that provide immunity to exotoxins. When exotoxins are inactivated by heat or by formaldehyde, iodine, or other chemicals, they no longer cause disease but are still able to stimulate the body to produce antitoxins. Such altered exotoxins are toxoids. Whe toxoids are injected into the body as a vaccine, they stimulate antitoxin production so that immunity is produced to disease. Diphtheria and tetanus can be prevented by toxoid vaccination.”

(Back to tetanus): "A patient who has had the full sequence of three doses of toxoid and a booster every ten years should be immune. However, people often do not get boosters on schedule, and serological surveys show that at least 50% of the U.S.A.'s population does not have adequate protection. . . If toxoid has been given before, the secondary immune response to a booster given after the injury will be rapid enough to be protective. Tetanus imune globulin (TIG), which is prepared from the serum of immunized humans, is often given simultaneously to provide temporary immunity. . .

In less developed areas of the world, tetanus arising from the severed umbilical cords of infants is a major cause of death. In some cultures, the practice of dressing the cut umbilical cord with such materials as soil, clay, and cow dung is a major contributor to the development of tetanus. Worldwide, there are probably several hundred thousand cases of tetanus from all causes each year."

“For example, the infection of a wound by Clostridium tetani need be no larger or more painful than a pin prick, yet the organisms in a wound that size can produce enough tetanus toxin to kill an unvaccinated human.”

From: Microbiology, An Introduction, 5th edition, Tortora, Funke, & Case, Benjamin/Cummins Publishing Company, 1995.

If you’ve not had a tetanus shot lately, I suggest getting one. It’s an extremely painful death - I lost a horse to it many years ago.

Facts do not cease to exist because they are ignored. - Aldous Huxley

6

The short answers:

(A) Yes.

(B) Tetanus is caused by a bacteria Clostridium tetani. The muscle spasms that cause lockjaw (aka “trismus”) are caused by the tetanus neurotoxin (called “tetanospasmin”) made by the bacteria…

The tetanus vaccine (which is the “T” in your DPT vaccine) contains a modified form of the toxin (called a “toxoid”), and does not contain the organism itself.

©The bacterium is found in soil and dust and transmission is associated with skin wounds. The rust is irrelavnt, AFAIK, execpt to indicate that the nail is probably old and dirty and thus probably has some of the bacteria on it. The nail is needed to puncture the skin. IOW, and old dirty nail probably has the bacteria on it, and is capable of delivering the bacteria past your skin.

Here’s tons of info on tetanus, which is where I got the quote above.

7

Wow! Very impressive and well researched simulposts, everybody!

Diphtheria Sours all around!

8

A nice light Septic Red for me please. OABTW, in the ER we usually booster anyone with unknown, or more than 5 years since last vaccine, who has a wound, it’s harmless if not needed.
Larry, RN

9

Damn, we’re good. Is this a record or something? Four simulposts with accurate info - kinda looks like we were all sitting around just waiting on someone to ask ‘The Tetanus/Lockjaw Question’.

Make mine a Clostridium Cocktail, please, hold the feces!

Facts do not cease to exist because they are ignored. - Aldous Huxley

10

My work here is finished, guess I’ll duck back over to one on the respiratory threads for a Lung Butter Stout,
Larry, see you in the emergency room.

11
  1. Pets’ nails tend to carry tetanus esp. outdoors pets from dirt, feces, etc.

Should your skin become deeply scratched or punctured by your pet’s nails, consider if you should get a tetanus booster!

  1. Can you receive too much tetanus vaccine?
    The adult booster lasts ten years. As a precaution, often a booster will be given after an accident (puncture, etc.) But… I have heard that even if no trauma, you can get a booster anytime without worry. Is this correct?

I’d rather have a bottle in front of me than a frontal lobotomy - Hawkeye 4077th

12

Hmm… I wouldn’t say you can get boosted without any worry. Vaccines are never risk-free.

This site from the CDC lists the slight risks associated with the DPT vaccine and under what conditions being vaccinated with it might be contraindicated.

I don’t want to overstate the risks, but they are there.

13

DPT!? I thought that when I was getting a tetanus booster, it was just tetanus. Do you need to be boosted in Diptheria & pertussis?

My last tetanus booster, about 8 years ago, made me a bit feverish. I had to ditch chemistry lab and nearly passed out on the subway. ::shrug:: Beats tetanus.

I’m pretty religious about them since horses are a hobby.

14

Animal claws can, indeed, be a source for tetanus infection. I can’t give you a reference right off the top of my head other than personal experience - I work in a vet clinic and attend school to become a vet tech when I can, and we are encouraged to get frequent tetanus boosters (about every 2 years).

The above is quoted from the site originally posted by Alphagene.

Any vaccine, medication, etc. carries a certain risk. Reactions are usually unpredictable, so always contact your doctor if you experience any unusual side effects after any sort of shot or medication.

You can get a tetanus shot separately from the DTP - if you experience a high risk exposure, you will probably get both a tetanus toxoid (TT) shot and a TIG shot (Tetanus Immunoglobulin). The TT stimulates your immune system to develop resistance; the TIG contains actual antibodies (produced by someone who has already been vaccinated) to immediately attack any bacteria that may have already established residence in your wound. Otherwise, tetanus toxin produced by these bacteria could kill you while your immune system is still trying to get in gear.

Facts do not cease to exist because they are ignored. - Aldous Huxley