Tetanus in Times of Trouble
October 7, 2012
16 Comments
Most of us have dutifully gone to get a Tetanus shot when we stepped on a rusty nail, but few have any real concept of what Tetanus is and why it is dangerous. The role of the survival medic is to maintain the well-being of their family or group in a collapse. This can be best assured with an understanding of what infectious disease is. Knowledge of risks, prevention. And treatment will be the armor plate in your medical defense.
Tetanus (from the Greek word tetanos, meaning tight) is an infection caused by the bacteria Clostridium Tetani. The bacteria produces spores (inactive bacteria-to-be) that primarily live in the soil or the feces of animals. These spores are capable of living for years and are resistant to extremes in temperature.
Tetanus is relatively rare in the United States, with about 50 reported cases a year. Worldwide, there are more than 500,000 cases a year, however. Most are seen in developing countries in Africa and Asia that have poor immunization programs. Citizens of developed countries may be thrown into third world status in the aftermath of a mega-catastrophe. Therefore, we can expect many more cases that could be your responsibility as medic to evaluate and treat.
Most tetanus infections occur when a person has experienced a break in the skin. The skin is the most important barrier to infection, and any chink in the armor leaves a person open to infection. The most common cause is some type of puncture wound, such as an insect or animal bite, a splinter, or even that rusty nail. This is because the bacteria doesn’t like Oxygen, and deep, narrow wounds give less access to it. Any injury that compromises the skin, however, is eligible; burns, crush injuries, and lacerations can also be entryways for Tetanus bacteria.
Tetanus Spores 
When a wound becomes contaminated with Tetanus spores, the spore becomes activated as a full-fledged bacterium and reproduces rapidly. Damage to the victim comes as a result of a strong toxin excreted by the organism known as Tetanospasmin. This toxin specifically targets nerves that serve muscle tissue.
Tetanospasmin binds to motor nerves, causing “misfires” that lead to involuntary contraction of the affected areas. This neural damage could be localized or can affect the entire body. You would possibly see the classical symptom of “Lockjaw”, where the jaw muscle is taut; any muscle group, however, is susceptible to the contractions if affected by the toxin. This includes the respiratory musculature, which can inhibit normal breathing and become life-threatening.
The most severe cases seem to occur at extremes of age, with newborns and those over 65 most likely to succumb to the disease. Death rates from generalized Tetanus hover around 25-50%, higher in newborns.
You will be on the lookout for the following early symptoms:
- Sore muscles (especially near the site of injury)
- Weakness
- Irritability
- Difficulty swallowing
- Lockjaw (also called “Trismus”; facial muscles are often the first affected)
Newborn with Arching Back Typical of Generalized Tetanus
Initial symptoms may not present themselves for 1- 2 weeks. As the disease progresses, you may see:
- Progressively worsening muscle spasms (may start locally and become generalized over time)
- Involuntary arching of the back (sometimes so strong that bones may break or dislocations may occur!)
- Fever
- Respiratory distress
- High blood pressure
- Irregular heartbeats
The first thing that the survival medic should understand is that, although an infectious disease, Tetanus is not contagious. You can feel confident treating a Tetanus victim safely, as long as you wear gloves and observe standard clean technique. Begin by washing your hands and putting on your gloves. Then, wash the wound thoroughly with soap and water, using an irrigation syringe with 3% hydrogen peroxide to repeatedly flush out any debris. This will, hopefully, limit growth of the bacteria and, as a result, decrease toxin production.
You will want to administer antibiotics to kill off the rest of the Tetanus bacteria in the system. Metronidazole (Fish-Zole or Flagyl) 500mg 4 times a day or Doxycycline (Bird-Biotic) 100 mg twice a day are among some of the drugs known to be effective. This study compares the use of Metronidazole versus Penicillin G: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1417474/
Remember, the earlier you begin antibiotic therapy, the less toxin will be produced. IV rehydration, if you have the ability to administer it, is also helpful. The patient will be more comfortable in an environment with dim lights and reduced noise.
Late stage Tetanus is difficult to treat without modern technology. Ventilators, Tetanus Antitoxin, and muscle relaxants/sedatives such as Valium are used to treat severe cases but will be unlikely to be available to you in a long term survival situation. For this reason, it is extraordinarily important for the survival medic to watch anyone who has sustained a wound for the early symptoms listed above.
As medic, you must obtain a detailed medical history from anyone that you might be responsible for in times of trouble. This includes immunization histories where possible. Has the injured individual been immunized against Tetanus? Most people born in the U.S. will have gone through a series of immunizations against Diptheria, Tetanus, and Whooping Cough early in their childhood. If not, encourage them to get up to date with their immunizations against this dangerous disease as soon as possible. Booster injections are usually given every 10 years (or if 5 years have passed in a person with a fresh wound, sometimes along with Tetanus Immunoglobulin antitoxin).
Tetanus vaccine is not without its risks, but severe complications such as seizures or brain damage occur is less than one in a million cases. Milder side effects such as fatigue, fever, nausea and vomiting, headache, and inflammation in the injection site are more common.
Given the life-threatening nature of the disease, this is one vaccine that you should encourage your people to receive, regardless of your feelings about vaccines in general. If not caught early, there may be little you can do to treat your patient without all the bells and whistles of modern medicine.
Dr. Bones.
To learn more: http://whqlibdoc.who.int/hq/2010/WHO_HSE_GAR_DCE_2010.2_eng.pdf
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And Joseph MD is no doubt heavily indentured to his industry that would be defunct if vaccines were forever forgotten which is exactly where they belong…
So other than the fact that you are a pure idiot, you’re saying that you would rather countless people die from diseases that we have cures for…. Right, ok. That makes a lot of sense.
There were 500,000 to 1,000,000 cases of tetanus worldwide last year,
almost all in undeveloped countries with little or no immunization
programs. There were 50 cases in the U.S. last year, a place with a
immunization program. I’m retired, and I had no “indenture” to anyone
then and I don’t now. I was one of the first physicians to adopt
alternative remedies and midwifery in my state, and I’m proud of that.
I
understand that vaccines are a sensitive subject to some and they
certainly come with some risks, but take a look at the images of the
tetanus victims in the article. What would you tell tem?
There were 500,000 to 1,000,000 cases of tetanus worldwide last year, almost all in undeveloped countries with little or no immunization programs. There were 50 cases in the U.S. last year, a place with a immunization program. I’m retired, and I had no “indenture” to anyone then and I don’t now. I was one of the first physicians to adopt alternative remedies and midwifery in my state, and I’m proud of that.
I understand that vaccines are a sensitive subject to some and they certainly come with some risks, but take a look at the images of the tetanus victims in the article. What would you tell them?
You see, when you step on a rusty nail in the barnyard, Tetanus has EVERYTHING to with the barnyard and very little to do with the rusty nail. #1 source of tetanus in the U.S. is rose gardening (i.e. thorn and manure).
absolutely right, Nurse Nancy!
I believe this is what my favorite poet, Rainer Maria Rilke, died from!
Thanks you convinced me I am going to make sure my shots are up to date.
I was 21 when I cut my hand on a rusty can that I threw up into the air for my husband to shoot. I went immediately and got a booster for tetanus. For the next three days, I could not move, eat or drink without extreme pain. My husband had to help me from the bed to commode and pull me off the commode. I forced myself to sip water. When he moved on the very new mattress that was firm, I could feel it and cried out. The sheet over me hurt. I lay in one position for hours until I had him assist me in turning or moving. For three days, even though I felt I was dying, he refused to take me to the doctor or ER.
Four years later, my first child accidentally hit the second one (about two years old) in the eye with a rusty, toy rake, leaving some pretty huge gashes in her eyelid very near the eye. The ER doctor gave her a booster or scheduled one in series. She almost immediately (30 min) became stiff, crying out when she was picked up or touched. I took her to the doctor who just said he did not know what was wrong! For three days, her eyes were closed. She was stiff as a board. I had to actually bend her to get her to sit on the commode. Then, I had to cajole her to drink, She had difficulty swallowing. I could not get her to say a word.
For the last 45 years since my episode, I have avoided live TETANUS vaccines. After my daughter’s episode, I never allowed any of my three children to have a live booster. Now, I have the doctor prescribe the killed vaccine, go to the pharmacy, pick it up, and return to the doctor’s office to have it administered. On a humorous and horrific note, the last time I injured myself, I debated whether to go to the doctor. I finally did and headed off in a rush to see the play, “The Night Thoreau Spent in Jail.” Well, it turned out that Thoreau’s brother died from tetanus. I was shaking with relief that I had gone to the trouble to get the killed/dead vaccine.
I am all for vaccines. But, I am terrified, absolutely terrified, of taking another TETANUS booster. When that daughter married, I reminded her of the tetanus vaccine. When she had children, I reminded her many times of our experience. I also warned the other two of the incident.
My doctor that I began to distrust told me that there was no reports of any reactions to tetanus or the booster. I knew he was a liar! Now, I know the truth.
An army medic, one of my friends, said that I was probably fully immune to tetanus, so I had the reaction. ???
Even though my second daughter was hospitalized after her 18 month DPT, throwing up uncontrollably and unable to stand due to dehydration, I still believe in vaccinations. The same doctor who said there were no reactions to tetanus vaccines, was the one who sent me home three days in a row when she was throwing up with elevated temperature. Finally, she did quit throwing up, but she could not stand or even sit up!
I do get my vaccines, but at 66, I worry even more about the tetanus booster.
Clearly, there are risks to vaccines and you are one of the people that have shown a sensitivity to the vaccine. Your family history makes me believe that there is some genetic component to this sensitivity. Indeed, you should probably stay away from live vaccine. Thanks for sharing your story.
Dr. Bones
Should I stay away from all live vaccines or just the live tetanus?
When I had my baby shots, I developed a fierce, large cyst that the doctor lanced, leaving me with a cute dimple on my upper right arm. However, I am told this cyst formation is not uncommon. Now, I wonder. I guess it was a cyst–infected pocket of pus. Do you think that was a part of our genetic sensitivity?
When I am asked about allergies at the hospital or at a doctor’s office, the nurse and doctor both react when they read “tetanus.” There are raised eyebrows.
Tetanus allergies are, indeed, relatively rare but exist. Whether an allergy is genetic in predisposition or a reaction to a particular batch of vaccines is hard to tell. I would think that you have had other vaccines in your childhood that you did not react to, so it is difficult for me to say that you are alllergic to ALL live vaccines. Given your complicated history, however, I would certainly question your doctor thoroughly before any new vaccine is given to you.
Dr. Bones
Awesome stuff!
Is the tetanus shot I give to my livestock (goats) if calculated to human weight, in a pinch good enough to use for humans if unable to get moderna healthcare????
I know this article was written several months ago, but I was hoping you might be able to answer my question.
My husband is allergic to tetanus. He was born in the United Kingdom (not sure if they have different vaccines as children than the United States, so just wanted to mention it in case it has any relevance) and was given a tetanus shot at school that caused a very fast and very serious reaction.
Anyway, my question is if you know of any herbal or natural remedies that can be used in place of a tetanus shot. My grandmother once mentioned that if you place a freshly cut piece of raw potatoe on the puncture it will help to draw out the “poison”. Do you know if that has any truth behind it?
Any suggestions at all would be more than appreicated.