Mad about Science: Tetanus

By Brenden Bobby
Reader Staff

This past weekend, I spent some time cleaning up the property when I suddenly felt a sharp pain on the bottom of my foot. After a few moments of creative swears that would have made George Carlin blush, I pried a half-buried wooden board and the offending nail from my shoe.

I hobbled inside and disinfected the wound and figured I was good. Luckily for me, my partner is a saint and she promptly asked me when I last received a tetanus shot. The fact that I had to stop and think about it was proof enough that it was time for a trip to the clinic.

The process had me wondering, what exactly is tetanus? And how does a simple shot in the arm prevent you from getting it?

Tetanus is a series of diseases that stem from toxins released by the Clostridium tetani bacteria. This bacteria is found in soil and the fecal waste of animals. Out in the wild, it’s completely harmless to humans; but, once it enters the human body through a puncture or a cut, a chain of events happen that can end in a life-threatening emergency. 

The bacteria reproduces through spores, which prefer dark and wet environments. Once entering the body through something like a rusty nail, it creates the perfect conditions to release spores and rapidly replicate.

The danger isn’t directly from the replication of the bacteria, but the toxins the bacteria produce during its lifecycle. It creates a neurotoxin called tetanospasmin which travels to and attacks the central nervous system of the human body, which results in violent and potentially lethal muscle spasms.

Muscle spasms and general loss of control of muscles — particularly in the face, jaw, neck and abdomen — are major symptoms of tetanus. These muscle spasms are most commonly linked to lockjaw, which is the inability to move your jaw while suffering from tetanus. These spasms are notoriously painful.

Muscle spasms also affect your ability to breathe, which is among the most lethal symptoms of the disease. Headaches, fever and chills occur while the bacteria reproduces in the body.

Treatment for a tetanus infection is for the patient to receive antibiotics, muscle relaxant medication and a tetanus antitoxin that actively counteracts the tetanospasmin attacking your nervous system. In severe cases where loss of respiratory function becomes a concern, the patient may be intubated and hooked up to a ventilator in order for the patient to continue breathing after their diaphragm has lost the ability to function.

Treatment isn’t a couple of days in a hospital bed, but a long-term affair that takes months to a year in order for the body to grow new nerve endings damaged by the tetanospasmin.

As grim as this is, it can all be very easily prevented by a quick shot once every 10 years. The vaccine exposes the body to a small amount of the tetanus toxins, allowing your immune system to attack and analyze the threat, which allows it to repel more concentrated levels of the bacteria and toxins, should you be exposed to it later. The vaccine is often paired with a vaccine for diphtheria and pertussis, or whooping cough.

The vaccine has a long history, having been invented in 1924. The bacteria was initially produced in animals in the late 1800s, with the bacterium isolated in 1889. Decades of refinement and research led to the development of the vaccine in the wake of World War I. By World War II, it was widely used throughout the European and Pacific theaters.

World War II had soldiers digging trenches and foxholes at an immense scale, along with regularly being wounded by flying metal, debris, and even the design of their own weapons and gear, which would have allowed a proliferation of the disease and many more deaths without the introduction of the vaccine throughout the war.

In the days before the tetanus vaccine, it was a disease with a high mortality rate. Newborn babies were almost guaranteed to die if exposed to the toxins, while healthy adults had around a 25% chance of dying. Seniors were at much greater risk if exposed.

Treatment reduced the mortality rate to about 15%, which was still a shocking and significant gamble.

As simple as prevention is now, there are some risks to the shot. People who have suffered a severe allergic reaction to a previous dose should consult a doctor before taking the vaccine.

Others at risk are those suffering from Guillain-Barre Syndrome, a condition in which the immune system attacks the body’s own nervous system to cause muscle weakness and even paralysis. It can somewhat mirror the effects of an advanced tetanus infection, which could complicate treatment.

Lucky for me, I seem to have dodged a bullet so far. I’ll have a limp for a couple of days, but I’ll just use that as an excuse to crowd the deviled eggs on turkey day.

Stay curious, 7B.