Tetanus is a rare disease resulting from a neurotoxin produced during infection with Clostridium tetani. The disease is characterised by rigidity and spasms of skeletal muscles with the jaw muscles usually affected (lockjaw) before muscle stiffness become more generalised. The case-fatality ratio can range from 10%-90% with it being higher in the young and elderly. The incubation period is between four to 21 days and a shorter incubation period is associated with higher mortality.
C. tetani are common environmental bacteria and can form spores which are highly resistant to heat and freezing. They are present in soil and manure and commonly enter the body through a wound, burn, puncture or scratch. The bacteria can then grow anaerobically at the site of infection and produce tetanus toxin. People who inject drugs (PWID) are at increased risk of infection and clusters have been previously reported in this group. Tetanus cannot be transmitted from person to person.
Immunisation against tetanus is the most effective method of disease prevention and has been part of the childhood immunisation schedule since 1961. Tetanus immunisation is part of the routine childhood immunisations and is administered in the pentavalent diphtheria, tetanus, pertussis, polio and Haemophilius influenzae B (DTaP/IPV/Hib) vaccine in the primary course and the quadrivalent diphtheria, tetanus, pertussis and polio (dTaP/IPV or DTaP/IPV) vaccine and the trivalent tetanus, diphtheria and polio (Td/IPV) in the booster course. Altogether, five doses of tetanus vaccine are administered in the childhood immunisation schedule.
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