Tetanus (lockjaw) in babies and children

What is tetanus?

Lockjaw is a convulsive disease caused by the bacterium Clostridium tetani. Infection occurs through polluted soil getting into an open wound. There is no risk of infection from person to person. The tetanus pathogen occurs worldwide and is present practically everywhere. In newborns, the stump of the umbilicus can become infected as a result of poor hygiene or poor care. The transmission time is five to 14 days. The disease is relatively rare thanks to the consistent vaccination of the population in industrialized countries. Only about ten to 20 cases are reported in Germany every year.

Signs of tetanus disease

• exhaustion
• sweating and fever
• insomnia
• chills
• spasm of the chewing muscles (trismus)
• Stiffness of the neck, chest and back muscles
• Entire body spasms from touch and light
• Strong pain
• Fixed grin due to muscle delay (risus sardonicus)
• Danger of respiratory arrest due to the spasm of the diaphragm

As part of the wound infection, the bacteria release a toxin that triggers tetanus: five days to two weeks after infection, cramps and symptoms of paralysis occur. These start on the face and then spread to the whole body. This is accompanied by severe pain, chills and exhaustion and ultimately respiratory paralysis.

treatment of tetanus

• Thorough surgical cleaning of the wound through which the pathogen entered. With a wide cut (excision) and open wound treatment, more oxygen gets into the wound area – which is unfavorable for the tetanus pathogen and its further reproduction
• Active immunization to trigger the formation of own antibodies (tetanus vaccination)
• High doses of antibiotics
• Administration of antibodies against the tetanus toxin (so-called tetanus immunoglobulin), which neutralize the toxin that has not yet reached the brain
• Intensive care monitoring
• Drug relaxation of the muscles (muscle relaxation)
• administration of sedatives
• Positioning of those affected in a darkened and soundproof – i.e. low-stimulus – room

Since most people have been vaccinated against tetanus, it is very rare these days. Timely vaccination can still prevent tetanus from breaking out in people who have been injured and who do not have adequate vaccination protection. However, as soon as symptoms of tetanus appear, they can only be alleviated. To confirm the diagnosis, doctors may draw blood from the patient and order a test for tetanus toxin — the toxin responsible for tetanus — in the blood. But even if no toxin can be detected, you cannot completely rule out tetanus. There is no antidote to the toxin of the pathogen. About 20 percent of the diseases are fatal, in infants it is even up to 50 percent.

Vaccination against tetanus

The tetanus vaccine is an inactivated vaccine, which means that it consists of a weakened version of the tetanus pathogen. Since the vaccine does not contain any living beings capable of reproduction, as is the case with measles or rubella vaccinations, for exampleIf this is the case, the vaccination is generally very well tolerated and possible at almost any time. An exception is when there is an acute febrile infection, regardless of the cause. Pregnant women in the first three months should also avoid vaccination. If you are pregnant, you should only vaccinate after careful consideration. In Germany, the Standing Committee on Vaccination (STIKO) of the Robert Koch Institute recommends the tetanus vaccination for children up to 15 months of age in the form of four partial vaccinations (primary immunization). The vaccination should be boosted at the age of 6 and 14 and then every 10 years. In infancy, the tetanus vaccine is usually part of a multiple vaccination (four, five or six-fold vaccination), later it is usually given together with the antigen againstadministered diphtheria .