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Tetanus

Please click the frequently asked questions below for further information and IPC precautions required:

  • What is Tetanus?

    Tetanus is a rare disease resulting from a neurotoxin that is produced during infection with Clostridium tetani.  C.tetani is a common environmental bacterium that forms spores that are highly resistant to extreme hot and cold temperatures.

    People who inject drugs (PWID) are at increased risk of infection.

    Treatment includes supportive care, wound debridement, and may involve administration of antimicrobials and anti-tetanus antibodies.

    Immunisation against tetanus is the most effective method of prevention and is included as part of the UK childhood immunisation schedule, with routine primary vaccination recommended at two, three, and four months of age, followed by a booster dose from age three years and four months, with a further booster at 13 to 18 years of age.

    Prophylactic immunisation is recommended following injuries involving tetanus-prone wounds if routine immunisation was not received or was received more than 10 years ago.

  • How does it spread?

    The bacterium is present in soil and manure and usually enters the body through a wound, burn, puncture or scratch.

    Tetanus is not spread from person to person.

  • What are the symptoms of Tetanus?

    There are three forms of tetanus (generalised, localised, and cephalic) however generalised tetanus is the most common presentation.

    Generalised tetanus is characterised by lockjaw, tonic muscle contractions and spasms.  Tonic contractions and spasms may lead to dysphagia (trouble swallowing), opisthotonus (spasm of the muscles causing backwards arching of the head, neck and spine), and a rigid abdomen; in severe cases they may cause respiratory distress.

    Localised tetanus is rigidity and spasms confined to the area around the site of the infection and may be more common in partially immunised individuals.  Localised symptoms can continue for weeks or may develop into generalised tetanus.

    Cephalic tetanus is localised tetanus after a head or neck injury, involving the muscles supplied by the cranial nerves

  • Why is this important?

    If NIAS staff are aware that the patient has a suspected or confirmed Tetanus, this should be communicated to EAC /NEAC and the receiving unit when transferring the patient to ensure effective patient care and management.

  • IPC Precautions
    • Standard Precautions should be used.
    • Hand Hygiene should be completed as per the 5 moments in line with usual practice.
    • Eye protection should be risk assessed for any concern regarding a splash risk.
    • Gloves and Aprons should be risk assessed and worn if contact with the patient’s blood or bodily fluids.
    • Laundry should be treated as per standard policy
  • What cleaning is required?

    All equipment and the ambulance should have an in-between patient clean, paying particular attention to touch points.

  • Do staff need prophylaxis or follow up?

    No staff follow up required.