Tetanus – colloquially called tetanus (ICD-10 A33: Tetanus neonatorum; A34: Tetanus during pregnancy, childbirth, and the puerperium; A35: Other tetanus) is a serious infectious disease (wound infection). The cause is the tetanus toxin (poison) produced by the gram-positive, spore-forming bacterium Clostridium tetani, known as tetanospasmin.
Tetanus manifests itself with muscle cramps and markedly increased muscle tone (state of tension in a muscle).
Occurrence: The pathogen is distributed worldwide and is found in soil, dust, and the natural intestinal flora of humans and animals.
The spores of the pathogen are resistant (resistant) to desiccation, heat and common disinfectants.
The tetanus spores enter the body parenterally (the pathogen does not penetrate through the intestine), i.e. in this case, it enters the body through the skin (percutaneous infection) – contaminated wounds (skin injuries caused by thorns, burns, bite wounds, etc.).
Human-to-human transmission: No.
The incubation period (time from infection to onset of disease) is usually between 3 and 14 days, sometimes longer. Rarely, months may pass before the onset of symptoms.
Four clinical forms of infection can be distinguished:
- Generalized tetanus
- Is the most common form in central Europe
- Mean incubation period: 8 days
- Neonatal (occurring in newborns) tetanus.
- Occurs mainly in (tropical) regions with inadequate medical care
- Usually occurs in the first two weeks of life as a generalized form
- Is the most common form worldwide
- local tetanus
In Germany, about 70 people get tetanus every year and about 1 million people worldwide.
The incidence (frequency of new cases) is about 0.16 diseases per 100,000 inhabitants per year (in industrialized countries). In countries in Asia, Africa and South America, where vaccination rates are low and medical care is inadequate, the number of cases is very high. Infected newborns die most frequently.
Course and prognosis: The course of the disease usually extends over 4-6 weeks. The prognosis has been significantly improved thanks to the possibilities of intensive care medicine. The “local” form of tetanus has the best prognosis.
The lethality (mortality related to the total number of people suffering from the disease) for the generalized form is between 10 and 20% with modern intensive therapy. Vaccination: A vaccination against tetanus is available.
In Germany, the disease is not reportable according to the Infection Protection Act (IfSG).
