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Tetanus is caused by the bacterium Clostridium tetani, the spores of which are

widespread in the environment. The disease is caused by the action of a neurotoxin,

produced by the bacteria when they grow in the absence of oxygen, e.g. in dirty

wounds or in the umbilical cord if it is cut with a non-sterile instrument.

Tetanus is characterized by muscle spasms, initially in the jaw muscles. As thedisease progresses, mild stimuli may trigger generalized tetanic seizure-like activity,

which contributes to serious complications and eventually death unless supportive

treatment is given.

Tetanus can be prevented by the administration of tetanus toxoid, which induces

specific antitoxins. To prevent maternal and neonatal tetanus, tetanus toxoid needs to

be given to the mother before or during pregnancy, and clean delivery and cord care

needs to be ensured.

Tetanus is an acute, often fatal, disease caused by anexotoxin produced by the bacterium Clostridium tetani. It ischaracterized by generalized rigidity and convulsive spasmsof skeletal muscles. The muscle stiffness usually involves thejaw (lockjaw) and neck and then becomes generalized.Although records from antiquity (5th century BCE) containclinical descriptions of tetanus, it was Carle and Rattonein 1884 who first produced tetanus in animals by injectingthem with pus from a fatal human tetanus case. Duringthe same year, Nicolaier produced tetanus in animals

by injecting them with samples of soil. In 1889, Kitasatoisolated the organism from a human victim, showed that itproduced disease when injected into animals, and reportedthat the toxin could be neutralized by specific antibodies. In1897, Nocard demonstrated the protective effect of passivelytransferred antitoxin, and passive immunization in humanswas used for treatment and prophylaxis during World War I.A method for inactivating tetanus toxin with formaldehydewas developed by Ramon in the early 1920's which led tothe development of tetanus toxoid by Descombey in 1924. Itwas first widely used during World War II.

Tetanus is caused by a neurotoxin released by Clostridium tetani, a spore-forming

anaerobic bacterium. It occurs throughout the world and remains an important cause

of death with an estimated annual mortality of 800 0001 000 000. Over half of these

deaths are in neonates. Tetanus is relatively rare in the developed world. For example,

there are 510 cases per year in the UK; 75% of these occur in individuals over the

age of 45 yr. There have been no cases in the UK of tetanus in the newborn for over

30 yr.

Tetanus is a clinical diagnosis. Individuals with symptoms and signs of tetanus should

be closely monitoredideally within an intensive care unit with immediate access toventilatory support. Modern management encompasses wound debridement,

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antimicrobial therapy, active and passive immunization, sedation and vigilant

monitoring.