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Tetanus

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Tetanus Tetanus is a potentially fatal disease that is rooted throughout all of human history. It is caused by a bacterium that can be contracted in a number of ways. While the human interaction and symptoms are not caused directly by the bacterium affecting human tissue as with normal bacterial infections. Instead, the symptoms common with the infection are caused by a reaction to a neurotoxin called Tetanospasmin (Wells). The symptoms of this toxin on the body are a result of the toxin binding to inhibitory neurons, preventing the release of neurotransmitters: glycine and gamma-aminobutyric acid (Wells). Due to the nature of this type of infection, not directly from a bacterium than can be killed by the body’s immune system, but from a neurotoxin there is very little host immune suppression. When the immune system does manage to rid the body of the bacterium there is no immunity to the bacterium created by the body and can result in reinfection with ease (Wells). However, a development of a vaccine for the bacterium has been developed and distributed in most countries. The bacterium Clostridium tetani is a rod-shaped anaerobic bacterium (“Clostridium tetani”). It enters the body through puncture wounds caused by an object that houses the bacterium. Once it enters the body it releases the neurotoxin which travels through the blood stream finding its way to the spinal column. Once it reaches the spinal column it begins to block neurotransmitter activity among skeletal muscles first affecting muscles in the back and jaw (“Clostridium tetani”). The characteristic symptoms of tetanus begin to appear now. The spasms of the jaw are known as lockjaw, and the spasms in the back are referred to as Opisthotonus. The characteristic signs of Opisthotonus are extreme arching of the back with the body entirely lifted off the ground, stomach up, with only the head or shoulder region and the heels of the feet making contact with the ground (“Clostridium tetani”). After the initial symptoms are present a series of further muscle spasms begin to manifest. Muscles involved with respiratory actions, swallowing, and occasionally kidney failure (“Clostridium tetani”). After all these symptoms manifest the most common causes of death are not directly from infection itself, but as a result of the toll on the body by the symptoms. Exhaustion is a common cause of death due to an inability to swallow food, and inability to sleep due to the muscle contractions and many patients’ bodies just give up (“Clostridium tetani”). Respiratory failure deaths are a result of the muscles not being able to perform their function and patients are unable to breathe causing death (“Clostridium tetani”). Cardiac arrest however is not caused by uncontrollable contractions of the heart muscle due to its electrical properties. The strong electrical contractions prevent the heart from being affected by the neurotoxin; however the cardiac arrest is again a result from the exhaustion of the body (“Clostridium tetani”). There are four different clinically recognized types of tetanus infection. First there is local tetanus. This means the area of the infection remains the only affected area of the body and does not exhibit any of the classical signs of tetanus. Left untreated it can spread to the rest of the body, but does not usually do so (“Clostridium tetani”). The second clinical recognition is “cephalic tetanut.” It is a type of localized tetanus that occurs when a person received a head injury and the tetanus does not spread. This shows signs in facial muscle and throat muscle spasms (“Clostridium tetani”). Generalized Tetanus is the third manifestation type, by far the most common, showing in eighty percent of tetanus infections. This type of infection shows all the characteristic symptoms of tetanus, lockjaw and Opisthotonus (“Clostridium tetani”). The last form of clinical tetanus infections is neonatal tetanus. This type of infection is transferred from the mother to the child occurring within 28 days after birth, resulting from the umbilical stump being infected with Clostridium tetani (“Clostridium tetani”). Throughout history humans have noticed a correlation between a wound and resulting symptoms of tetanus. Like most infections before the advent of microbiology, it ran unchecked through human history. Due to its anaerobic nature it is capable of surviving for many years in spore form on a variety of surfaces, lending itself to easy transmission to the patient’s body through open wounds. Commonly it is associated with rust, which is a misconception. Again due to the viruses anaerobic nature is thrives on surfaces coated in rust. The surfaces tend to be sharp and capable of penetrating skin. This just becomes the way the bacterium attaches itself to the host (“Teanus”). This ease of infection caused high rates of tetanus in humans throughout history and is still prevalent today in developing countries where modern medical practices are harder to come by. Because of the bodies inability to develop an immune response to the bacteria it is possible to survive an infection only to be infected again at a later time (“Teanus”). The infection is also highly fatal, with a death rate of close to fifty percent (“Clostridium tetani”). The strongest defense to tetanus in the past was a strong body capable of fighting off the infection and keeping its strength through the symptoms of the disease. This of course meant a higher mortality rate for the elderly and children; however it is not uncommon for tetanus to kill a healthy adult (“Clostridium tetani”). After the microbiology revolution of the 1800’s scientists began to isolate the bacterium that caused tetanus and develop a vaccine as well as diagnosis conditions. The isolation of the bacteria was set in motion in 1884 by the works of Carle and Rattone who first reproduced the virus in animals (“Tetanus”). They extracted the pus from a human victim and injected it into an animal host. Also in 1884 another researcher, Nicolaier, created an infection in an animal host by injecting the animals with soil samples (“Tetanus”). Working off this information in 1889 a researcher named Kitasato isolated the bacterium from a human host. He used this isolation to infect an animal host and postulated that is could be counteracted with a certain set of antibodies (“Tetanus”). Later in 1897 Nocard showed that it was possible to prevent infection by the use of an antitoxin (“Tetanus”). While this did not keep the bacterium from infecting humans, it prevented the neurotoxin from affecting the body, allowing for the body to easily fight the bacterial infection. Now the vaccine is commonly administered to all children in the developed world, and the Center for Disease Control (CDC) recommends a booster shot every 10 years, as well as a booster shot if one is potentially infected through an accident (“Tetanus”). In the developed world we have mostly eliminated cases of tetanus, as well as neonatal tetanus. However in the developing world tetanus is still a dangerous infection, with new cases being reported every day. Tetanus vaccine must be made available in the developing world in order for infection rates to be culled. Because the infection is not treated with antibiotics it does not run the risk of becoming an antibiotic resistant bacterium, which makes it cheaper and safer to treat underdeveloped parts of the world. Countries of high rates include most of northern Africa where the climate and environment are conducive to the incubation and spread of the bacteria. Coupled with an underdeveloped society of limited medical facilities, lack of proper foot ware help make the bacteria easily transmuted to humans. The high mortality rates make tetanus a feared problem in these parts of the world. Like most medical advances the work of the microbiology revolution allows us to better understand these infections and help us do everything to prevent their spread.

Works Cited
"Institutional Links." Clostridium Tetani. Public Health Agency of Canada, 30 Apr. 2012. Web. 29 Nov. 2012. .
"Tetanus." Tetanus. Center for Disease Control, n.d. Web. 29 Nov. 2012. .
Wells CL, Wilkins TD. Clostridia: Sporeforming Anaerobic Bacilli. In: Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 18.

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