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Pregnancy, Delivery and Postpartum
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Zahra Ameen, Katy Kuhrt, Kopal Singhal Agarwal, Chawan Baran, Rebecca Best, Maria Garcia de Frutos, Miranda Geddes-Barton, Laura Bridle, Black Benjamin
Tetanus occurs when a wound becomes infected with the bacterium Clostridium tetani. If the neonate gets infected – for example, by cutting the cord with a contaminated instrument – mortality is very high (65–90%).
Striated MusclesSkeletal and Cardiac Muscles
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
The anaerobic bacterium Clostridium botulinum produces an exotoxin that inhibits acetylcholine release from cholinergic nerves. Consequences include gastrointestinal and urinary dysfunction, blurred vision and paralysis, which spares limbs but affects respiratory muscles. Aminopyridines may be used to treat the paralysis. Clostridium tetani toxin (tetanus toxin) also prevents acetylcholine release, as well as produces generalized muscle spasms by removing spinal cord inhibition.
Diseases of the Nervous System
Published in George Feuer, Felix A. de la Iglesia, Molecular Biochemistry of Human Disease, 2020
George Feuer, Felix A. de la Iglesia
Tetanus is brought about by infections with the Gram-positive anaerobe microorganism Clostridium tetani.288,289,384 The spores of this anaerobe microbe are found in soils throughout the world. Locally produced toxin penetrates into the central nervous system through motor nerves. The toxin tetanospasmin is bound to presynaptic nerve endings in muscle and then transported to the perikarya of anterior horn cells.475 The toxin blocks the release of the inhibitory neurotransmitter, glycine.447
Suspected tetanus in an unvaccinated pediatric patient
Published in Baylor University Medical Center Proceedings, 2023
Kimberly Walter, Renita Thomas, Swasti Gyawali, Sowmya Kallur
Tetanus is a life-threatening vaccine-preventable illness. It is caused by tetanospasmin, a potent exotoxin of Clostridium tetani. Tetanospasmin causes neuromuscular dysfunction by inhibiting presynaptic GABA and glycine release. This leads to tonic spasms and paroxysmal contractions of skeletal muscles.1 Spores of Clostridium tetani are present throughout the environment in soil, dust, and manure and are often transmitted to humans via contaminated wounds. Tetanus is extremely rare in the United States due to vaccination efforts, with only 20 cases reported in 2018 and 26 cases in 2019.2,3 Here, we describe a suspected case of tetanus in a 10-year-old unvaccinated child in central Texas resulting in a 1-month stay in the pediatric intensive care unit and ultimately requiring a tracheostomy tube.
Global epidemiology of viral hepatitis and national needs for complete control
Published in Expert Review of Anti-infective Therapy, 2018
Simone Lanini, Raffaella Pisapia, Maria Rosaria Capobianchi, Giuseppe Ippolito
The first step is ‘infection control’ representing the reduction of the circulation of an epidemic agent at a level that is locally acceptable. This is the epidemic profile of AHA in North America and Western Europe where HAV is still circulating but it is not perceived as major public health issue any more. The second step is the ‘diseases elimination’ that is achieved when the attributable morbidity/mortality for a specific infection agent is near to zero, though the agent is still circulating. This is the epidemic profile of tetanus in many industrial countries where toxigenic strain of Clostridium tetani are well represented in the environment but clinical cases of tetanus are exceedingly rare due to high vaccine coverage. The third step is the ‘elimination of the infection’ implying that the incidence of autochthonous cases of infections in a specific region is zero while sporadic cases due to imported cases are still possible. This is the current epidemic profile for malaria in Europe. Finally, ‘eradication’ is achieved when no more case of a specific infection are reported at global level. Smallpox is the unique example for human diseases at present.
Maternal immunization: where are we now and how to move forward?
Published in Annals of Medicine, 2018
Ivo Vojtek, Ilse Dieussaert, T. Mark Doherty, Valentine Franck, Linda Hanssens, Jacqueline Miller, Rafik Bekkat-Berkani, Walid Kandeil, David Prado-Cohrs, Andrew Vyse
Vaccination against tetanus, pertussis and diphtheria is included in the routine vaccination schedule in many countries, and tetanus and diphtheria are now rare diseases in industrialized countries. Most cases of tetanus occur in developing countries among new-borns or mothers following delivery in poor hygiene conditions [27]. Tetanus cannot realistically be eradicated because the causative agent of tetanus, Clostridium tetani, is widespread in the environment, highly resistant to many antimicrobial measures, and transmitted by open wound contact (as opposed to person-to-person transmission) [28]. Nevertheless, efforts are being made to reduce the burden of tetanus worldwide. These efforts focus on prevention using vaccination, improvement of perinatal care and post-exposure prophylaxis in high-risk areas [28].