The immunity to the tetanus toxin is induced only by immunization. The recovery of a clinical form of tetanus does not infer protection against subsequent attacks since the amount of toxin that causes disease is much less than that required to induce immunity. Therefore, all tetanus patients should be immunized with tetanus toxoid, either at diagnosis or during convalescence. The used vaccine is tetanus toxoid, which has been shown to be useful and safe since its first production in 1929. Tetanus toxoid consists of toxin-treated with formaldehyde. Serum protective levels of> 0.01 U.I/ml are considered.
Is It OK to Get a Tetanus Shot Before 10 Years of Age?
Tetanus is a disease totally preventable by vaccination. The most effective strategy to eliminate neonatal tetanus is the immunization of pregnant women.
Since 1987, the O.M.S, through the Expanded Program of Immunization, recommends immunization with tetanus toxoid to all women of childbearing age; in previously unimmunized women, recommends the administration of the first dose of tetanus toxoid as soon as possible during pregnancy.
Another measure of control of neonatal tetanus is hygienic practices during childbirth and post-partum.
Pregnant women who were not previously vaccinated against tetanus and diphtheria should receive two doses of dT spaced appropriately and following the usual pattern. Those who have received two doses must complete the primary vaccination during pregnancy. Pregnant women who have completed their primary vaccination should receive dT booster doses if ten or more years have passed since the last dose.
Likewise, the inclusion of tetanus vaccination in childhood immunization programs is recommended. The recommended vaccination regimen is: first three doses with DTP or DTPa at 2-3 months, 4-5 months and 6-7 months, a fourth dose with DTPa at 15-18 months and a fifth dose with DTPa at 4 to 6 years; booster dose at 14 years with dT and recommend boosters every 10 years (dT or dTpa).
Due to the severity of this disease, the World Health Organization has recommended starting the vaccination scheme from an early age. The general scheme of vaccination consists of a primary series of 3 or 4 doses, according to age, and a booster dose every 10 years, since antitoxin levels decrease over time.
The germ responsible for the infection is Clostridium tetani, anaerobic bacillus, and spore-forming microorganism. The bacillus is a natural inhabitant of the intestinal tract of animals such as horses, cows, sheep, dogs, rats, chickens and other domestic animals, and also of man. C. tetani can be found in human and animal feces and spores, widely distributed, can survive in dry soils for years.
C. tetani is not an invasive organism. Tetanus is caused by the action of a powerful neurotoxin (known as tetanospasmin), which is produced during the growth of the bacteria. Tetanus toxin is neurotropic, binding to the ganglioside receptors of the nerve endings. Once in the neuronal tissue, the tetanus toxin cannot be affected by the antitoxin. The tetanus toxin can be inactivated by formaldehyde, obtaining the tetanus toxoid, which induces the formation of specific antitoxin.
These antibodies play an important role in protection against tetanus.
-Reservoir: The intestine of man and some animals, mainly horses where it lives naturally and innocuously. The spores are found in the soil, mud, and dust, with a universal character.
-Mechanism of Transmission: The infection occurs by penetration of the organism through the epithelium (usually skin), usually in the form of spores, as a result of wounds, tears, and burns contaminated with dirt, dust or feces of animals or humans. Sometimes it is through contaminated syringes, drug users, or insignificant injuries that have gone unnoticed.
Neonatal tetanus, which is a clinical form of mandatory notification as well, is usually transmitted by an infection in an unhygienic cut of the umbilical cord, or by an improper care of the cord stump, especially when “treated” or “covered” with contaminated substances (for example, animal droppings), by cultural habits. The role of early circumcision in transmission is not yet clear.
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