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Published: Sunday, June 16, 2013, 12:01 a.m.

Get your shot, you don't want to mess with tetanus

Summer weather means more time outside working, playing and savoring the sunshine.
Sometimes it results in extra scrapes and scratches from grabby blackberry vines or rusty nails playing hide-and-seek. At some point, there is an injury that makes you wonder: Do I need a tetanus shot for that?
"Tetanus is rare (in the U.S.) because of the vaccine, but it doesn't stay that way if people don't keep up with receiving the shots," said Dr. John Dilworth, an infectious disease specialist at The Everett Clinic.
Tetanus is a spore that universally lives in the soil and is impossible to eradicate. If it enters a wound, the bacteria produce a toxin that invades the nervous system.
Resulting symptoms include seizures, muscle spasms strong enough to break bones and jaw cramping commonly known as "lockjaw." The incubation period is generally eight to 10 days.
Once contracted, tetanus is difficult to treat even with modern medicine.
Thanks to vaccination, tetanus is almost entirely preventable. According to the Centers for Disease Control and Prevention, only 19 cases were reported in the U.S. in 2009. However, it remains a serious danger to anyone not immunized. More than 14,000 cases were reported by the World Health Organization in 2011.
Many combination vaccines cover tetanus. The DTaP shot treats tetanus, diphtheria and whooping cough (pertussis). It's given to children with a course of five shots at set intervals by 7 years old.
The Tdap shot is typically administered once, often about age 11. However, adults planning to be in close contact with a child 12 months and younger should receive a Tdap to prevent whooping cough. Otherwise, adults receive a Td booster every 10 years.
If it's been more than five years since your last shot, you are advised to receive another if you sustain an injury.
"Be careful because sometimes people think it's a minor wound and don't go to the doctor, which means you won't be thinking about getting a tetanus shot," said Rita Mell, a registered nurse and immunization program manager for the Snohomish Health District. "That's when you can get into problems.
"Tetanus toxins are lethal. It takes a very little amount to set things in motion. Don't mess with it."
Puncture-type wounds are common incubators. The bacteria do not need oxygen to survive. When an infected object penetrates deeply into the flesh, tetanus thrives in the damaged tissue. However, even a scrape is enough to endanger an unvaccinated individual.
"If you're doing work in the yard, anything with manure or fertilizer has a particular risk," Mell said. "A prick from a thorn or a rose bush can even inject it into the skin.
"There is also a potential inside the house. For example, working with vegetables grown in the garden that you didn't wash and then you cut yourself while chopping."
Those who are at slightly higher risk for tetanus include the elderly, diabetics -- because of wound issues -- and needle drug users.
At the beginning of 2013, the CDC released new recommendations for pregnant women to receive a Tdap dose during their third trimester. The change is partially an effort to address recent outbreaks of whooping cough.
"A woman's antibodies pass to the fetus, so the baby is born with some passive protection they received from the mother's bloodstream," Mell said.
"Babies may not receive their own first dose until 6 months or older. The shot (a Tdap for the pregnant mother) helps protect babies when they're most vulnerable and still building immune systems."
Side effects from tetanus-related shots are typically mild. Young children may experience low-grade fevers, fatigue and fussiness. The most common side effect for all ages is soreness and redness at the injection site.
"There might be some discomfort, but it's highly variable from person to person," Dilworth said. "Some people avoid getting it because it hurts, but that's a small price to pay to protect yourself from getting tetanus, which you might not survive at all."
Story tags » DiseasesImmunizationsPreventative medicine

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