Editing Tetanus (section)

{{short description|Bacterial infection characterized by muscle spasms}}
{{about|the disease|the physiological use of the term|Tetanic contraction}}
{{Infobox medical condition (new)
| name          = Tetanus
| synonyms      = Lockjaw
| image         = Opisthotonus_in_a_patient_suffering_from_tetanus_-_Painting_by_Sir_Charles_Bell_-_1809.jpg
| caption       = [[Muscle spasm]]s (specifically [[opisthotonos]]) in a person with tetanus. Painting by [[Sir Charles Bell]], 1809.
| field         = [[Infectious disease (medical specialty)|Infectious disease]]
| symptoms      = [[fever]], cramped-up jaw, [[muscle spasm]]s, [[headache]], [[seizure]]s, sweating, and trouble swallowing
| onset         = 3–21 days following exposure
| duration      = Months
| causes        = ''[[Clostridium tetani]]''
| risks         = Break in the skin
| diagnosis     = Based on symptoms
| differential  =
| prevention    = [[Tetanus vaccine]]
| treatment     = [[Tetanus immune globulin]], [[muscle relaxant]]s, [[mechanical ventilation]]
| medication    = [[diazepam]] and [[methocarbamol]]
| frequency     = 209,000 (2015)
| deaths        = 56,700 (2015)
| prognosis     = 6.4% risk of death
}}

'''Tetanus''' ({{etymology|grc|{{wikt-lang|grc|τέτανος}}|tension, stretched, rigid}}), also known as '''lockjaw''', is a [[bacterial infection]] caused by ''[[Clostridium tetani]]'' and characterized by [[muscle spasm]]s. In the most common type, the spasms begin in the jaw and then progress to the rest of the body. Each spasm usually lasts for a few minutes. Spasms occur frequently for three to four weeks.<ref name="CDC2012Pink" /> Some spasms may be severe enough to [[bone fracture|fracture bones]].<ref name="CDC2013S">{{cite web |date=January 9, 2013 |title=Tetanus Symptoms and Complications |url=https://www.cdc.gov/tetanus/about/symptoms-complications.html |url-status=live |archive-url=https://web.archive.org/web/20150212225108/http://www.cdc.gov/tetanus/about/symptoms-complications.html |archive-date=12 February 2015 |access-date=12 February 2015 |website=cdc.gov}}</ref> Other symptoms of tetanus may include [[fever]], [[sweating]], [[headache]], [[dysphagia|trouble swallowing]], [[hypertension|high blood pressure]], and a [[tachycardia|fast heart rate]]. The onset of symptoms is typically 3 to 21 days following infection. Recovery may take months; about 10% of cases prove to be [[death|fatal]].<ref name=CDC2012Pink>{{cite book|last1=Atkinson|first1=William|title=Tetanus Epidemiology and Prevention of Vaccine-Preventable Diseases|date=May 2012|publisher=Public Health Foundation|isbn=9780983263135|pages=291–300|edition=12|url=https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html|access-date=12 February 2015|url-status=live|archive-url=https://web.archive.org/web/20150213010501/http://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html|archive-date=February 13, 2015}} {{CDC}}</ref>

''C. tetani'' is commonly found in soil, saliva, dust, and manure. The bacteria generally enter through a break in the skin, such as a cut or puncture wound caused by a contaminated object.<ref name="CDC2012Pink" /><ref name="CDC2013C">{{cite web |date=January 9, 2013 |title=Tetanus Causes and Transmission |url=https://www.cdc.gov/tetanus/about/causes-transmission.html |url-status=live |archive-url=https://web.archive.org/web/20150212223308/http://www.cdc.gov/tetanus/about/causes-transmission.html |archive-date=12 February 2015 |access-date=12 February 2015 |website=www.cdc.gov}}</ref> They produce [[toxin]]s that interfere with normal muscle contractions.<ref name=CDC2013Doc>{{cite web|title=Tetanus For Clinicians|url=https://www.cdc.gov/tetanus/clinicians.html|website=cdc.gov|access-date=12 February 2015|date=January 9, 2013|url-status=live|archive-url=https://web.archive.org/web/20150212224705/http://www.cdc.gov/tetanus/clinicians.html|archive-date=12 February 2015}}</ref> Diagnosis is based on the presenting signs and symptoms. The disease does not spread between people.<ref name=CDC2012Pink/>

Tetanus can be prevented by [[immunization]] with the [[tetanus vaccine]]. In those who have a significant wound and have had fewer than three doses of the vaccine, both vaccination and [[tetanus immune globulin]] are recommended. The wound should be cleaned, and any dead tissue should be removed. In those who are infected, tetanus immune globulin, or, if unavailable, [[intravenous immunoglobulin]] (IVIG) is used.<ref name=CDC2012Pink/> [[Muscle relaxant]]s may be used to control spasms. [[Mechanical ventilation]] may be required if a person's breathing is affected.<ref name=CDC2013Doc/>

Tetanus occurs in all parts of the world but is most frequent in hot and wet climates where the soil has a high organic content.<ref name=CDC2012Pink/> In 2015, there were about 209,000 infections and about 59,000 deaths globally.<ref name=GBD2015Pre>{{cite journal | vauthors = Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, etal | collaboration = GBD 2015 Disease and Injury Incidence and Prevalence Collaborators | title = Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015 | journal = Lancet | volume = 388 | issue = 10053 | pages = 1545–1602 | date = October 2016 | pmid = 27733282 | pmc = 5055577 | doi = 10.1016/S0140-6736(16)31678-6 }}</ref><ref name=GBD2015De>{{cite journal | vauthors = Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, etal | collaboration = GBD 2015 Mortality and Causes of Death Collaborators | title = Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015 | journal = Lancet | volume = 388 | issue = 10053 | pages = 1459–1544 | date = October 2016 | pmid = 27733281 | pmc = 5388903 | doi = 10.1016/S0140-6736(16)31012-1 }}</ref> This is down from 356,000 deaths in 1990.<ref name=GBD2014>{{cite journal | vauthors = Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, etal | collaboration = GBD 2013 Mortality and Causes of Death Collaborators | title = Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013 | journal = Lancet | volume = 385 | issue = 9963 | pages = 117–71 | date = January 2015 | pmid = 25530442 | pmc = 4340604 | doi = 10.1016/S0140-6736(14)61682-2 }}</ref> In the US, there are about 30 cases per year, almost all of which were in people who had not been vaccinated.<ref>{{cite web |title=About Tetanus |url=https://www.cdc.gov/tetanus/about/index.html |website=Centers for Disease Control and Prevention |publisher=United States Government |access-date=4 August 2019}}</ref> An early description of the disease was made by [[Hippocrates]] in the 5th century BC. The cause of the disease was determined in 1884 by [[Antonio Carle]] and [[Giorgio Rattone]] at the [[University of Turin]], and a [[vaccine]] was developed in 1924.<ref name=CDC2012Pink/>