Shaken Baby Syndrome

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Amniotic fluid problems

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Choosing a pre-school

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Newborn reflexes

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Mastitis

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Colic

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Antenatal Classes

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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Tetanus

Tetanus is an infectious disease caused by the bacterium Clostridium tetani. This bacterium is able to live for several years in the soil, in the form of a spore. Tetanus occurs when a wound becomes contaminated by bacterial spores. Infection follows when these spores are activated, develop into bacteria that multiply and produce a toxin known as tetanospasmin. This poison affects the nervous system, resulting in painful muscle contractions, particularly of the jaw and neck muscles. Tetanus is also commonly known as lockjaw (Mayoclinic, 1998-2010; WebMD, 2010).

 

How is tetanus transmitted?

Tetanus spores are found throughout the environment, particularly in soil, dust and animal waste. The bacteria most commonly enter the body through puncture wounds, such as those produced by splinters, rusty nails, insect bites and burns, as well as any other break in the skin or IV drug access site. Tetanus is therefore acquired through contact with the environment and is not transmitted person-to-person (WebMD, 2010).

 

Babies may get tetanus if the umbilical cord is cut using unsterile instruments at the time of birth. The risk of infection is higher if their mother did not receive the tetanus toxoid vaccine during pregnancy (MehtaChildcare).

 

Symptoms

Tetanus has an incubation period of 3-21 days and produces the following symptomology:

·         Due to contractions of the muscles of the jaw (masseter muscle), your child will be unable to             open his mouth (‘lockjaw’)

·         Swallowing difficulties

·         Risus sardonicus, or the appearance of a fixed smile, due to contraction of the facial muscles

·         Stiffness in the neck and irritability

·         Continuous severe headaches

·         Muscular spasms in the neck, back, abdomen and limbs (tetany). These spasms may be violent         and agonisingly painful, occurring over a period of 10-14 days

·         The spasms may result in breathing difficulties

·         When the toxins cause the back muscles to contract, the back may suddenly arch backwards.            This is called opisthotonos

·         In extreme cases, the child’s body may bend like a bow, so that only the heels and back of the          head touch the bed

·         Tetanus spasms are commonly triggered by light, sound or touch (A.D.A.M., Inc., 1997-2008;              Ayurvediccure.com, 2004-2008; Collins, 2003; Scumdoctor.com, 2006).

 

Other signs and symptoms may include

·         Fever

·         Sweating

·         Elevated blood pressure

·         Rapid heart rate

·         Uncontrolled urination and defecation (A.D.A.M., Inc., 1997-2008; Mayoclinic, 1998-2010).

 

When to consult your doctor

Make an appointment with your doctor for a tetanus booster shot if your child has a deep or dirty wound, hasn’t had a booster shot in 5 years, or you are unsure of his vaccination status. See your doctor for a tetanus booster shot for any wound, particularly one that has been contaminated with dirt, animal faeces or manure, if your child hasn’t had a booster shot in the past 10 years or you are uncertain of his vaccination status (Mayoclinic, 1998-2010).

 

Diagnosis

A tetanus diagnosis is made on the basis of the following

·         Physical examination

·         Medical history

·         Immunisation status

·         Signs and symptoms of tetanus – muscle spasms, stiffness and pain (Mayoclinic, 1998- 2010)

 

Treatment

Since tetanus is an incurable disease, treatment generally involves wound care, medications to ease symptoms and supportive care.

 

Wound care

The site of the infection will be cleaned and drained to remove any dirt, abscesses, dead tissue or foreign bodies (emedicinehealth, 2010).

 

Medications

·         Antibiotics are used to treat the source of the bacterial infection

·         A course of tetanus antitoxin injections (such as tetanus immune globulin) may be given to                 neutralise the toxins already circulating in the blood

·         Sedation and muscle relaxants are given for muscle spasms

·         Pain medication is prescribed as needed

·         A tetanus booster shot is given in order to prevent future tetanus infection

·         Other medications, such as magnesium sulphate and certain beta blockers, may be used to                control involuntary muscle spasms, especially those affecting heart beat and respiration

·         IV rehydration may be required because constant muscle spasms place increased metabolic               demands on the body

·         Bed rest in a non-stimulating environment; i.e. dim lighting, reduced noise, and a stable       temperature, help reduce the frequency of muscle spasms (A.D.A.M., Inc., 1997-2008;          Children’s Hospital Boston, 2005-2010; emedicinehealth.com; eMedicineNet, 2010)

 

Supportive care

In the case of severe respiratory problems, a tracheostomy, or breathing tube, will be surgically inserted into the windpipe or temporary mechanical ventilation may be required (Children’s Hospital Boston, 2005-2010).

 

Prognosis

Without treatment, tetanus can be fatal, killing 1 out of 4 infected people. The death rate among untreated newborns is even higher. With the correct treatment, a person who survives the acute phase of the illness generally recovers completely (A.D.A.M, Inc., 1997-2008).

 

Prevention

 

Self-care at home

All wounds that cause a break in the skin need to be cleaned thoroughly with soap and running water. Any open wound runs the risk of developing tetanus. Use a clean dry cloth to stop or minimise bleeding. Apply pressure directly to the site of bleeding to help control blood loss. Apply a thin layer of antibiotic ointment to the wound to discourage bacterial growth and infection. Although exposure to air speeds up the healing process, apply a bandage daily to keep the wound clean and free of bacteria, until a scab has formed (emedicinehealth, 2010; Mayoclinic, 1998-2010).

 

Tetanus vaccine

Due to the adventurous, playful and sometimes accident-prone nature of children, it is important to immunise them against tetanus. Once the bacteria have entered the skin, bathing and hand washing have little effect on preventing its progression (CHOP, 2010).

 

The tetanus vaccination is contained in a preparation known as the DTaP, where the T stands for tetanus. This vaccine is given in a series of 5 shots; namely at the ages of 2 months, 4 months, 6 months, 15-18 months, and finally at 4-6 years of age. The tetanus vaccination is made by taking the tetanus toxin and rendering it inactive by means of a chemical. The inactivated toxin is known as a toxoid. Once the toxoid is injected into the body, the immune system of the recipient produces antibodies against tetanospasmin. This means that a vaccinated person may get a Clostridium tetani infection but the toxins produced will be neutralised by their antibodies, and they will not suffer tetanus (CHOP, 2010; Methachildcare).

 

The tetanus vaccine may cause mild side-effects on administration, such as mild localised pain and swelling, and occasionally a low-grade fever. Severe allergic reactions, such as hives, difficulty breathing and low blood pressure, are rare and can be treated with medication (CHOP, 2010).

 

The tetanus vaccination does not provide lifelong immunity to the disease and it is therefore recommended that a booster immunisation is given every 10 years (Children’s Hospital Boston, 2005-2010).

 

References

http://www.mehtachildcare.com

http://www.scumdoctor.com

http://www.chop.edu/index.html

http://www.babycare.ayurvedicure.com

http://www.childrenshospital.org

http://health.nytimes.com