Tetanus is an often fatal infectious disease caused by the toxigenic strains of the tetanus bacillus. Tetanus is a devastating disease in developing countries and has not yet entirely disappeared from industrialized countries.
The bacterium penetrates the body through lesions (e.g., soiled wounds, open fractures, chronic ulcers…) or as a result of medical acts performed under insufficient aseptic precautions.
Following an incubation period of 4 to 21 days, tetanus most often presents as a generalized spastic disease. Contractions of the jaw muscle (or trismus) are a characteristic feature and are followed by spasms of the back muscles (opisthotonos) and sudden generalized convulsions.
In the absence of treatment, the outcome is almost always fatal, particularly in the very young or the elderly.
Even after appropriate treatment, tetanus-related mortality remains high.
Tetanus bacillus is ubiquitous and present in the soil in the form of highly resistant spores. Its reservoir can thus not be eliminated, but vaccination is a very effective weapon in the prevention of the disease.
In 2002, over 200,000 tetanus-related deaths were estimated to occur worldwide, of which approximately 180,000 were due to neonatal tetanus. (26)
Tetanus vaccines are based on tetanus toxoid, and are usually combined with other valences (e.g., diphtheria, pertussis, polio, Hib…).
26 - Tetanus vaccine. WHO position paper. WER 2006, 81:197-208: