Tetanus is a potentially fatal disease which causes severe contraction of themuscles. Historically called "lockjaw," it usually begins with muscle spasmsin the jaw making it difficult to open one's mouth, causes difficulty swallowing, and stiff and painful neck, shoulder, and back muscles which soon spreads to muscles of the abdomen, arms, and legs. (A baby born in unsanitary surroundings can develop neonatal tetanus.) If not treated, the disruption of muscular control may result in fatal interference with breathing. Tetanus is caused by the bacterium called Clostridium tetani, a microorganism whichlives in soil, invades the body through breaks in the skin--especially deep puncture wounds--and produces a toxin called tetanospasmin. Although tetanus was widespread at the turn of the century, it can be prevented today through immunization.

Several important scientists made significant contributions to the control oftetanus. Arthur Nicolaier (1862-1942) discovered he tetanus bacterium in 1884. Three years later, while engaged in a study of disinfectants, German bacteriologist Emil von Behring noticed that the blood serum of tetanus-immune laboratory ratsneutralized the anthrax bacteria. He set about isolating the substance that gave the rats resistance to the acteria.

In the Berlin laboratory of scientist Robert Koch, Behring joined with Japanese bacteriologist Shibasaburo Kitasato, the first person to isolate the tetanus bacterium in pure culture in 1889. He later isolated and described the bacteria that cause diphtheria, anthrax, and bubonic plague. Behring and Kitasato discovered that the presence of tetanus and diphtheria toxins in blood cause the blood to produce antitoxins that neutralize the poisonous substances. When they injected small amounts of tetanus toxin into animals, the animals produced antitoxins, which gave them immunity from the disease. Furthermore, blood serum containing antitoxins extracted from these animals and injected it into other animals, gave the new animals immunity to tetanus, as well.They called this procedure "blood serum therapy."

Behring developed a way to produce antitoxin serum in guinea pigs, and laterdeveloped a toxin-antitoxin mixture which was an effective vaccine against tetanus. In 1893, French scientist, Pierre-Paul-Emile Roux (1853-1933), assistant to Louis Pasteur at the Pasteur Institute, developed improved procedures for using antitoxin serum to prevent as well as treat tetanus.

Today, the tetanus vaccine is included in the DPT vaccine, which also prevents diphtherinna and pertussis (whooping cough). The DPT inoculation contains weak toxins that serve to stimulate the growth of antibodies to the diseases.It is three shots administered twomonths apart beginning about two months after birth. Booster shots are given at fifteen months, and four to six years. Atetanus booster is recommended every ten years, even for the elderly. If a person suffers a dangerous ound, an additional tetanus injection may be administered at that time.

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