Among the many medical issues people tend to worry about after disasters - or any injury - is whether they need a tetanus shot. From my years in practice, I've noticed quite a few don't know what a tetanus shot is, what it prevents and when they need one.
Before the mid-1940s, when the shot wasn't available, the number of documented cases of tetanus infection in the U.S. ran about 300 to 500 annually. That number is now about 30 per year. The decrease is attributed to better wound care and the tetanus shot.
Worldwide, there are more than 10,000 cases reported each year, presumably for the opposite reasons - poor hygiene and no tetanus shot.
Though tetanus is rare in the U.S., the mortality rate runs at about 30 to 40 percent if the disease isn't treated. With the best of hospital intensive care, that rate falls to about 10 percent - still significant.
One of the main distinguishing characteristics of tetanus is severe, prolonged muscle spasms. If the throat muscles spasm, victims often can't breathe and require a ventilator. They can't swallow either, hence the nickname "lockjaw."
What tetanus is
Tetanus is caused by bacteria found in dirt and manure. Many associate tetanus with getting cut by a rusty nail. While that's one way to get it, the bacteria can enter the body with any scratch or cut. In general, the deeper and dirtier the wound, the higher the risk. Rusty nails can cause a puncture wound that's impossible to clean adequately. Other high-risk wounds are crush injuries and those associated with broken bones, burns and face injuries.
Once bacteria enter the body, they produce a toxin that causes the symptoms, which start three to 21 days after exposure. Antibiotics can kill the bacteria but apparently not fast enough to thwart the production of the toxin. So your best bet to fight tetanus is building antibodies to the toxin before you become infected.
What the tetanus shot does
To build antibodies, you start with a base series of immunizations. But with time, this antibody buildup weakens. That's why you need a regular booster that pushes your body to produce more antibodies. Since this boost might take a few days to peak, it's best to get a shot every 10 years to stay ahead. Many doctors would suggest one at five to seven years if you get a wound during that time that is high-risk. Severe side effects from a tetanus shot are rare, but many do have a sore arm the next day. Acetaminophen (Tylenol) or ibuprofen (Advil) and a few days to recover usually solve that problem.
If you have what a doctor thinks is a high-risk wound, you might require an additional injection of tetanus immunoglobulin. This shot is full of antibodies that start fighting the toxin immediately, working with the antibodies you've already built from your immunization series. This also will be suggested if you never had your full tetanus shot series as a child or didn't continue with the boosters.
Unfortunately, the antibodies from the immunoglobulin shot don't last long. Since you can't fully predict what injury might contain the bacteria, you need the basic series for overall coverage.
Family doctor James Hubbard teaches how to survive during disasters or any time you can't get expert medical help at TheSurvivalDoctor.com.