By: Mary Peterson, meg21[at]stny[dot]rr[dot]com, Horseheads, NY
How many times have you pulled a weed or walked barefoot in your garden, ‘for just a minute’ without adequate protection? Shoes, gloves and a tetanus shot are vital tools to do the job right and do it safely.
Tetanus is an extremely serious disease of the nervous system caused by an exotoxin (bacterial poison) produced by Clostridum tetani bacteria. Although tetanus is preventable through safe and effective immunization, nearly 1 million people die each year world-wide. In the US, there are about 200 cases reported annually.
Most of these cases are newborns who contract tetanus through contamination or infection of the umbilical cord. Emil von Behring developed a vaccine against diphtheria and tetanus in 1890 and outbreaks of tetanus in the trenches in 1915 were controlled through serum injections. In 1925 a Canadian pathologist James Collip obtained an extract from the parathyroid gland for treating tetanus.
So who is at risk? Anyone who has not received an immunization; anyone working in a garden who comes in contact with thorns or sharp tools; anyone who has allowed their immunization to lapse.
You get tetanus by having a cut or deep puncture wound that receives little oxygen and becomes infected with C. tetani. Wounds that are deep, jagged, dirty or have gone untreated for several hours carry a high risk of tetanus. Worldwide, tetanus is estimated to kill 1 million people annually, mostly in the third world countries where people haven’t been immunized.
While this bacteria is wide spread, it is most commonly found in soils contaminated with animal or human feces (solid waste). Horse manure is often the source of this bacteria. The tetanus bacteria produces spores that are resistant to drying and therefore can survive for long periods of time in soil, street dust, dried fecal material and in injectable street drugs.
Clostridium tetani infects human cells at the wound site, and causes them to produce the tetanus toxin. This toxin is poisonous to nerves. Tetanus causes painful muscle spasms usually starting with the jaw and neck and can affect the muscles required for breathing. Symptoms include headache, depression, difficulty in swallowing and in opening the mouth. Stiffness of the neck and spasm of the facial muscles gradually spreading to other muscles of the body.
There is no microbiological or blood test to confirm the diagnosis. Clinical physical evidence confirms the diagnosis along with the history of a contaminated injury. In addition to antibiotics respiratory support using a ventilator may be required along with muscle relaxants.
Aside from keeping your tetanus immunization renewed every 10 years, all wounds should be promptly and carefully cleaned with soap and water.
Fortunately there is an immunization against tetanus. It is routinely given during childhood, but immunity is not permanent. Boosters are needed at least every 5 to 10 years. A tetanus booster is only effective if given within 72 hours of a wound.
The usual period between boosters is 10 years. Any serious, contaminated puncture wound should receive a booster shot of tetanus toxoid and a doctor may order additional antibiotics to prevent any further infection of the wound.
Left untreated, symptoms usually start 10 days after the wound is contaminated by the bacteria, but the onset can range from 3 to 21 days. Even with aggressive treatment, tetanus kills between 10 and 20% of the people who develop it. If left untreated approximately 60% of all cases are fatal.
Rosarians, especially those who have not had their tetanus booster in the last ten years, are at risk. Those over 60 are most vulnerable.
While you are looking over your catalogs for new roses for the coming season, review your immunization record too and if your last shot was 10 years ago, schedule an appointment to have your tetanus immunization upgraded. There could be a killer lurking in your garden, so you want to be prepared.
To download the pdf version of this article click here.