Tetanus Shot: effects.side effects and reaction to booster dose given during pregnancy.

Tetanus shot

Tetanus is an acute infectious disease caused by clostridium tetani, and characterized by intermittent tonic spasms of the masseters resulting in what is commonly known as lock jaw. Other symptoms include difficulty in swallowing, restlessness, irritability, stiff neck arms or legs, headache, fever, sore throat, chills, and tonic spasms. Later symptoms include difficulty in opening the mouth (trismus), facial muscle spasms resulting in a unique expression, which might look something like an elevated eyebrows known as Risus sardonicus and smile which appears fixed permanently. There is also profound spasm of abdominal muscles and also muscles of neck & back and even episthotonos may occur. Sphincteral spasm may cause urinary retention or constipation. Infections may also be seen post partum in the uterus known as maternal tetanus and in new borns near the umbilical region known as tetanus neonatroum. Clinically the disease does not confer immunity. Tetanus is a preventable disease of great significance particularly the neonatal form in developing countries. The manifestations of tetanus are caused by an exotoxin (tetanospasmin) elaborated by clostridium tetani, a gram positive anaerobic spore forming bacillus. Tetanus may follow trivial or even in apparent wounds if the oxygen content of the injured tissue is low. The mode of transporting the toxins to brain maybe blood borne or it may travel along the nerves which supply the motor system all the way to brain. The incubation period ranges from 2 to 50 days.

Therapy involves maintaining an adequate airway ensuring early and adequate use of human immune serum globulin neutralizing nonfixed toxin, preventing further toxin production, providing sedation controlling muscle spasm hypertonicity , fluid balance, and intercurrent infection. The commonly known tetanus shot is a prophylactic antiserum injected into a person to provide adequate cover against the eventual development of tetanus. The benefit of a tetanus shot is very much depended on how much tetanospasmin is bound to the ending of the nerve known as synaptic membrane. For adults a single IM injection of 3000IU of tetanus immune globulin is generally recommended, with a range of 1,500 to 10,000IU depending on wound severity. There is always a considerable risk of serum sickness and in present days antitoxin of animal origin is far less preferable. If horse serum has to be used however the usual dose is 50,000IU intra muscular or intra venous. In some cases immune globulin is injected directly into the site of the wound, but this is not as important or even effective as proper and clean wound care. An allergic or hypersensitivity reaction may occur to tetanus shot. These are generally IgE mediated reactions after the patient has been exposed to the drug one or more times without incident. Once hypersensitivity has developed, the reaction can be produced by doses far below therapeutic amounts and usually below those levels that produce idiosyncratic reactions. Clinical features include are restricted in there manifestation. Skin rashes, serum sickness like syndromes, unexpected fever, anaphylaxis, and eosinophillic pulmonary infiltrates appearing during drug therapy are usually due to hypersensitivity. Some cases of anaemia, thrombocytopenia and agranulocytosis may also be observed. Rarely vasculities develops after repeated exposures. Liver damage has been reported in circumstances consistent with development of specific hypersensitivity.