Doctors are concerned about even a small uptick in the terrible infection often called lockjaw. Symptoms that may go away three to 21 days to appearincluding muscle spasms that make it difficult to breathe. As the infection spreads, the patient's jaw tightens, causing the face to form a wide smile and the back muscles to arch into a painful arch.
“It looks terrible,” said Dr. Mobin Rathore, chief of pediatric infectious diseases and immunology at the University of Florida College of Medicine in Jacksonville.
Tetanus bacteria live in soil and manure. Infection may arise from a puncture wound, and the illness may persist for several weeks of medical care.
Treatment can be difficult and expensive. 6 year old child unvaccinated boy in Oregon He racked up nearly $1 million in medical bills after contracting tetanus in 2019, according to a report from the Centers for Disease Control and Prevention.
Rathore compared the cost of vaccines to the cost of intensive care.
“It’s not even pennies to the dollar, it’s pennies to hundreds of thousands of dollars,” Rathore said. “It's very expensive.”
When a 9-year-old unvaccinated patient arrived in Rathore, Florida this year with a muscle spasm, he recognized the signs. He remembered tetanus wards from his medical school days, where patients were treated in darkness and silent isolation.
“The slightest noise can cause spasms in many of these patients,” Rathore said.
Tetanus spasms, which can also be triggered by light (known as “photophobia”), are extremely painful and can tighten the muscles around the airways.
Between the bright lights, loud noises and incessant beeping in the hospital's intensive care unit, options to minimize stimulation to Rathore's young patient were limited. The nine-year-old was sedated, intubated and given tetanus immune globulin antibodies and a vaccine to reduce the risk of future illness.
The child was in the hospital for 37 days.
Dr. Matthew Davis, the plant's chief medical officer and chief scientific officer for Nemours Children's Health in Florida and Delaware, said that “it was only after we had widespread vaccination that we saw a decrease in tetanus cases and therefore a decrease in the risk of mortality from it.”
John Johnson, a vaccine and epidemic response adviser at Doctors Without Borders, works in countries like the Democratic Republic of Congo (DRC) where tetanus remains a problem. Last year, 540 cases were reported in the DRC. according to the World Health Organization.
“This is one of those things that is so stupidly easy to prevent,” Johnson said. “If you see one case of tetanus in the United States, it's a disgrace. There's no reason we should see more of this disease.”
“My jaw was completely locked.”
After the initial series of vaccinations in childhood, booster vaccinations are recommended for adults every 10 years, although many are unaware of the need.
Nikki Arellano, 42, hasn't had a tetanus shot since 2010, when she was injured while helping her friend prepare for her wedding last month. An accident with a metal arch at the altar resulted in a small cut on his leg. The following week, she had difficulty chewing during lunch at work due to jaw pain.
Two days later she could not open her mouth.
“My jaw was completely shut,” said Arellano, of Reno, Nevada. “I went to the emergency room and they tried to give me a bunch of sedatives, painkillers and muscle relaxants to get my jaw open, but nothing worked.”
Arellano was diagnosed with tetanus and admitted to the hospital. She was connected to an intravenous pump so she could receive antibiotics.
“Every time it ended, it was like a very, very loud beep. When it started, my muscle contractions would stop,” she said.
Arellano said her spasms first started in one arm, then spread to both arms and then to her entire body. “Your back was arching really bad, like there were really, really painful muscle spasms.”
Arellano began having trouble swallowing, raising concerns that her airway might be compromised.
“It was very scary,” she said.
She spent almost a week in the hospital and is still recovering.
Increased risk associated with climate change
Natural disasters such as hurricanes, tornadoes, and floods are known risk factors for tetanus outbreaks. When people rummage through debris, they are also more likely to be injured by loose fingernails or shards of glass.
“As the Earth warms, there is already a documented increase in the frequency, intensity and duration of many extreme weather and climate events,” said Christy Eby, an epidemiologist and professor of global health at the University of Washington who studies the health impacts of climate change. “And as there is more flooding, fewer vaccinations against diseases like tetanus means people will be at greater risk.”
Some states that are at greatest risk of severe natural disasters, including Florida, Texas and Kansas, have seen a noticeable decline in tetanus vaccinations, according to NBC News.
