When should the tetanus shot be given? What are the symptoms of tetanus?

There are always many accidents in daily life that cause some abrasions on the skin and some wounds will bleed. If such wounds are not treated with disinfection, they are prone to infection and can also lead to tetanus. So, when should the tetanus shot be given?

When should the tetanus shot be given?

The so-called tetanus shot is a way of obtaining protection through passive immunization, that is, after facing possible infection, protection is obtained by injecting anti-tetanus globulin. There are two commonly used preparations: 1) Tetanus antitoxin (TAT, derived from horse). 2) Human tetanus immunoglobulin (TIG, derived from humans). The former requires a skin test, while the latter does not. The price is slightly more expensive, about a few dozen yuan, which is within the psychological tolerance of ordinary people.

Of course, the sooner TAT and TIG are injected after an injury, the better, generally not more than 24 hours, but it is still worth injecting after that (because the incubation period of tetanus infection is generally about a week, but the disease can occur as quickly as 24 hours, so the sooner the injection after an injury, the better). The protection time of TAT is about 2-3 days, and the protection time of TIG is 2-3 weeks. There is no absolute conclusion in clinical practice on this, but it is roughly within this range. If you face the risk of infection again after this time, you need to be injected again. The duration of protection provided by active immunity obtained through injection of tetanus toxoid is relatively complicated, and you can consult your doctor. Generally speaking, if you are injured within 3 years after the last vaccination, you do not need to be injected with tetanus toxoid again. If it has been more than 3 years, you should get a booster injection. For severely contaminated wounds, in addition to the injection of tetanus toxoid, TAT or TIG may be injected at another site as appropriate. In fact, ideally, if someone has no history of immunization and is facing possible infection, in addition to being protected by an injection of TAT or TIG, they should also be injected with tetanus toxoid for active immunity if circumstances permit. However, due to clinical limitations such as individual and hospital reasons, this measure has not been taken, and the use of TAT or TIG alone is still the main method.

For pregnant women, the toxic effects of TAT or TIG are unclear and should be used with caution. However, tetanus toxoid (i.e. tetanus vaccine) is safe and, generally speaking, is used the same way as normal people. As for the prevention of neonatal tetanus, if the pregnant woman has been vaccinated with tetanus toxoid in the past, she only needs to receive a shot of tetanus toxoid in the early pregnancy, at the latest 3 weeks before delivery. The antibodies can cross the placenta to allow the fetus to also obtain this protective antibody. If the pregnant woman has not been vaccinated with tetanus toxoid in the past, she should receive another shot 4 weeks after the first shot as a booster.

What are the symptoms of tetanus?

Symptom 1: Muscle spasms and cranial nerve palsies

The early clinical symptoms of tetanus are: spasm of the masseter muscles, clenched jaws, and a "bitter smile" on the face due to contraction of the facial muscles. Most patients often suffer from opisthotonos, laryngeal spasm, dyspnea, and even suffocation to death due to muscle spasms or tonic convulsions. Patients who have been vaccinated with tetanus toxoid in the short term or have a mild infection may develop localized or abortive muscle spasms, or convulsions of a part or a limb. About 3% to 4% of tetanus patients with head injury develop facial paralysis accompanied by contralateral facial muscle spasm, but it is rare for cranial nerves III, VI, and VII to be damaged simultaneously.

Symptom 2: Central nervous system dysfunction

Severe cases often present with a series of symptoms and signs, which are currently believed to be related to sympathetic nervous system hyperfunction. The patient complained of palpitations, sweating, fever, pale distal limbs, increased blood pressure, especially systolic blood pressure; increased excretion of catecholamines in urine and high blood sugar. These are all symptoms of tetanus.