Tetanus is a nervous system disorder that causes severe muscle spasms. It is caused when a spore that is in the soil, known as Clostridium tetani, gets into damaged skin. It will not grow in healthy tissues, which is why things such as splinters and other puncture wounds, burns, and certain fractures put the body at risk for it. Once inside the body it produces a toxin that irreversibly attaches to the spinal cord and brain stem, and after a few days the symptoms begin.

I can’t imagine many diseases that would make me feel more helpless than if I watched my child in the grips of tetanus. It starts with restlessness, sweating, and rapid heartbeat. Later it progresses to the inability to open the mouth due to muscle spasms (lock jaw). They have episodes of intense and painful contraction of muscles and intense muscle spasms that can be triggered by stimuli such as physical touch, light, or sound. It would be so terrible to try to comfort my child and triggering an episode of them arching their back, clenching their hands, straightening their legs, and holding their breath. The worst part is that there is no change in their awareness, they know it is happening, and they know that it hurts.

The muscles surrounding the throat and lungs can even stiffen to the point that they may need help breathing as well. They are usually monitored in the intensive care unit due to this, and also for the need to control pain.

An intensive care doctor told us the story of a young unvaccinated child with tetanus: “She was walking outside with her parents in a large field, and cut her foot on something. Soon after, she started having muscle spasms in her calves. They got more and more intense, so her parents brought her to the hospital.” The child ended up needing intensive treatment, including numerous rounds of painful treatment injections. The parents finally realized how important vaccination was when she was transferred to the ICU because there was concern she would need assistance with her breathing.

How long can the symptoms last? A long time. The toxin attaches to the nerve and requires the new nerve growth until symptoms resolve, usually around 4-6 weeks. The main treatment is trying to control the pain, and ensuring they continue to breathe.

The bad news is that we can’t eliminate the element in the soil that causes tetanus, and we certainly can’t protect our children from open wounds.

But we CAN give them a vaccination that can prevent this terrible disorder!

Related stories:

• The Flu Can Kill
• It's only the flu that killed her
• Chicken pox: Why We Vaccinate

About the author

Sperry Binnicker is a nurse practitioner at Willow Park. Sperry joined Cook Children's in 2009 in the Pediatric Intensive Care Unit (PICU). In that role, she earned the Daisy Award, an award given to a nurse that is nominated and selected by the parents of patients for excellence in patient care. She continued her education while working full time and received her master’s degree from the University of Texas at Arlington in May of 2015.She is a Board Certified Pediatric Nurse Practitioner and a member of the National Association of Pediatric Nurse Practitioners. Learn more about the Willow Park staff here.

Now I know that the reason that no one got whooping cough when I was younger was due to a vaccine that I received called DTP. We now give a slightly different version of the vaccine called DTaP. Children are supposed to received DTaP at 2, 4, 6, 12-18 months, and 4 years of age. They then get a booster dose of a related vaccine called TDaP at 11 and a second TDaP booster in adulthood (recently added to the recommendations).

Whooping cough, which is also known as pertussis, has been on the rise all over the country for several years now. I see it in our clinic in Mansfield and throughout the area. There are various theories as to why it is coming back. Some theories center around the idea that people’s immunity toward pertussis wears off as they get older. Others deal with the issue of people who do not vaccinate themselves or their children. Still more center on possible mutations in the illness itself. Whatever the cause, what we do know is that it is here and causing problems.

Whooping cough can be very dangerous for children, especially if they are under age 1, but many parents don’t realize that their children have it until they have been sick for at least a couple of weeks. At the beginning, it can look like a simple cold. The typical story is that the child has been sick for 2 weeks or more and is having “coughing spasms” that can cause them to “lose their breath,” vomit, or even pass out. Regular cough medicine hasn’t helped (not to mention it isn’t recommended in children). Parents have typically tried all of the regular tricks like honey, humidifiers, vapor rubs, etc.

Under age 1, however, children don’t necessarily cough. Instead of coughing, infants may simply not breathe, which is called apnea. Since that is a very dangerous and silent problem that can kill, we must do our best to protect infants from even catching pertussis – which is where vaccination comes back into play. All people in the same household as an infant, including adults, should have a current pertussis vaccination.

Unfortunately, pertussis doesn’t have a simple, quick test like strep or flu does. In our office in Mansfield, we do have a test that we can take the sample in the office, though, which isn’t typical of many clinics. The result from the test is usually available in about 3 days. Pertussis can be treated with an antibiotic, but only if it is caught early. Once past the early phase, a person must simply recover from it, and that can take up to 3 months, even if there are no complications from the infection.

Vaccination is not a 100 percent guarantee that children will not get the whooping cough, however, it has been shown to greatly reduce their chances of getting it, and if they do get it, their case will likely be less severe than if they were not vaccinated. There are also children who cannot receive the DTaP vaccine for various reasons, some of whom have serious health problems. We all need to do the best we can to protect ourselves and our neighbors from this disease, which is making quite the comeback in our community.