Power Point of Tetanus and vaccine -1.pptx

Tetanus

1. Tetanu

2. Tetanus - What is Tetanus? •The Biology: Clostridium tetani - Prevention by Vaccination •Treatment

3. What Is TETANUS ? Bacterial disease , a ffects the nervous system . Often caused by infection to cuts/wounds, especially when they are deep Other causes: Burns Abortion Frostbite IV drug abuse

4. Continual excitatory discharge of the motor and autonomic nervous system — Lockjaw — Suffocation — Muscle rigidity/spasms — Stiffness — Bell's Palsy — Dysphagia Uncontrollable muscle spaSIRS may lead to respiratory or cardiac arrest, and severe BP changes What Is TETANUS?

5. Most common : Symptoms may progress in a descending pattern Frequent muscle spasms lasting several minutes Uncommon : Affects a specific area of the body Same area as the infection site May be a precursor to generalized tetanus What Is TETANUS?

6. Neonatal Tetanus Affects newborns without passive immunity from their mother Usually due to infecte d umbilical stump Rare in U.S., but prevalent in underdeveloped countries Neonatal Tetanus ID# 6374 (1995). Source: Center for Disease Control--Public Health Image Library What Is TETANUS?

7. Rare form Mainly involving the facial nerves Sometimes occurs with ear infections, or after head injury Man with Cephalic Tetanus (1965). Source: Center for Disease Control- - Public Health Image Library What Is Chepalic TETANUS?

8. Decreased prevalence in industrialized nations Tetanus is rare in the U.S. due to immunizations and improved wound car e Approximately 5 deaths per year In the U.S. it affects mostly older people Gardening during retirement years Mortality rate in the elderly: >50% Incidence of Tetanus

9. Worldwide public health issue Ninth most common cause of death due to infectious disease Approximately 250,000 deaths per year Global fatality rate: 30-50 o Neonatal tetanus Mortality rate: 90% Incidence of Tetanus

10. THE BIOLOGY: C LOSTRIDIUM TETANI Obligate anaerobe Bacillus About 0.3- 1.Um by 3- 12pm Gram- positive Mesophile Endospores “drum- stick” shape Motile Some may produce flagella 3-4 times it's length Gram Stain of Cloetridium tetani — ID#6072 (1595). Source: C enter for Disease Control- - Public Health Image Library

11. Clostridium tetani Produces two exotoxins: Tetanospasmin— neurotoxin that causes muscle spasms Tetanolysin no known clinical significance Incubation period = 3 - 14 days Produces spores Extremely resilient to temperature, moisture, chemicals, and even 10-15 minutes of autoclaving (l2 l‘C) Germination occurs when exposed to anaerobic conditions such as wounds and tissue necrosis THE BIOLOGY: C LOSTRIDIUM TETANI

12. THE BIOLO£xY: lJLt1i?TFIDIUM TFTANI Commonly found in: Soil Manure/human & animal feces Dus Rust Noncommunicable

13. Tetanospasmin: Excreted into the bloodstream Travels through nerves or by lymphocytes to CNS Attach to presynaptic inhibitory nerve endings . Blocks the release of inhibitor neurotransmitters , causing muscle spasms One of the most p o tent toxins known Lethal dose: o 175 nanograms for a 1541b/70kg person (That's 0.000175 miligrams ) THE BIOLOGY: C LOSTRIDIUM TETANI

14. PREVENTION BY VACCINATION The best way to prevent Tetanus is by vaccination Virtually 100% efficacy rate in properly immunized Girl Receives Vaccine— ID#9297 (2006). Source: Center for Disease Control--Public Health Image Library

15. PREVENTION BY VACCINATION Three types of Vaccines: DTaP vaccine (Diphtheria, Tetanus, Pertussis) DT vaccine (Diphtheria, Tetanus) Td Vaccine (Tetanus, Diphtheria)

16. DTaP: “3-in-1” Recommended for childhood immunization Protects against Diphtheria, Tetanus, and Pertussis Given 5 doses(2 months, 4 mo nths, 6 m onths, l n - 18 m onths,4- 6years) Only for children under age 7 PREVENTION BY VACCINATION

17. DT “2-in-1” For children less than 7 years old. If a child has an allergic reaction to the Pertussis vaccine in DTaP. PREVENTION BY VACCINATION

18. Td “2-in1” Adult vaccine Slightly differs in dosage of Diphtheria vaccine than in DT. Anyone over the age of 7 Injected, usually in arm PREVENTION BY VACCINATION

19. T Vaccine: A vaccine for Tetanus by itself can be given (Tetanus Immune Globulin/HTIG) -Injected into arm -Made from blood of person or animal containing antibodies against Tetanus Typically for an adult who is having a dirty wound/injury taken care of PREVENTION BY VACCINATION

20. TREATMENT Although immunization is available, Tetanus is not eradicated.

21. TREATMENT Those at risk: Lack of immunization Partial Immunization Fully immunised patients have still been documented to contract the disease Very rare

22. TREATMENT Main Goals: Use a method of attacking the anaerobic, spore forming bacillus Find a way around the actions of the nervous system caused by the Tetanus toxic

23. TREATMENT Recognition of Tetanus Vital to the victim Stabilize and Resuscitate Neutralize Tetanus Toxin Clean wound with antibiotics Treat any muscle spasms Control Pain

24. TREATMENT Resuscitation Most common cause of death in Tetanus is due to respiratory failure. Can be a general complication of the disease, failure to treat spasms quickly enough, or as a side effect of medications. Tracheotomy is performed as precaution. Helps to prevent a stimulus from causing another spasm.

25. TREATMENT agents Antibiotics Alpha and Be\a Blocker Alpha 2 Agonise Opioid Detoxified Exotoxin Human Immunoglobin P ancuronium Succinylchoiine Class Drug Indication Benzadiazepines Diazepam Midazolam Spasm Control and Sedation GABA- B Agonist Inthrathecal baclofen Spasm Control Refractory to BZ Muscle Relaxant Dantrolene Spasm G ontrol Alternative Neuromuscular blocking Vecuronium SpaSm Control Refractory to BZ, Metronidazole Benzyl Penicillin Benzathine Penicillin 1. Labetaloi 1. Clonidine 1. Morphine Sulfate \ . DTaP 2. Tetanus Toxoid 1, HTIG Minimize Sedation Elimination of C. Tetani Toxin Control of Autonomic Dysfunction Control of Autonomic Dysfunction Control of Pain and Peripheral Vasodilatation Active Immunization Passive lmm unization, Neutralizes Free Exotoxin, Treatment of Tetanus, Post exposure

26. TREATMENT HTIG (immune globulin) Tetanus toxin binds to nerve endings that normally calm the muscle, blocking the inhibitory signals. HTIG neutralizes the free form tetanospasmin toxin by binding to it, prohibiting it from blocking signals Frees the neurotoxin without crossing blood brain barrier

27. TREATMENT Administration of Td Contracting the disease does not ensure immunity Injected simultaneously with HTIG Enhances short- term (passive) immunity and long- term (active) immunity.

28. TREATMENT Eliminating the toxin: Excision — Surgical removal of the toxin producing organisms. Creates an aerobic environment, hindering the growth of C. tet ani spores Only to be done after Td is given to the patient due to the release of t etanospasmin during the procedure

29. TREATMENT Antibiotic mode of action depends on which antibiotic is used Metronidazole is used most often for tetanus Works by inhibiting nucleic acid synthesis