Tetanus is an infection caused by the gram positive anaerobic bacteria Clostridium tetani. This infection has been controlled universally by various immunization programs and tetanus vaccines. However, there are still cases of tetanus being reported in the unimmunized group of developing countries and even in developed countries like the United States. Tetanus infections can be prevented by active and passive immunizations.
Active immunization of tetanus:
The best preventive mode for tetanus is by an active immunization. The active immunization consists of two preparations — the combined vaccine and the monovalent vaccines. The combined tetanus vaccine includes the diphtheria vaccine and pertussis vaccine. It is called the DPT vaccine. The first dose is given at six weeks after birth followed by two doses each at an interval of four to eight weeks. The first booster is given at 18 months and the second booster which contains only tetanus and diphtheria vaccine is given at five to six years of age.
The monovalent tetanus vaccines include plain or formal toxoid and adsorbed tetanus toxoid. 0.5 ml of the tetanus vaccine is injected in the deltoid region followed by a second dose after four to eight weeks.
Passive tetanus immunization:
The passive tetanus immunization is for temporary protection against the tetanus infection. It is available as Human tetanus hyper immunoglobulin and Anti Tetanus Serum- equine.
Active and passive tetanus immunization:
This type of immunization is given to non-immune persons. Here the patient is given 1500 units of ATS in one arm and tetanus toxoid in the other arm. This is followed by TT injection at six weeks and later the third dose after one year.
Tetanus vaccination in pregnant women:
Tetanus vaccine is administered in pregnant women to avoid tetanus neonatorum. At least two doses should be given, one as early as pregnancy is confirmed and the next at least three months prior to delivery.
Antibiotics against tetanus:
Although tetanus vaccine is the best mode for the treatment of tetanus infection, antibiotics like Benzathine penicillin or Erythromycin can be given to penicillin sensitive persons. This kills the vegetative forms of the tetanus bacilli that may emerge from the sporulating form.