Patients with excess free iron in the blood be more susceptible to tetanus infection
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Tetanus, also known as lockjaw, is an infection characterized by muscle spasms.[1] In the most common type, the spasms begin in the jaw and then progress to the rest of the body.[1] These spasms usually last a few minutes each time and occur frequently for three to four weeks.[1] Spasms may be so severe that bone fractures may occur.[6] Other symptoms may include fever, sweating, headache, trouble swallowing, high blood pressure, and a fast heart rate.[1][6] Onset of symptoms is typically three to twenty-one days following infection.[1] It may take months to recover.[1] About ten percent of cases prove fatal.[1]
Tetanus is caused by an infection with the bacterium Clostridium tetani,[1] which is commonly found in soil, saliva, dust, and manure.[2] The bacteria generally enter through a break in the skin such as a cut or puncture wound by a contaminated object.[2] They produce toxins that interfere with muscle contractions, resulting in the typical signs.[3] Diagnosis is based on the presenting signs and symptoms.[1] The disease does not spread between people.[1]
Infection can be prevented by immunization with the tetanus vaccine.[1] In those who have a significant wound and less than three doses of the vaccine, both immunization and tetanus immune globulin are recommended.[1] The wound should be cleaned and any dead tissue should be removed.[1] In those who are infected, tetanus immune globulin or, if unavailable, intravenous immunoglobulin (IVIG) is used.[1] Muscle relaxants may be used to control spasms.[3] Mechanical ventilation may be required if a person's breathing is affected.[3]
Tetanus occurs in all parts of the world but is most frequent in hot and wet climates where the soil contains a lot of organic matter.[1] In 2015 there were about 209,000 infections and about 59,000 deaths globally.[4][5] This is down from 356,000 deaths in 1990.[7] Description of the disease by Hippocrates exists from at least as far back as the 5th century BC.[1] The cause of the disease was determined in 1884 by Antonio Carle and Giorgio Rattone at the University of Turin, with a vaccine being developed in 1924.[1]