TETANUS

New Zealand Listener, Volume 31, Issue 792, 24 September 1954, Page 18

TETANUS

This is the text of a talk on health broadcast recently from ZB. YA

and YZ stations of the NZBS

by

DR

H. B.

TURBOTT

Deputy-

Director-General of Health __

S a boy, somebody frightened me about lockjaw, or tetanus. Whenever I stood on a nail or was wounded from anything rusty, I was relieved when there was no stiff jaw trouble afterwards at mealtimes. There had been planted in my mind an association between wounds with dirty, rusty things and lockjaw. Not much was known about tetanus then. Antitoxin had not been discovered. It’s amazing how recent our knowledge is in many diseases in which prevention or cure is taken as a matter of course by this generation. It was only in 1889 that a Japanese doctor, Kitasato, working in Koch's laboratory in Berlin, discovered the tetanus bacillus. It was not until 1915 that an antitoxin was used to prevent lockjaw. Yet the disease was known to Hippocrates 400 years before Christ. One of his aphorisms was: "Those who are attacked by tetanus either die in four days, or, if they survive these, recover." He thought the cause was a loss of phlegm from the brain making the nerves dry up. An English Outline of Military Surgery in 1832 described tetanus because it was common in troops

in Egypt and India, sacknaleie it was the result of wound injury to a nerve, but being puzzled because lockjaw sometimes happened after the slightest of wounds. Nowadays we have sufficient knowledge to prevent its occurrence. Yet in New Zealand in 1953 we know of 29 cases. On average, about every second person who contracts tetanus dies. It’s not easy to cure, but readily prevented. That’s why I am talking about it. The tetanus bacillus is a germ, tiny in size, but packing a terrific punch when it gets to manufacturing its poison or toxin! This it can only do in the absence of air. Hence the association of lockjaw with deep wounds, or wounds sealed off with pus or dirt or even plaster. Grass eating animals harbour this germ in their gut, especially horses. Sometimes it is found in human faeces (continued on next page) a A A TL LL LL LT

The germ itself is particularly tough, and to make sure of survival has a spore form. Tetanus spores can live for years, in sun, wind, hail or snow. Dust on farms, from gardens heavily manured, from streets-these are the more likely places to find the spores. Deep punctured wounds are just the thing, dark and damp with oxygen cut off. Nails, splinters, firearms, garden forks make the kind of wounds that are ideal. Skin scratches and scrapes are less likely to provide the right conditions, unless festering or sealed off. After the germ gains entry, it takes up to three weeks to develop its poison. This toxin acts on the nerves, The neck muscles stiffen, there are painful spasms of the jaws. The only hope of saving life lies in antitoxin treatment in the early stages. As the disease progresses, the muscles "generally go into spasms and the body is racked with convulsions. Since the Great War doctors have learnt to guard against tetanus by giving antitetahic serum to all accident victims and wherever they encounter deep and dirty wounds. The last World War proved the value of prevention. Troops in that.war were given prior protection, and didn’t have to rely solely on antitetanic serum after they were wounded. The same process was used as for diphtheria protection. The troops were immunised beforehand with anti-tetanus

toxoid. Not a single case of tetanus followed the violence of the Dunkirk landing. Nor should New Zealand be having cases of tetanus. Immunisation protects against this killer. There is no reason why our children shouldn’t be immunised in infancy or early childhood. It takes at least two injections to build up enough protection, and a booster dose a year later is wise. Thereafter, following a likely injury, another booster dose is all that is necessary, and you don’t then have to have those large injections of antiserum so commonly given now. Antiserum gives temporary protection for the time of the wound. Immunisation, appropriately boosted, gives permanent safety. So talk this matter over with your doctor. This is your anti-tetanus task! Prompt first aid to all scrapes and scratchesyour doctor’s aid for deep or doubtful wounds-permapent protection through immunisation. ---