Tetanus Jabs?

[larry the spark]

I recently went to the chemist for treatment for some small patches dermatitis on my hands. In talking to her she asked did I work with anything unusual and noticed a few little nicks from using blades. I told her I spent as much time as possible outdoors and was working with earth, wood, metal and so on on a regular basis. She recommended I get a tetanus jab which I'm going to do as I can't remember the last time I had one. Anyway, I guess it should be common sense but never would have occurred to me, so I'm just wondering if anyone else takes this precaution. Or like me are we all running around happily unaware we could be risking lockjaw and drinking through straws!!

 

[Adi007]

I think I have them too often!!!! I can never remember when I last had one either. Been told so many different things over the years that I guess it's better to be safe than sorry!

 

[steve a]

Last time I saw my Doctor I asked him about tetnus, he said I could have one if I wanted one , so I did. I'm pretty sure he said they last about 5 years.
Maybe the Doc will throw some light on this one.

 

[Doc]

There's a lot of confusion about tetanus, even among doctors.

The standard tetanus immunisation schedule involves a tetanus jag at the ages of 2, 3 and 4 months, preschool and before leaving school. That's five in total. Provided you were born after 1961, and your parents had the common sense to get you immunised, this is what you should have had, but it might be wise to check.

We USED to recommend a booster every 10 years, and lots of GPs will still tell you this. However, the current advice is that if you have had five doses in your life, you do not need further boosters.

There are two exceptions. Firstly, if you are travelling abroad, and may not be able to get medical attention (including immunoglobulin) following a tetanus prone wound, AND your last tetanus jag was more than ten years ago, then we would give you a tetanus booster. (actually a tetanus and diphtheria booster....it's a long story, and I won't go into it just now).This is an official recommendation from the Joint Committee on Imms and Vaccs.

Secondly, there is an unofficial recommendation - but from an authoritative and respected source (the NHS Scottish Centre for Infection and Environmental Health) that could apply to bushcrafters:

'While not included in the JCVI recommendations, the risk of contaminated wounds is so high in certain high risk groups (e.g. farmers, gardeners and outdoor athletes) that they could be considered for 10 yearly boosters of toxoid unless they have become hypersensitive to the vaccine. This will avoid them having to receive repeated doses of immunoglobulin.'

Which leads on to wound management: if you have definitely had five tetanus jags in your life, a clean wound only requires usual wound care. A tetanus prone wound (contaminated with soil or manure, with much dead tissue, puncture type or sustained more than 6 hours before surgical treatment) may need treatment with tetanus immunoglobulin (antibody) which unlike the normal tetanus jag is a blood product and carries a potential risk in that regard. Hence the unofficial recommendation above.

I believe that the protocol for tetanus in other countries is different.

 

[larry the spark]

Thanks for that doc! I think I'll err on the side of caution though and get the jab as the dermatitis on my fingers is always getting dirty when I'm outdoors which aggrevates it greatly. Think a good pair of leather gloves in order too

 

[grumit]

hi larry i had one in 2000 and as i work with the land all day i;m due another in 2010 :-D

 

[Adi007]

Many thanks for that info Doc! :biggthump

 

[Martyn]

Interestingly, hospital admissions for lockjaw are on the increase. Tetanus was almost a thing of the past, but only a few weeks ago, we had a patient admitted into ICU with tetanus. It's cased by a very common bacteria found in the soil almost everywher. Infection is through a bite, scrath, wound and the "illness" is a result of the toxins released by the bacteria, specifically the effect of these toxins on your nervous system. First signs are a "locking" of the jaw muscles, difficulty in swallowing etc. The guy was in ICU for about 4 weeks on a ventilator and the treatment is unpleasant. Tetanus can make you fit/convulse almost continuously, sending all your muscles into spasm - you can suffocate to death - in order to prevent this fitting, we were giving him huge doses of magnesium (for doc, we were maintaining serum levels at 4 to 5 mmol/l). Mg is necessary for muscle contraction, but if you overdose on it, it can have the opposite effect, ie disconnecting your nervous system, effectively paralysing you - which is what we were trying to achieve (to stop the siezures).

Nasty.

The guy was bitten by a horse.

 

[Stew]

Hhm, I always thought it was caused by rusty metal. I didn't realise it was found in soil!