Dreaded Tetanus Causes Swift Death

Northern Advocate, 11 August 1938, Page 9

Dreaded Tetanus Causes Swift Death

The death last week, says the Taranaki Daily News of an 111-year-old New Plymouth schoolboy from the dreaded disease of tetanus, or lockjaw, has drawn attention to the constant danger to which people of all ages are exposed and has emphasised the need for precaution in dealing with even the smallest scratch.

• Deaths from the disease are fortunately normally very rare and this base is the only one in New Plymouth since 1936, when the victim also was a schoolboy. Death came swiftly to the 1 la-year-old boy. He first became ill on Sunday, having received the wound —only a slight scratch —when playing near his home two weeks before. On Tuesday, just three days later he was dead.

The swiftness with which the disease worked on the unfortunate lad necessitated the use of a large amount of anti-toxic serum than is usual with ccses in the effort' made at the New Plymouth Hospital to save his life. Serum was rushed to New Plymouth from city hospitals, chiefly Wellington, by ’plane but all to no avail. The disease of tetanus is caused by the toxin of an anaerobic bacillus found in soil contaminated by horse dung and therefore in the dust of streets and of gardens and other cultivated land. Breach of Surface. The bacilli or their spores gain access to the body through a breach of the surface, perhaps trivial, such as a small scratch, and remain localised. The toxin they elaboi-ate travels by the sheaths of local nerves upwards, affecting the nerves themselves in its course towards the spinal cord. Ultimately nerve cells are affected. The necessary condition for multiplication of the bacilli are afforded by the dirt and other micro-organisms gaining access to the wound with the tetanus bacilli.

Tetanus may affect persons at any age, even the newly-born infant, but is commonest in male adults. Horses are very liable to the disease. In man, the first symptom is stiffness in the back of the neck or the muscles of the jaw and face. The sooner the symptoms come on after injury the worse is the prognosis of tetanus. In the absence of anti-toxin treatment, when they arise within a week of the injury, the prospect of recovery »is very remote; if within ten days the prospects are bad; if they do not come on until three weeks or so after the injury there is hope. Anti-Toxin Treatment. Prognosia is much improved by prophylactic anti-toxin treatment. In the developed disease anti-toxin serum is of doubtful value, even though injected intrathetically by lumbar puncture. The only available treatment is absolute quiet in a darkened room, morphia to relieve pain, and such amount of liquid food as will sustain life Gn the appearance of tetanus in the British Army during the early days of the Great War, immediate steps were taken to cope with it. The disease could be prevented if a dose of antitetanus serum were given as soon as a wound was sustained, because some days elapse before the bacilli, which remain in the wound, are able to secrete sufficient poison to precipitate an attack. From that time every wound, no matter how slight, was followed as soon as possible by a dose of anti-tetanic serum. , In September, 1914, the ratio of , tetanus cases-to wounds was nine per 1000. In October, 1918, the ratio was 0.5. The effect is not always absolute prevention. But even in those cases in which tetanus does supervene in spite of inoculations, the incubation period is lengthened, and the death rate is lowered;, other things being equal, a long incubation period tends to result in a milder attack than a short incubation period, thus any circumstance prolonging the incubation | period will also tend to lower the I death rate.