A33
*Notifiable condition
DESCRIPTION
Tetanus is an acute spastic paralytic illness caused by tetanospasmin, the neurotoxin produced by C. tetani. Neonatal tetanus is the most common form of the disease, usually caused by umbilical stump infections or contamination.
The disease only occurs in infants of non-immunised mothers or mothers with insufficient levels of protecting antibody to tetanus toxin.
DIAGNOSTIC CRITERIA
Clinical signs
- Presents with difficulty in sucking and swallowing due to masseter spasm, i.e. trismus, usually on day three with associated hunger and crying.
- Temperature of 40–41⁰C.
- Tenseness and rigidity of all muscles, including paraspinal and abdominal muscles.
- Fists clenched and the toes fanned.
- Opisthotonic spasms and clonic jerks following sudden stimulation by touch and noise:
- spasms are painful,
- not true seizures,
- there is no loss of consciousness, and
- laryngeal spasms may result in respiratory distress.
- Umbilicus may appear normal but there may be discharge from, or dirt/dung on umbilicus.
REFERRAL
- Seek urgent telephonic guidance prior to referral.
- All infants with suspected neonatal tetanus.