Some time back I saw a stage production of Lee and Lawrence’s two-act play, The Night Thoreau Spent in Jail. The play revolves around Henry David Thoreau’s refusal to pay a poll tax that he believed would be used to support a war. One of the scenes that has always stayed with me is where John Thoreau, Henry’s brother, nicked himself while shaving. Unfortunately, John got tetanus from the cut and died eleven days later.
As gardeners, tetanus is an infection of which we should be mindful. Tetanus comes from the anaerobic bacterium Clostridium tetani. “Anaerobic” means that the bacterium flourishes in the absence of oxygen. Before the bacterial form of C. tetani begins to reproduce, it survives as an endospore. An “endospore” is a dormant form of the bacterium which allows the bacterium to survive in unfavorable conditions and to reproduce itself once the proper (anaerobic) conditions are present. Tetanus is a Gram-positive bacterium and its endospores enable the bacteria to lie dormant for decades. The endospores of tetanus are especially prevalent in soil and manures. Tetanus, the infection, usually begins from puncture wounds and deep cuts, when the endospores are carried into an anaerobic environment. When the endospores are carried into this type of favorable environment, the dormancy ends and the bacteria begin reproducing.
The common name for tetanus is "lockjaw." Tetanus is from the Greek word "tetanos," which means "taunt." The disease causes prolonged contraction of skeletal muscles. This tightening often begins in the jaw muscles. Thus, the term "lockjaw."
Conventional wisdom is that one needs a close encounter with a rusty nail to get tetanus. However, the rust is not a necessary component. Puncture wounds, because the endospore are driven deeply into a anaerobic environment, is what is required. That is also probably why we are taught to make sure a cut bleeds freely to "wash out" this harmful toxin.
The incubation period of tetanus varies between eight days to several months. Because of the use of the tetanus vaccine, death from tetanus in the United States is relatively rare. The CDC credits the 13.2% fatality rate to the widespread use of the vaccine.
Unfortunately, the vaccine is only good for about ten years. Regular booster shots are needed. If you don’t know when you had your last tetanus booster, get one immediately. If you wait until you have a cut or puncture, the effectiveness of the shot is dramatically decreased, and multiple shots are needed to reduce the chances of getting lockjaw. Post-exposure injections are not a guarantee of prevention of lockjaw.
Tetanus boosters are widely available (without a prescription) at drug and grocery store pharmacies for around $50 without insurance. This is definitely a situation where an ounce of prevention is worth a pound of cure. Make sure your tetanus booster is current.
Written January, 2013
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