Two individuals in western Bangladesh who recently had different surgeries at Dinajpur Medical College Hospital ended up contracting tetanus from the procedure, according to the Dhaka-based news source, The Daily Star. 

Clostridium tetani /CDC
Clostridium tetani /CDC

The report notes that both patients underwent surgery on Sep. 15, one had a tumor removed and the other had a hernia operation.

The patients were later discharged and returned 12 days post-surgery to have their stitches removed. Upon examination, physicians discovered both patients had tetanus.

They were transferred to another hospital in Dinajpur so they could be quarantined (although tetanus is not communicable person-to-person).

The Medical College hospital suspended all surgeries for 72 hours.

Emdadul Haque, deputy civil surgeon of Dinajpur General Hospital, said, “The two tetanus patients are being treated here in quarantine. There is no need to panic.”

The report does not discuss the investigation, if any, into the apparent nosocomial transmission of tetanus.

Tetanus is caused by a very potent toxin produced by the anaerobic bacterium, Clostridium tetani. The spores of this organism are very resistant to environmental factors and are found widely distributed in soil and in the intestines and feces of horses, sheep, cattle,dogs, cats, rats, guinea pigs, and chickens. Manure-treated soil may contain large numbers of spores. In agricultural areas, a significant number of human adults may harbor the organism.

These spores are usually introduced into the body through a puncture wound contaminated with soil, street dust, animal bites or animal or human feces, through lacerations, burns or trivial unnoticed wounds or by injecting contaminated drugs. So many times, you hear about concern over stepping on a rusty nail; however, the rust has nothing to do with tetanus. At this point, the spores germinate into the bacteria, which multiply and produce toxin.

Depending on the extent of the wound, the incubation of tetanus is around 10-14 days.

Some of the common symptoms of tetanus are lockjaw, followed by stiffness of the neck, difficulty in swallowing, and rigidity of abdominal muscles. Other symptoms include elevated temperature, sweating, elevated blood pressure, and episodic rapid heart rate. Spasms may occur frequently and last for several minutes. Spasms continue for 3–4 weeks. The typical features of a tetanus spasm are the position of opisthotonos and the facial expressions known as “risus sardonicus”. The death rate for this disease ranges from 10-80% depending on age and quality of care.

This disease in not transmitted from person to person. Even if you had tetanus and recovered, this potent toxin produces no immunity.

Prevention of tetanus is through vaccination.

Robert Herriman is a microbiologist and the Editor-in-Chief of Outbreak News Today and the Executive Editor of The Global Dispatch

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