Accidental tetanus: injuries caused by debris carried by floods can cause serious infection

Debris washed away by floods can cause injuries and subsequent infection with the bacteria that cause tetanus.

Situations such as floods increase the chances of contamination by the microorganism, since rubble and debris – such as broken glass, tiles and tiles, nails and screws – are carried away by the force of the water, which can cause injuries to the population. The bacteria, in turn, uses the wound to invade the body and, when developing, produces a very powerful toxin called tetanospasmin, capable of acting on the cells of the central nervous system.

According to the Ministry of Health, more than 500 cases of accidental tetanus were registered in the country between 2021 and 2023, with the majority of those affected being retirees, agricultural and construction workers, as well as students and housewives. In recent years, the fatality rate has been higher than 25% – a number considered high when compared to developed countries – and the evolution of the condition may be related to the age of the victim, as well as the presence of renal, respiratory and infectious complications.

Butantan anti-tetanus serum can be used to treat the disease

Signs and treatment

In case of injuries, it is recommended to wash the area with clean running water and neutral soap. It is also recommended to seek a basic health service so that a professional can assess the situation of the injury. Finally, it is important to pay attention to the appearance of the first symptoms of the disease, generally between five and 15 days after contamination, characterized by low fever, changes in the wound region, painful muscle contractions, stiffness of the limbs and abdominal region, in addition to of head and back pain.

More serious conditions may include generalized spasms, difficulty swallowing, sweating and cardiac arrhythmia. Also according to the health agency, situations in which the incubation period is less than seven days present a worse prognosis.

Treatment can be done with the so-called anti-tetanus seruma medicine produced by the Butantan Institute from the plasma of horses immunized with tetanus toxin itself, capable of neutralizing the effect caused by the bacteria Clostridium tetani.

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Prevention

In addition to using safety equipment, such as gloves, boots and helmets, whenever possible, immunization is the best prevention against the disease – and the tetanus vaccine accompanies Brazilians for life. First of all, it is called pentavalent: in its composition there are antibodies capable of fighting not only tetanus, but also diphtheria, whooping cough, hepatitis B and infections caused by Haemophilus influenzae B. Pentavalent is applied in the baby’s first year of life, following a three-dose schedule.

Boosters should be given at 15 months and 4 years of age – at these stages, the immunizing agent is known as DTP and, in addition to tetanus, it contributes to the prevention of whooping cough and diphtheria. After that, the vaccine must be administered again every ten years, now called dT, to prevent diphtheria and tetanus. In case of serious injuries or pregnancy, the booster needs to be brought forward if the last dose was more than five years ago.

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Incorporated into the National Immunization Program (PNI) in 1992, the tetanus vaccine contributed to a significant drop in the occurrence of the disease. According to data from the Ministry of Health, in 1991 – a year before vaccination began – Brazil had 1,460 cases of tetanus throughout the national territory; in 2023, there were only 135 records.

Reporting: Natasha Pinelli

Photos: Gustavo Mansur/Palácio Piratini/State Government of Rio Grande do Sul and Comunicação Butantan (photo 2)