The tetanus bacillus enters the body and multiplies at the site of an injury. It is an anaerobic bacterium, meaning that it flourishes where oxygen is not present, i.e. in deep wounds. The onset of the disease is marked by fatigue, soreness and irritability. Within a few days there develops a stiffness around the jaw and a laboured breathing. As swallowing becomes difficult, the mouth fuses shut and the victim suffers prolonged, violent and agonisingly painful contractions of the voluntary muscles of the jaw, neck, abdomen and extremities. Despite intensive pharmacological and therapeutic research, the prognosis for each case of tetanus is doubtful and the death rate is high. The infectious agent Clostridium tetani is excreted by infected animals, especially horses.
Medical experts point out that tetanus can never be completely eradicated because it is not spread person-to-person, but rather through exposure to the tetanus bacterium, found in soil everywhere. Therefore elimination of maternal and neonatal tetanus – the most frequent occurence – defined as less than 1 case of tetanus for every 1,000 births.
A cheap and highly effective vaccine for tetatus has been available for over 70 years. But the obstacles to distributing the vaccine are many. In countries most at risk, extreme poverty is pervasive, along with malnutrition, disease, illiteracy, limited communication and transportation infrastructures, and only the most rudimentary national healthcare system. There are also dangerous traditional practices, including the common remedy of using cow dung – often loaded with tetanus bacteria – to heal fresh wounds.
Tetanus is an acute disease caused by toxins released by the Clostridium tetani bacterium. It causes painful spasms of the muscles, locking the jaw. Infection occurs when bacteria enter open sores and cuts. Death ensues when breathing is restricted, as happens in over half the cases of infection. The immediate source of infection may be soil, dust, or animal and human faeces.
There is no profit in the tetanus vaccine business. One of the three companies producing the 25 million doses of tetanus vaccine used per year in the USA ceased production in 2001.
There was an overall failure of the global medical community to meet the 1990 World Summit for Children's goal of eliminating maternal and neonatal tetanus worldwide by the year 2000. The global tetanus initiative has been revised towards a 2005 deadline.