The Smile You Don’t Want!

It was just a little prick to the toe, probably by a thorn or a small, sharp stick.

Janie* was used to scratches and scrapes as she worked in her large flower and vegetable garden in the heat of summer. On most days she wore open-toed shoes in keeping with her cooler summer clothing.

Being an avid gardener and always striving to have the best, most healthful produce, she made compost from fruit and vegetable peelings, eggshells, and other household food waste. On their small farm she and her family raised animals and poultry, and the manure from these was just the thing to further enrich her plants and produce.

Although Janie washed her feet well after gardening that day, it wasn’t long before the toe began to swell and show signs of infection. In a passing thought, Janie wondered when she had received her last tetanus injection. She considered checking her immunization record with the doctor’s office. However, the toe healed up rather quickly, and since she had no further symptoms, she soon forgot the tetanus issue.

Several weeks later Janie began to notice a strange feeling in her throat—not a typical sore throat, just a different feeling. Her doctor ordered a series of blood tests and sent Janie home to await the results. The next morning she had difficulty swallowing and called the doctor, who then put a rush on the test results. However, the findings all came back negative. Concerned about the progression of symptoms, the doctor made an emergency referral to a neurologist, who diagnosed Janie with tetanus and immediately admitted her to the hospital.

The next 10 days were a nightmare of increasing nerve spasms and agonizing muscle contractions, mainly in the neck, stomach, and jaw. Cramping in the arms and legs and difficulty in breathing increased, as did terrible pain. When the medications became inadequate, Janie was put in a medically induced coma and placed on a ventilator. She progressed to kidney failure and then suffered a fatal heart attack.

WHAT IS TETANUS?

Tetanus is a serious bacterial disease. Once the bacteria enters the body, the incubation period can be from seven days to three weeks. Often called “lockjaw,” tetanus affects the nervous system, causing painful muscle contractions and making it difficult to open the mouth, swallow, and breathe. Generalized muscle spasms, convulsions, profuse sweating, fever, and chills are also associated with the disease. One of the hallmark symptoms can be an abnormal spasm of the facial muscles, which produces a painful, locked-in smile.

The tetanus-causing bacteria (or Clostridium tetani) is present in dust,soil, around animal feces, and in compost and manure. This bacteria can easily enter the body through a cut or wound as tiny as a pinprick or small scratch. Tetanus is not transmitted from person to person.

Globally, tetanus strikes about one million individuals annually, as reported by research from the Mayo Clinic. Most of those affected live in developing countries, where the tetanus immunization is not common or the vaccine readily available. In North America tetanus is rare, so rare that most practicing physicians today have never seen a case. However, their unfamiliarity with its symptoms can delay diagnosis and lifesaving treatment.

RISK FACTORS

A combination of factors needs to be present for the tetanus bacteria to enter and become activated in the bloodstream. There has to be initial exposure through a cut or wound. Those who have not received the vaccination series as a child, and/or who have not kept their 10-year booster shots up-to-date, are at risk. Untreated or infected puncture wounds, such as body piercings, tattoos, gunshot injuries, surgical wounds, infected ulcers, and animal bites, can all provide tetanus spores a pathway into the bloodstream. Diabetics are especially susceptible and need to be particularly vigilant in wound treatment and in maintaining their immunization schedule. Young children who for one reason or another have not received immunization are seriously at risk.

Tragically, there is no cure for this disease once the tetanus toxin has fused with the body’s nerve endings. Treatment focuses on managing the painful symptoms until the body is able to grow new nerve endings, thus eradicating the toxin completely. This process can take several months, during which time medications will be prescribed to control muscle spasms and pain. Taking these sedatives over the long term can have the possible effects of minor mental deficits, cerebral palsy, and brain damage, especially in young children. It’s not unusual in particularly severe cases for the patient to be placed on life support with artificial ventilation to assist with breathing. The disease of tetanus can be fatal.

LIFESAVING FACTS

Tetanus disease can be prevented by a safe and effective vaccine. If you are allergic to any component of the vaccine, you should talk with your physician.
You cannot get tetanus from the vaccine.
Tetanus toxin is produced by bacteria found in soil, dust, and manure.
Tetanus disease cannot be spread from person to person.
Most cases of tetanus have occurred in individuals who either have never received the primary series of tetanus vaccines or have not kept up with their 10-year booster injections
About 10 to 20 percent of reported cases of tetanus are fatal.
Those who contract tetanus usually have to spend several weeks in the hospital in intensive care, and frequently need to be placed on breathing support.
Recovery from tetanus may not result in immunity. Routine booster injections should be initiated as soon as the patient is stabilized.
The tetanus vaccine is commonly combined with diphtheria vaccine. Diphtheria is a serious bacterial infection that can be transmitted easily from person to person. It affects the mucous membranes, eventually releasing dangerous toxins throughout the body. If left untreated, it can result in difficulty swallowing and breathing, inflammation of the heart muscle, paralysis, and kidney failure. For adults, the tetanus-diphtheria booster (Td) given every 10 years provides effective protection against both of these diseases
The Tdap vaccine (tetanus-diphtheria-acellular pertussis) should be given to adults in place of one Td vaccine. This will result in protection against pertussis, usually called “whooping cough.” Pertussis, a highly contagious disease, can cause serious illness in children, teens, and adults and can be particularly life-threatening in babies.

Vaccination protection against the potentially deadly disease of tetanus may one day save your life. This precaution can be compared to the paramount importance of storing up in our hearts precious truths and promises from God’s Holy Word. When occasions of temptation, uncertainty, sorrow, and spiritual crisis threaten us, “angels are round about those who are willing to be taught in divine things; and in the time of great necessity they will bring to their remembrance the very truths which are needed” (Ellen White, The Great Controversy, p. 600).

*Name has been changed.