The bacterium Clostridium tetani. Tetanus is acquired through
exposure to the spores of Clostridium tetani, which are present
in soil worldwide. Nature of the disease The disease is caused
by the action of a potent neurotoxin produced by the bacterium
(e.g. when present in dirty wounds). Clinical symptoms of
tetanus are muscle spasms, initially of the muscles of
mastication causing trismus or “lockjaw”, which results in a
characteristic facial expression – risus sardonicus. Trismus can
be followed by sustained spasm of the back muscles
(opisthotonus) and by spasms of other muscles. Finally, mild
external stimuli may trigger generalized, tetanic seizures,
which contribute to the serious complications of tetanus
(dysphagia, aspiration pneumonia) and lead to death unless
intense supportive treatment is rapidly initiated. Wounds can
become infected with the spores of Clostridium tetani anywhere
in the world. Risk for travellers Every traveller should be
fully protected against tetanus. Almost any form of injury,