Another review of EliteCare got us thinking about tetanus and the childhood warning, “If you step on a nail you’ll get lockjaw!”

After I cut my arm on a rusty nail, I walked into the emergency rather stressed. The admissions person, nursing staff, and doctor all did an excellent job in calming me down and were professional when obtaining background information, getting vitals, and inspecting the wound to determine what course of action to take. I would go back there in a heartbeat should any emergency arise with me or any loved one. Mary T 6/23/13

Tetanus is also known as lockjaw due to, well, your jaw getting locked in place. Some of the first symptoms of tetanus include muscle contractions in the area around the mouth, which can leave the jaw rigidly frozen. It’s a scary thought that only gets worse when you discover that sometimes those contractions can spread to the rest of the body, resulting in spasms so intense they have been known to cause bone fractures. These violent, seizure-like spasms also make it difficult to breathe and swallow. Some of the other telltale signs of tetanus are fever, drooling, excessive sweating, uncontrollable urination or defecation and irritability (when we read this we laughed—sorry, but if your jaw was locked and you were uncontrollable drooling, sweating, and urinating—wouldn’t you be just a little crabby?). The symptoms usually appear one week after infection but may be noticeable within a few days.

Tetanus is no joke

All wisecracking aside—left untreated, 1/4 people die from tetanus. However, with proper treatment, less than 10% of infected patients die. Wounds causing infection occurring on the head or face seem to be more dangerous than those on other parts of the body.

The Dreaded Vaccine

A tetanus vaccine is part of a standard vaccination regime for infants, however the effects fade over time. Adults are urged to update their (painful) vaccine every ten years –we’ve all had them. Man, they’re not pleasant. But the next time you’re gritting your teeth during the shot think of drooling out of one side of your cemented jaw, while you sweat profusely and curse at your friend who’s drove you to the emergency clinic.

Tackling the Old Wives’ Tale

Ok, so the legend is true—stepping on a rusty nail DOES have the potential to cause tetanus. Do you know what else can cause tetanus? A perfectly sterilized nail, a sewing needle, or even a scratch from your cat.

Allow us to explain.

Tetanus is caused by bacteria called Clostridium tetani, which is commonly found in soil, dust, and animal feces. The bacterium isn’t dangerous in the soil or manure because it can only reproduce in an oxygen-deprived setting. Here’s where the nail can come into play—seeing that a puncture wound, such as one that could occur from stepping on a rusty nail, can provide a rich breeding ground for the Clostridium tetani bacteria. The rust is not the carrier of the bacteria, rather just an assumed culprit since the nail has been outside long enough to get rusty, and therefor it probably has been exposed to soils containing the bacteria. While a rusty nail puncture can produce a breeding ground for the bacteria, so can a stab wound from a knife, a tattoo from an amateur, or even a gunshot wound.

What to do if you step on a rusty nail – or experience a similar injury

Clostridium tetani doesn’t care about antiseptics. Cleaning a wound will not flush out the bacteria and you need to head to an emergency clinic for an antitoxin known as tetanus immune globulin. The antitoxin should be administered as soon after the injury as possible. Those that wait risk their entire body freezing up, starting with the mouth, and will have to endure a treatment regimen that can include sedatives, muscle relaxers, multiple days of rest without stimulation and possibly even surgery.