Human tetanus immunoglobulin

Tetanus is an acute disease of the nervous system induced by the neurotoxin (poison) from the tetanus bacterium, Clostridium tetani. It is caused when the bacterium Clostridium tetani gets into the body, through a puncture wound in most cases. The bacteria grow in the wound and produce a very powerful poisonous toxin. The first symptoms are stiff muscles near the wound followed by spasm of other muscles; historical descriptions include stiffening the jaw muscles until it is locked in position ("lockjaw"). This is followed by frequent and painful fits. The muscle spasms can interfere with breathing. Anyone who is not fully protected against tetanus is at risk from the disease which can kill. The treatment for tetanus is very difficult so prevention is the main approach.

Tetanus is rare in the UK because of the immunisation programme, the main preventative approach. While vaccination has largely diminished the incidence of tetanus in Europe since it was introduced in the 1950s, it has not disappeared. Tetanus immunisation was provided to the Armed Forces from 1938 and therefore a large percentage of the elderly male population is immune. Those most at risk are elderly women.

In the UK, vaccination against tetanus infection is part of the childhood immunisation schedule. The first dose is given to babies at 2 months old followed by two additional doses at one-month intervals. Booster doses are also given at age 3-5 years (3 years after the primary course) and at age 13-18 years. Booster doses in addition to 5 doses is not recommended except in the case of the treatment of a tetanus-prone wound.

The following are considered tetanus-prone wounds:

  • Any wound or burn that requires surgical intervention that is delayed for more than 6 hours.
  • Any wound or burn at any interval after injury that shows one or more of the following: significant degree of dead tissue, puncture-type wound, contact with soil or manure (both likely to harbour tetanus organisms) and any clinical evidence of sepsis.

Human tetanus immunoglobulin contains antibodies against tetanus.  It is given to certain groups of patients with tetanus-prone wounds to help them fight the infection straightaway.  It is often given in hospital Emergency Departments to patients with certain types of injuries.