Neonatal tetanus is a form of tetanus, an acute toxic illness confined to the newborn. It is characterized as a neurological disease resulting in severe muscle spasms, which can persist for at least a week and commonly results in death. The agent is Clostridium tetani, which usually enters the bloodstream or motor nerves through an infected umbilicus. C. tetani produces two toxins, including tetanospasmin, the extremely potent neurotoxic component causing spasms. This toxin reaches the nervous system and eventually becomes fixed in the ganglion cells of the spinal cord or cranial nerves. Neonatal tetanus differs from numerous other bacterial diseases in that it is not transferred from person to person; instead, C. tetani is found in soil and is introduced into the body through an exposed area. The disease has been known by various names, including tetani neonatoria, trismus nascentium, lockjaw, and the “9-day illness” or “fits” because it normally occurs during the first 9 days of life. Its association with filth and rural conditions means that neonatal tetanus is still common in Third World nations and is one of their greatest public health problems. Mortality rates are high, even with modern treatment, and preventive measures are essential to avoid the disease.
Distribution and Incidence
Neonatal tetanus today is a problem confined primarily to Africa, Asia, and the West Indies, although before the twentieth century, it was global in occurrence. The bacillus, found in soil, water, intestines, and the feces of animals and humans (where it can survive for years if not exposed to sunlight) is ubiquitous.