|What to do About Tetanus|
|Friday, 30 October 2009 19:32|
Question: What are your thoughts on getting the tetanus vaccine? Are there any natural ways of treating tetanus?
Answer: This is a question that has come up many times over my years of medical practice. Parents have often asked my advice about tetanus prophylaxis for their children. As with other areas of medicine, I can lay out the issues, but it is difficult for me to say that there is only one way to handle this question.
First, the basic facts. Tetanus is the name we give to the illness that is caused by the toxin secreted by the bacteria Clostridium tetanii. This bacterium is an obligate anaerobe which means it can only live in the absence of oxygen. It is ubiquitous in the soil, and is widely distributed all over the world. When the bacteria enters the human body in a wound, and if the wound is devoid of oxygen (such as a puncture wound from a nail) then the bacteria can flourish inside the wound. If the wound is exposed to oxygen, which is what happens with common lacerations, then the tetanii bacteria will be unable to grow. If they grow, they eventually will produce a tetanus toxin (a poison) that selectively puts the skeletal muscles of humans into a tight spasm. The skeletal muscles include the major muscles of movement. The smooth muscle, such as the viscera (intestines) or the specialized muscle of the heart are unaffected by the tetanus toxin. As more and more of the toxin is produced, the affected person will eventually go into full body spasms and then develop â€ślockjawâ€ť which is the dreaded outcome of a tetanus exposure as the jaws remain tightly clenched.
The mortality rate for an episode of full blown tetanus is high and in some studies upwards of 50 percent of the patients who contract tetanus will not survive. If one does survive, the tetanus toxin is eventually cleared from the body and no residual repercussions remain. The key point in this is that even though the tetanus toxin is made by a bacterium there usually is no significant infection at the site of the wound. In some cases, the doctors have actually been unable to locate any overt signs of infection at all, but somehow the bacteria had grown in the body and had made their toxin. Also, the symptoms of tetanus usually start about one week after exposure to the bacteria (from the wound) but can occur up to months following the incident. This makes it even more difficult to track down the infection or to be confident that any particular incident no longer presents a danger.
In the U.S., there are about fifty cases of tetanus per year; it is a much bigger problem in third world countries, especially among infants who can contract tetanus from the cutting of the umbilical cord with an unsterile instrument.
Conventional medicine offers two ways to deal with tetanus. The first and most common is to give people, usually children, a series of tetanus shots or vaccines. The vaccine contains a very small dose of the tetanus toxin and the theory is that the vaccine recipient will make antibodies that can neutralize the toxin if it should every occur as a result of infection. Usually an initial series of three shots is given at two, four and six months and then â€śboostersâ€ť at varying intervals thereafter.
The second method of dealing with tetanus is to wait until an exposure has occurred, or at least a likely exposure and then give what is called hypertet, which is serum containing the neutralizing antibodies. In this case, the recipient is not making antibodies himself; he is given them to neutralize the toxins that are already in his system.
Back when I was first practicing, hypertet (tetanus immune globulin) was made from collecting the serum of horses that were â€śhyperimmunizedâ€ť with tetanus. The rate of severe anaphylactic reaction to this medicine was about 20 percent, with most of these reacting patients dying from the medicine. Luckily, I have never been in a situation that required me to give anyone this treatment and for that I have always been grateful.
Today, the hypertet is made from recombinant DNA, maybe not the greatest thing in the world, but it is nowhere near as lethal. Still, there have been numerous episodes of hypertet contaminated with various viruses so this preparation is also to be avoided if at all possible.
This then brings us to the bottom line: since we all want to avoid taking the hypertet, the real choice is whether to use the vaccine preventatively or do nothing except practice good wound care.
Regarding the vaccine, it is important to note that tetanus vaccinations are different from all the other vaccines. First, tetanus is unlike the other illnesses for which children are given vaccines. It is not a childhood illness, like pertussis or measles. It really isnâ€™t even an infection, its more of poisoning, from poison made by bacteria. This means there is nothing good about getting tetanus, unlike the immune enhancement that comes about through the usual childhood illnesses.
Second, unlike the other vaccines, there is no cell-mediated immunityâ€”white blood cells clearing the virusâ€”with tetanus, because it is a poisoning, not an infection.
The bottom line here is that unlike all the other childhood illnesses, there is nothing good about having gone through tetanus or contracting tetanus; it is a fairly deadly poisoning which is best handled only by prevention. Thus, for a number of years, tetanus was the only vaccine I ever gave the children in my practice. I gave three shots, usually starting at about two years old and I never gave boosters. This was because of National Institutes of Health research, which claims that no one who has received all three shots for tetanus has contracting clinical tetanus. By the way, the vaccine does not contain thimerosol; however, there is no telling whether it contains other questionable ingredients.
During the last decade, however, there have been some counter arguments that have stayed my hand with regard to giving the tetanus vaccine and made the whole situation unsettled. First, it has become clear that the incidence of clinical tetanus dropped to a very low level even before routine vaccination was practiced in this country. Why this is no one knows, but it mirrors the pattern seen in the rest of the childhood illnesses. Second, there have been some published studies showing that having tetanus antibodies facilitates the penetration of unrelated viruses into the cells. One of the viruses mentioned was HIV, another was hepatitis C. The implication is that somehow having tetanus antibodies from the tetanus vaccine makes one susceptible to seemingly unrelated viral infections. The mechanism of this is obscure and as far as I know there has been no follow-up. I canâ€™t find this original reference, but I distinctly remember a patient showing me the research in the early 1990s. This, plus the worry about the chemicals used to preserve the vaccine, make this a more difficult choice than it was in the early days.
A few other points are worth mentioning. One is that a number of patients over the years have told me they wanted to have only the tetanus vaccination but were told by their pediatrician that it was unavailable as a single vaccine. This is not true: any doctor can purchase plain tetanus toxoid from any of the major vaccine manufacturers. Second, there is no reason to get a booster tetanus shot after a wound if you have already been vaccinated. As I said, you are protected if you have had three vaccines at any time in your life, even fifty years ago. There is also no reason to give hypertet to anyone who has done the original series of three shots. And finally, even though there are worries about the vaccines, it is something that, given at the right timeâ€”certainly not at two monthsâ€”in an otherwise healthy child is a fairly reasonable prevention strategy.
What if you get a puncture wound from a nail or a staple, have not had the vaccinations, and do not want to take the hypertet? Obviously scrupulous wound care is the first priority. In addition, it makes sense that super nutrition could help your body deal with the toxin should it take hold. That means extra cod liver oil, natural vitamin C, lacto-fermented foods and plenty of bone broths. Avoid stresses after the injury and get plenty of bed rest so your body can devote itself to dealing with the challenge.
I was excited to see an article by Dr. Thomas Cowan on tetanus (Fall, 2009). As a family doctor in New Zealand I have to work hard to get balanced information so that my patients can make informed decisions about vaccination.I found the article very good but with one concern.
Dr. Cowan states, â€śAs I said, you are protected if you have had three vaccines at any time in your life, even fifty years ago.â€ť He was referring to an earlier statement about National Institutes of Health research claiming no one who has received all three shots for tetanus has contracted clinical tetanus.
Reading the epidemiological study (www.medscape.com/medline/abstract/9665156), the findings actually indicate that 13 percent of cases of tetanus between 1995-1997 had reported that they had received the full primary series of tetanus vaccinations. Admittedly we are talking very small numbers here (roughly a one-in-fifty-million chance per year) and as a result, Dr. Cowanâ€™s statements remain in essence true, especially as 9 percent of those 13 percent had had four or more vaccinations for tetanusâ€”it seems as though those people were probably going to get tetanus no matter how much they were vaccinated. It might seem nit-picky but I believe that integrity and transparency are vital if we are to rise above the rhetoric and propaganda.
I have to mention that I greatly respect Dr. Cowanâ€™s stand for health and get a great deal of value out of Wise Traditions. I am a staunch advocate of the WAPF philosophy and continue to try and influence my practice with its truisms. Many thanks indeed.
Dr. Mark Edmond, MB ChB
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Fall 2009.
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|Last Updated on Wednesday, 04 April 2012 14:48|