Tetanus

[Ruthla]

I got a small puncture wound on my foot about 5 days ago, from stepping on a sewing needle, and it's now nearly healed. But some people on another message board are all panicking about tetanus, and from my quick google search on tetanus, I see that it has an incubation period of 2-3 weeks. I'm reading about "toxins from an infected wound getting into the bloodstream". Does this mean that the wound needs to be obviously infected to cause systemic tetanus?

I honestly wasn't the slightest bit worried about tetanus at the time of the injury. It bled profusely for the first minute, which I'd always heard (on here) means that tetanus spores get killed off when oxygenated blood gets around. It did stop bleeding quickly (while I was washing it off in the bathtub with tea tree oil soap) which worried me a bit, but only a bit. It continued to bleed internally for the next few hours, or so I guess from the bruise that formed that has since started receeding.

It no longer hurts to walk on that foot and there are no signs of infection whatsoever. Is it safe to assume I'm at zero risk for tetanus?

Also, my last tetanus shot was 8 years ago. Are they now saying people "need" boosters every 10 years or every 5? Also, what would my risks be if I had a similar injury 5 or 10 years from now, when the booster was fully "expired"? I had a horrible reaction to the last booster, and at the time swore I'd never have another vaccine again. But I also don't want to panic every time I cut my foot.

[KimPM]

Last fall I stepped on a dirty, rusty nail outside in the grass. It's been at least 14 years since my last tetanus shot; I will not get another one. What I did was to clean it out mechanically so I couldn't see any more debris. Then flush it with peroxide. I also did daily soaks in epsom salt for a week. I also made sure it didn't close over on the outside (like it wanted to) before it had healed on the inside. For at least a week, I kept pulling apart the outside and flushing again with peroxide. I also took some homeopathic ledum - just in case.

I also let other responsible adults know, in case any weird symptoms showed up I could be immediately taken to a hospital and treated for tetanus. In that case, you'd want them to give you the TIG (tetanus immune globulin) shot - it's a human blood product. A booster tetanus shot wouldn't do anything for you at that point. In my case, I was fine.

Tetanus is highly unlikely from your injury, but it still is statistically possible. The problem is that tetanus spores are very hardy and can survive amazing conditions. They tend to be in dirt, but the spores can be anywhere - just in lesser concentration than in dirt. The spores can turn into tetanus bacteria in an anaerobic environment, like when a wound closes over but is not healed on the inside. When a wound bleeds, it brings oxygen in the blood. Peroxide also adds oxygen. So this is why I did what I did.

You can have tetanus without any signs of other infection. I've heard of people being admitted to a hospital not knowing they had gotten tetanus from a cut sustained a week or so beforehand. It even took the hopital awhile to figure it out. There was obviously no external signs of infection.

I've read that you can have localized tetanus as well as systemic. I presume the localized version would be like odd nerve issues - pain, tingling, cramping, or other weird sensations.

I've also read in a book that there was evidence of the tetanus vaccine being active for at least 40 years. I don't know how true that is.

Only you can decide if getting another vaccine is worthwhile to ease your mind.

[Ruthla]

So I should have re-opened the wound when it closed up so fast? And I should do that next time I step on a needle?

[KimPM]

Originally Posted by Ruthla

So I should have re-opened the wound when it closed up so fast? And I should do that next time I step on a needle?

Depends on how deep and wide it was initially. If you think it didn't have a chance to heal internally first (the hole was deep and/or wide), then yeah, reopen the top and clean it out again. A needle should not be very wide, so I would think it should heal up internally pretty quickly, unless it went very deep. Plus, with the profuse bleeding, I wouldn't worry as much.

Oh and the conventional HCPs like to give tetanus vaccines every 10 years. I don't know what that's based on. However, I mentioned before about the possible evidence on lasting at least 40 years. The other thing is, I don't think you can get just a tetanus vaccine, it's always at least a TD - tetanus-diphtheria vaccine. For children, I think you have to get one with at least all three in it: TDP tetanus-diphtheria-pertussis.

Although I do surmise why they like to push a booster shot if you go to the ER with an injury. I think it's a holdover from the '60s and before, when they had only horse-serum TIG, before they developed human-serum TIG. A large percentage of persons getting a horse-serum TIG had bad reactions, some fatal. And a second horse-serum TIG resulted in an even higher percentage of bad reactions, those being worse than the first. At that time, the majority of the population was not vaccincated for tetanus. So given this situation, if you visited an ER with an injury at that time, they would also push a tetanus vaccine on you, so you wouldn't have to get another horse serum shot in the future if you had another injury. These days with the human serum TIG, there are way fewer reactions to it. But I think the mentality of pushing the vaccine for any injury has pretty much stuck.