Winnipeg Free Press - PRINT EDITION

Spring thaw spurs tetanus warning

Gardeners at risk

  • Print

TORONTO -- You do not want to get infected with tetanus.

The disease, which used to kill about 40 to 50 Canadians a year in the 1920s and '30s, is now only rarely reported. Canada sees, on average, only a couple of cases a year.

But doctors who have seen what tetanus does do not forgot it.

The bacteria multiply and start producing toxins that force muscles into painful contractions. One of the first places where those contractions take hold is in the muscles of the jaw -- that's where tetanus's other name, lockjaw, comes from. Patients are racked with spasms.

It can take weeks and even months for the toxins to break down and the muscles to release, if they do. Between 10 and 20 per cent of tetanus cases die.

Infectious diseases specialist Dr. Allison McGeer vividly recalls the first time she saw a tetanus case. It was Nov. 1, 1981, and she was a medical intern in the emergency department. In walked a British man in his late 70s. "He said 'I think I have lockjaw,"' McGeer recalls.

"Three hours later, he was intubated and paralyzed. And he stayed in the ICU until the end of February. I have absolutely no idea how he survived."

The disease is caused by the bacteria Clostridium tetani, which are found in soil. The bacteria form spores, a hardy casing that helps them survive.

Because the bacteria are in soil, they are also in dust, so the spores can settle on objects like the thorns of a bush or a fence. Typical tetanus stories involve gardening, which is why health practitioners promote the shots around this time of year.

"Gardening is particularly bad because you have your hands in soil.... You're more likely to injure your hands when you are gardening -- which is why people focus on the gardening. Doing anything outside," McGeer says.

That's just how the British man became infected.

He had been gardening and got a splinter from a wooden railing. The fragment of wood burrowed deep into the tissue between his thumb and index finger. He had never had a tetanus shot, growing up before the vaccine was added to the complement of vaccinations given in childhood.

Induced comas

People who haven't been vaccinated but who have been exposed -- or possibly exposed -- are treated with tetanus immune globulin, tetanus antibodies taken from donated blood. But when a case progresses to the stage that the British man's had, treatment involves placing patients into induced comas to combat the spasms. Patients are also put on ventilators, machines that breathe for them.

"You sedate the hell out of them so they're not awake, and then every once in a while you let the paralysis lift to see if they go into spasm. And if they go into spasm, you paralyze them again and you just wait," McGeer says.

But the toxins wreak havoc on the heart. The British man endured tachycardia -- a rapidly racing heart beat -- for hours on end. That can interfere with the circulation of blood, causing organs like kidneys to go into failure.

Dr. Ian Gemmill, medical officer of health for the health unit that serves four counties in and around Kingston, Ont., recalls a different tetanus case. In 1985, a man from his region was walking when he got knocked over by a cyclist. His face scraped the ground.

When emergency room staff treat skin wounds, they will often give tetanus vaccine, just to be on the safe side. But because this man had been in the Armed Forces, health professionals assumed he had had tetanus shots at some point in his life. He had not, Gemmill says.

"This was really a preventable case and it was kind of tragic as a result because the person ended up dying."

Fortunately, doctors in Canada these days don't often have to struggle to keep tetanus patients alive, because a large proportion of the population has been vaccinated.

Tetanus is among the shots given in childhood. It's bundled in vaccines that protect against diphtheria, pertussis (whooping cough), polio and Hemophilus influenzae type B. Adults need booster shots every 10 years.

"Think about tetanus this time of year, especially if you're a gardener or you're working with your hands," says Gemmill. "Because that's exactly the kind of person who might sustain a injury."


-- The Canadian Press

Republished from the Winnipeg Free Press print edition April 10, 2013 D8

Fact Check

Fact Check

Have you found an error, or know of something we’ve missed in one of our stories?
Please use the form below and let us know.

* Required
  • Please post the headline of the story or the title of the video with the error.

  • Please post exactly what was wrong with the story.

  • Please indicate your source for the correct information.

  • Yes


  • This will only be used to contact you if we have a question about your submission, it will not be used to identify you or be published.

  • Cancel

Having problems with the form?

Contact Us Directly
  • Print

You can comment on most stories on You can also agree or disagree with other comments. All you need to do is be a Winnipeg Free Press print or e-edition subscriber to join the conversation and give your feedback.

You can comment on most stories on You can also agree or disagree with other comments. All you need to do is be a Winnipeg Free Press print or e-edition subscriber to join the conversation and give your feedback.

Have Your Say

New to commenting? Check out our Frequently Asked Questions.

Have Your Say

Comments are open to Winnipeg Free Press print or e-edition subscribers only. why?

Have Your Say

Comments are open to Winnipeg Free Press Subscribers only. why?

The Winnipeg Free Press does not necessarily endorse any of the views posted. By submitting your comment, you agree to our Terms and Conditions. These terms were revised effective April 16, 2010.


Make text: Larger | Smaller


Stephen Harper announces increased support for Canadian child protection agencies

View more like this

Photo Store Gallery

  • A Canada goose makes takes flight on Wilkes Ave Friday afternoon- See Bryksa’s 30 Day goose a day challenge- Day 09- May 11, 2012   (JOE BRYKSA / WINNIPEG FREE PRESS)
  • MIKE.DEAL@FREEPRESS.MB.CA 100615 - Tuesday, June 15th, 2010 The Mane Attraction - Lions are back at the Assiniboine Park Zoo. Xerxes a 3-year-old male African Lion rests in the shade of a tree in his new enclosure at the old Giant Panda building.  MIKE DEAL / WINNIPEG FREE PRESS

View More Gallery Photos


Are you concerned about the number of homicides so far this year?

View Results

Ads by Google