TETANUS – DIPHTERIA – PERTUSSIS VACCINE
What is tetanus ?
Tetanus is a severe infectious disease caused by bacteria which are commonly found in the soil. The bacteria penetrate into the body of its victims through contact with any type of breach in the skin, such as wounds, burns or animal bites. Being injured by a contaminated object can result in the transmission of tetanus.
Once in the body, the bacteria reaches the nervous system and can cause painful muscle spasms, especially affecting the muscles of the jaws. At this stage, the victim can not open his/her mouth anymore. Other symptoms include headaches, trouble swallowing, a fever and high blood pressure. An infection with tetanus is a medical emergency, which requires immediate treatment with tetanus immune globulin, antibiotics and agents such as benzodiazepines to control the muscle spasms. Permanent breathing troubles and paralysis can occur, as well as death in 10 to 20% of the cases (even if the victim receives intensive care).
What is the risk for travelers ?
Tetanus is present worldwide, but the disease is more prevalent in developing countries. Most of the reported cases of tetanus occur in Africa and in Asia, where access to vaccination is limited. All the international travelers who are not vaccinated are at high risk for the disease, as they may easily be injured with a contaminated object or be affected by a wound which could be in contact with infected soil. The persons using injecting drugs, as well as the humanitarian aid workers who are constructing or demolishing buildings face a higher risk.
How to prevent tetanus ?
The only effective protection against tetanus is vaccination. If you intend to travel to another country, especially in Africa or in Asia, you must see a doctor before your departure and make sure that your vaccination is up to date. The vaccine against tetanus is usually combined with vaccines against pertussis and/or diphtheria. Children should get vaccinated with the DTaP vaccine at 2, 4, 6 and 18 months old, and between 4 and 6 years old. Teenagers between 11 and 18 years old must get a dose of Tdap vaccine. Adults over the age of 19 years old must get a booster dose of tetanus vaccine every 10 years.
What to do in case of injury ?
If you are victim of an injury while traveling, you must see a doctor immediately. He/She will evaluate your risk of exposure to tetanus and give you a booster dose of vaccine if necessary. Note that even if you are vaccinated, a booster dose can be recommended, especially in the event of a serious wound or if you received your last booster dose against tetanus more that five years ago. If you are victim of a severe open wound which may have been contaminated with soil and bacteria, it must be surgically cleaned.
What is diphtheria ?
Diphtheria is an infectious and contagious disease. It is transmitted through the coughs and the sneezes of infected persons, but also through direct contact with the skin sores of a victim of the disease. Among the symptoms of diphtheria, a fever, throat soreness and a thick coat in the throat and in the nose can be quoted. In some cases, neck swelling and skin sores can also appear. If the disease becomes severe, the victim may experience swelling of the heart and of the nerves, as well as great difficulties to breath. Death occurs in 5 to 10 % of severe diphtheria cases. It is good to know that the persons experiencing skin sores have more chances to fully recover from the disease.
What is the risk for travelers ?
The persons traveling to developing countries are highly exposed to diphtheria. In developed areas, the risk of being infected is relatively low, as the local population is usually vaccinated against the disease.
How to prevent diphtheria ?
The only way to effectively prevent diphtheria is to get vaccinated. If you intend to travel to a country at risk, you should see a doctor and make sure that your vaccination against diphtheria is up to date before your departure. In the United States, the diphtheria vaccine is available only in combination with vaccines against tetanus and/or pertussis. Three kinds of diphtheria vaccines are commercialized : the Tdap and the Td for teenagers and adults, and the DTaP for children. The Td is a combined vaccine which protects against diphtheria and tetanus. Teenagers and adults must get a booster dose of Td every 10 years. The Tdap is similar to the Td, but it offers protection against pertussis in addition. The DTaP vaccine is given to young children under the age of 7 years old. Children are administrated five shots of DTaP : at 2, 4, 6 months old, between 15 and 18 months old and between 4 and 6 years old.
While traveling, you should always have good hygiene practices. Wash your hands frequently with clean water and soap, or with a hand sanitizer containing at least 60% alcohol. Never touch your face, especially your eyes, your nose and your mouth, if your hands are not clean. When sneezing or coughing, cover your mouth and nose with a disposable tissue, never with your hands. Throw the tissue in a bin right after use. Avoid close contact with other people, such as hugs and kisses.
If you feel sick :
If you feel sick while or after traveling in a country at risk and you think that you may be infected with diphtheria, you must see a doctor as soon as possible. Inform him/her of the places you have visited. Remain isolated until you have fully recovered, to avoid the spread of the disease.
We make every effort to ensure that the information posted on our website is up to date and accurate according to the latest public health recommendations; however, it is impossible for us to make changes on a daily basis.
For the most current travel health recommendations, please call our clinic as make an appointment with one of our travel health professionals.