Section 18 Neonatal Tetanus

Introduction of Neonatal Tetanus

Tetanus is a traumatic infectious disease. When the skin is broken，tetanus spore is brought into the wound. With the depletion of oxygen in the wound，tetanus spore is transformed into Clostridium tetani in necrotic tissue，which produces tetanus toxin that is retrograde along the nerves to the central nervous system，disrupting the normal inhibitory regulatory function of the nerves，causing generalized muscle rigidity and paroxysmal spasm. Finally the patient succumbs to death due to suffocation and heart failure. This disease has a high mortality.

Neonatal tetanus is one of the types of tetanus，accounting for about 80% of the total tetanus cases. It’s mostly caused by unscientific old-fashioned methods of delivery，such as cutting the umbilical cord with nonsterile sharp tools （household scissors or glass sheets） or treating the umbilical cord with contaminated dressings. Clostridium tetani infects the umbilical cord wound and multiply to produce exotoxin in residual roots，causing neonatal tetanus finally.

1. Diagnostic criteria for neonatal tetanus

（1） Having the history of using non-sterile tools in the process of delivery or treating the wound with unsterilized measures after birth.

（2） Clinical manifestations：NT takes place in day 4-6 after birth，with the earliest in day 2 and latest in day 14. At early stage，the baby has trismus and sucks hard，later it develops to facial spasm，presenting forced smile. Limb muscles develop paroxysmal tonic spasms and rectus abdominises become rigid，like a plank；neck becomes stiff presenting opisthotonos；respiratory muscles and throat muscles spasm can lead to suffocation，respiratory failure and heart failure.

（3） When taking secretions from umbilic wounds for anaerobic bacteria culture，some patients（30%） may be Clostridium tetani test positive.

2. Prevention measures

（1） Conducting delivery using sterile procedures.

（2） Immunizing fertile women using tetanus toxoid.

新生儿破伤风疑似病例个案调查表

新生儿破伤风疑似病例情况调查表

Epidemiological Questionnaire for Neonatal Tetanus Suspects

Questionnaire

Questionnaire for Investigation of Neonatal Tetanus Suspects

（本节编者-马钰　本节核对-孙艺　龙佳丽）