Medicines to Prevent Tetanus
============================

Some wounds can cause tetanus unless the person has already had the
necessary vaccinations.  Antitetanus immunoglobulin and the tetanus
vaccine are 2 medicines given by injection that prevent tetanus after
a wound.  One or both are needed depending on whether the person is
up-to-date with tetanus vaccinations and the seriousness of the
wound.  Give the necessary injections as soon as possible.  Do not
wait for signs of tetanus.

A person is up-to-date with tetanus vaccines, when:

* They had all 6 doses (a series of 3 as a baby, and later at least
 3 boosters).
 OR
* They had the first 3 doses and at least one booster within the
 last 10 years.

To know which medicines to prevent tetanus are needed, it is best to
know if the person has had a vaccine against tetanus and when.  Many
people do not know if they have had these vaccines.  If their
vaccination history is unknown, give medicines as if they are not
up-to-date with their vaccines.

-> Give the vaccine against tetanus AND give antitetanus
immunoglobulin globulin:

* If the wound is deep or dirty and the person has not had a
 tetanus vaccine within the last 5 years or their vaccination
 history is unknown.

-> Give the vaccine against tetanus but do not give antitetanus
immunoglobulin globulin:

* For any wound, even one that is minor and clean, if it is not
 certain that the person received at least 3 vaccinations against
 tetanus (the first 3 doses are usually given during a baby's first
 year).
* If the wound is deep or dirty and 5 years or more has passed
 since the most recent tetanus vaccine or vaccine booster.
* If the wound is minor and clean and 10 years or more has passed
 since the most recent tetanus vaccine or vaccine booster.

-> No injection is needed:

* If the wound is deep or dirty but the most recent tetanus vaccine
 was within the last 5 years.
* If the wound is minor and clean and the person is up-to-date with
 their tetanus vaccines.

But if the person has HIV or another illness that lowers their
immunity, give antitetanus immunoglobulin for any wound, even a minor
one.  If they are not up-to-date with the tetanus vaccine, they will
need the tetanus vaccine too.

Tetanus vaccine
===============

* Vaccines to prevent tetanus often come combined with other
 vaccines.  Abbreviations for such vaccines include: DPT, Tdap, Td,
 Dt and others.
* The DPT vaccine protects against diphtheria, pertussis and
 tetanus and by 6 months old, babies need a series of 3 injections
 of this vaccine.
* Older children get 3 booster injections of DTP or another
 combination vaccine to prevent diphtheria and tetanus (such as Td
 or Dt).
* Receiving all 6 doses of these vaccines against tetanus (the
 series of 3 and then 3 boosters) gives protection from tetanus for
 decades.
* People who did not receive all 6 doses or did not have one within
 the last 10 years may need a booster vaccine.
* Giving the vaccine against tetanus to a pregnant woman whose
 vaccinations are not up-to-date helps protect both the woman and
 her newborn baby from tetanus.

Antitetanus immunoglobulin human (Tetanus immune globulin)
==========================================================

If a person is not up-to-date with their tetanus vaccination (the
series of 3 injections, and at least 3 boosters, or one booster
within the past 10 years), then they should be given antitetanus
immunoglobulin as soon as possible after getting a wound that might
cause tetanus.  If giving both the tetanus vaccine and the
antitetanus immunoglobulin at the same time, use separate needles and
inject in different places on the body.

Side effects
------------

There may be pain and tenderness where the injection was given.

Important!
----------

Antitetanus immunoglobulin can cause a severe allergic reaction for
some people.  Always have epinephrine (adrenaline) available in case
of an allergic reaction.

Some live virus vaccines, including those preventing measles,
rubella, and tuberculosis, should not be given for 3 months after
someone has received antitetanus immunoglobulin because it may make
the other vaccines less effective.

How to use
----------

Injection
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40px-NBgrninject.jpg>

Inject the medicine deep into the muscle.

For a wound less than 24 hours old:

Inject 250 units one time only.

For a wound more than 24 hours old, or a wound that is very likely to
be infected with tetanus:

Inject 500 units one time only.

Also give an antibiotic such as metronidazole OR penicillin G.

antibiotics
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