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Tetanus is caused by infection with a bacterium, Clostridium tetani, which is present in the soil, in animal dung and in faeces and enters the body through wounds.
The bacterium produces a toxin which can make skeletal muscles unusually rigid, and may result in spasms. Because these spasms may affect the facial muscles, tetanus is sometimes known as lockjaw. Ultimately, breathing may become difficult or impossible, resulting in death. Neonatal tetanus, which affects newborn babies, usually results from unsafe delivery in unhygienic conditions or without skilled birth attendants. Unsterile cutting and care of the umbilical cord is a frequent source of infection. As with many other infectious diseases, poverty greatly increases families' vulnerability.
There are an estimated 201 000 deaths from neonatal tetanus each year. However the total number of tetanus deaths is much greater because mothers, older children and others can also be affected. WHO estimates that there are some 281 000 deaths altogether each year. Safe and effective vaccines against tetanus has been available for decades and are usually given with those for diphtheria and pertussis.
Since the World Summit for Children in 1993 the WHO has been working to eliminate neonatal tetanus as a public health problem. Strategies that governments can employ to achieve this goal include:
- Ensuring that all pregnant women receive at least two doses of tetanus vaccine
- Ensuring safe clean delivery for all women.
For more information see:
WHO page on neonatal tetanus
Why the Convention on the Rights of the Child Matters