Diphtheria/Tetanus/Pertussis Vaccines

What causes tetanus?

exposure to endotoxin from bacteria Clostridium tetani (found in soil and animal intestines/feces)

How is tetanus transmitted?

primarily through exposure through wounds or mother to baby at birth

What are symptoms of tetanus?

• lock jaw, followed by neck → progresses to generalized disease

• spasms at site of injury

• damage to initial cranial nerve 

What are risk factors for tetanus?

• immunocompromised

• diabetes

• no primary series or booster in past 10 yrs

• dirty wounds/puncture wounds/devitalized tissue

What causes diphtheria?

toxigenic strains of Corynebacterium diphtheriae (bacterial toxin)

How is diphtheria transmitted?

primarily via respiratory droplets/secretions or skin contact with infected person

What are early stage/non-specific symptoms of diphtheria?

• sore throat

• upper respiratory viral-like illness

What are classic hallmark symptoms of diphtheria?

• thick gray membrane along the respiratory tract that bleeds if removed

• swollen mucosa and cervical adenopathy

• neuritis and carditis (toxic mediated complications)

What causes pertussis (whooping cough)?

bordetella pertussis (bacteria)

How is pertussis transmitted?

respiratory secretions/droplets

What are stage 1 symptoms of pertussis?

runny nose, fever, mild cough

What are stage 2 symptoms for pertussis?

• sudden and severe frequent coughing fits

• characteristic whooping sound may be heard

What are stage 3 symptoms for pertussis?

gradual recovery in frequency and severity occurs over weeks to months

When are Tdap boosters (Adacel and Boostrix) recommended?

• adolescents: 11-12 yrs

• adults: every 10 yrs

• every pregnancy @ 27-36 wks

• for wound management if >5 yrs since last Td/Tdap