1. Vaccination is the key for the prevention of this disease. Therefore, a strict vaccination schedule must be followed. Tetanus usually occurs among those persons who are either not vaccinated at all, or to whom proper dosages have not been given.



Therefore, all children should be immunized and this immunization should be maintained throughout life by administering booster dosages of tetanus vaccine at regular intervals. Also, all pregnant mothers should get a cover of vaccination. If the mother is already vaccinated, booster dosages must be administered.

In addition to the above, in all cases of injury or wounds, vaccination must be done as a preventive measure, even if the injury is small. Besides injuries, tetanus vaccination is also indicated in the case of ear discharge (otitis media), as these cases are likely to get tetanus through perforations in their ear-drums.

Tetanus vaccination is essential as a preventive measure before minor/major operations. At the same time, a precise regimen of sterilization must be practiced so as to avoid the incidence of tetanus in operated cases, as is noticed occasionally.

Since an attack of tetanus does not give immunity to the patient against tetanus, therefore, those cases of tetanus that recover from the disease need to be administered tetanus vaccine for future prevention.

2. The second most important step in the prevention of tetanus is immediate care of the wound. Roadside injuries should be given very careful attention as accidental wounds are almost always contaminated with tetanus spores and are likely to cause tetanus. Apart from a thorough cleaning of the wound, all foreign bodies; debris, etc. must be carefully removed, and if need be, even the whole wound may be surgically excised under anesthesia so that the wound becomes thoroughly sterile. This is especially required when the wound is mutilated one. If this little step, though of very high importance, regarding treatment of the wound is kept in mind, it will serve as a very helpful measure in the prevention of tetanus.

3. Hygienic conditions must be maintained both at home and outside. One should not walk barefoot even in one's house. All types of injury have to be avoided as far as possible, especially in the case of children.

4. Early warning signals of tetanus must always be kept in mind, especially 'lockjaw', so that even if tetanus occurs, early urgent preventive/therapeutic steps can be taken, so that the disease is prevented from proceeding to an advanced stage, and the life of the patient is saved.

It may be concluded that it is only by following the above preventive measures religiously that one can succeed in overcoming this deadly disease in all respects. And for that a prophylactic strategy is the urgent need at the national level.

Tetanus may also develop in cases of ear discharge (otitis media), when the tetanus spores which may be present in the discharge of the ear, gain entry into the body through perforation/ s in the ear-drum of these patients. Such cases are called 'otogenic tetanus'. This is of great importance, because such cases usually remain ignored till they get tetanus. This calls for energetic treatment of the prevailing disease of the ear, as well as urgent vaccination against tetanus usually, these cases have not been vaccinated for tetanus earlier. Cases of otogenic tetanus are not uncommon. The author discussed such cases in one of the issues of Current Medical Practice. The disease is more common among children, and the parents should have the requisite awareness about this disease.