Tetanus, Diphtheria, Pertussis

Tetanus is an illness that can occur after an injury with a contaminated object. The bacteria that causes tetanus is often found in soil, and can get into the body through a break in the skin such a wound, burn, scratch or bite. Tetanus is common throughout the world, and is most often encountered in children or those who do manual labour, as well as unvaccinated individuals.

This disease is often called “lockjaw” as is affects the muscle systems, making jaw muscles tighten so that affected individuals cannot open their mouths. Other symptoms of tetanus include headaches, painful muscle stiffness, trouble swallowing, seizures, fever and high blood pressure. This disease is quite dangerous as it can cause trouble breathing and in severe cases paralysis. Even with intensive, modern care, 10-20% of people with tetanus will die from symptoms. For this reason, vaccination is the most important means of prevention.

Tetanus occurs throughout the world, and you are at risk anywhere. Travel does not generally increase the risk unless you are doing humanitarian aid work, construction or demolition of buildings, or working outdoors. Anyone not vaccinated against tetanus is at risk if injured by a contaminated object, using drugs, or having a medical procedure in an unhygienic setting.

As with any preventable diseases, it’s recommended that you receive a tetanus vaccine if you have not already had one, before you travel. The tetanus vaccine is most often given in conjunction with the vaccine for Diphtheria and Pertussis, or the Tdap (adult) or DTaP (child) vaccines. This vaccine is covered by OHIP and routinely given every 10 years. If you are traveling or engaging in work where the risk of tetanus is high, a booster shot is recommended. In addition, always take precautions to avoid injuries while working or travelling, as you are always at risk of contraction from a contaminated object.

Diphtheria is an illness spread through coughing and sneezing, or through contact with skin sores of an infected person. Diphtheria is a serious illness, and is deadly in 5-10% of cases where breathing problems occur. For this reason, it is important that you are vaccinated against Diphtheria no matter where you live. The disease has the highest occurrence rate in developing countries, where the risk of contraction is highest due to lack of vaccinations.

Symptoms of this illness include fever, sore throat and a thick coating of the nose and throat. In certain cases, neck swelling and skin sores may also occur. In the most severe instances, swelling of the heart and nerves, as well as trouble breathing can occur. About 5-10% of cases where trouble breathing manifests result in death, despite treatment.

This disease occurs worldwide, but is most common in developing countries with low rates of vaccination. Portions of Africa, South and Central America, Asia and Eastern Europe have the highest rates of Diphtheria, while industrialized countries such as Canada have low rates owing to the availability of vaccination.

The Diphtheria vaccine is the most effective means of preventing contraction of this disease. The vaccine against Diphtheria is available in combination with other vaccines against tetanus and pertussis, and are commonly given in the form of Tdap or Td for adults, and DTaP for children. Boosters should be received every ten years or following exposure to any of the diseases. While travelling, it is important to also take precautions against the spreading of Diphtheria by maintaining good standards of hygiene, washing hands, covering your mouth and nose while sneezing or coughing and avoiding close contact with people who are ill.

Pertussis is also known as ‘whooping cough’ and is a contagious disease spread by coughing and sneezing. This disease is seen in all countries, but has the highest rates in developing countries where immunization is not common.

Early symptoms of Pertussis are similar to a cold, and include fever, running nose, sneezing, low fevers, mild cough and pauses in breath in babies and young children. Later on fits of cough will manifest, followed by a high pitched “whoop” and exhaustion. This disease is most serious in babies, and has a 1% mortality rate in those under a year old.

While Pertussis is seen in all countries, it’s more prevalent in countries with lower vaccination rates such as developing countries. Most at risk are infants, immunocompromised people, as well as those who have not had a follow up vaccination. When travelling with babies and unvaccinated individuals it’s necessary to avoid areas of high population as well as sick people.

If you are not already vaccinated, or have been vaccinated as a child, we recommend a dose of the Tdap vaccine to ensure you are immune. The Pertussis vaccine is commonly given in conjunction with Tetanus and Diphtheria, and is called the DTaP vaccine. This vaccine is routinely given every 10 years during your physical exam at your doctor’s office and it is covered by OHIP.