TETANUS, ALSO CALLED LOCKJAW, IS CAUSED BY THE TOXIN OF CLOSTRIDIUM TETANI. SPORES OF THIS BACTERIUM ARE INTRODUCED INTO THE BODY THROUGH PUNCTURE WOUND. UNDER THESE ANAEROBIC CONDITIONS THE BACTERIA GROW AND PRODUCE TOXINS (TETANOSPASMIN, TETANOLYSIN), WHICH CAUSE SKELETAL MUSCLE SPASMS & AUTONOMIC NERVOUS SYSTEM DISTURBANCE. PROTECTION IS ACHIEVED BY VACCINATION IN CHILDHOOD AND FOLLOWING BOOSTER INJECTIONS. IN CHILDREN <7 YEARS OF AGE, THE TETANUS VACCINE IS ADMINISTERED AS A COMBINED VACCINE, WHICH ALSO INCLUDES VACCINES AGAINST DIPHTHERIA AND PERTUSSIS (DPT). IMMUNITY IS GENERALLY ACHIEVED BY THREE LIFETIME DOSES OF THE VACCINE; BOOSTER SHOTS OF THE VACCINE ARE RECOMMENDED EVERY 10 YEARS TO MAINTAIN IMMUNITY. FOR ADULTS AND CHILDREN >7 YEARS OF AGE, COMBINED VACCINES OF TETANUS AND DIPHTHERIA (DT, DTAP) ARE COMMONLY USED.

BORDETELLA CAUSES ACUTE INFECTION OF THE RESPIRATORY TRACT COMMONLY MANIFESTING AS PERTUSSIS / WHOOPING COUGH. OF THE 10 IDENTIFIED SPECIES OF BORDETELLA, ONLY 4 SPECIES ARE OF MAJOR MEDICAL SIGNIFICANCE. B. PERTUSSIS LEADS TO VIOLENT COUGH WHEREAS B. PARAPERTUSSIS CAUSES A MILDER INFECTION. IT IS A HIGHLY COMMUNICABLE DISEASE AND AN IMPORTANT CAUSE OF INFANT MORTALITY & MORBIDITY. ACTIVE IMMUNIZATION HAS BEEN ABLE TO REDUCE THE INCIDENCE OF PERTUSSIS.

DIPHTHERIA IS CAUSED BY CORYNEBACTERIUM (C.) DIPHTHERIAE, AN AEROBIC, NON-SPORULATING ROD BACTERIUM. THE VIRULENCE OF C. DIPHTHERIA IS DERIVED FROM THE DIPHTHERIA TOXIN. HUMANS ARE THE ONLY RESERVOIR FOR THE BACTERIUM. ACTIVE IMMUNIZATION IS THE METHOD OF CHOICE FOR THE PREVENTION OF DIPHTHERIA. THE IMMUNITY PRODUCED BY THE ANTITOXIN LARGELY PREVENTS THE ILLNESS BUT NOT THE INFECTION SO THAT THERE CAN ALSO BE CARRIERS AMONG THOSE WHO HAVE BEEN VACCINATED.