Plasma is a vital weapon against tetanus and rabies

05/20/2024

Tetanus is a serious illness caused by Clostridium tetani bacteria, which produce a toxin that causes painful muscle spasms. Those convulsions of a person's muscles can even cause bone fractures. If untreated, tetanus has a 30-40% fatality rate. Tetanus cannot spread from person to person. It’s rare nowadays with 50-100 cases in the United States annually, after the introduction of a vaccine in the 1920’s. However, people who do not stay up to date on their Tetanus vaccine people remain vulnerable to tetanus

The disease arises when C. tetani spores find a low-oxygen environment, allowing them to grow. Various types of wounds and injuries can provide suitable conditions for tetanus to take hold, including surgical procedures, burns, deep punctures, crushing injuries, ear infections, dental abscesses, animal bites, and complications during pregnancy. The reason many people associate rusty objects with tetanus is that the bacteria is often found in soil that's rich in organic material like manure or dead leaves which is the same environment where rusty objects are typically found. The hallmark symptoms of tetanus occur when the tetanus toxin interferes with the release of chemicals in the nervous system that normally prevent muscle convulsions and contractions. 

Rabies is another preventable, with post-exposure prophylaxis (PEP), viral disease that causes neurological issues and is almost always fatal within weeks once symptoms appear. It is caused by the rabies virus, which is a lyssavirus that is usually transmitted through the bite or scratch of an infected animal, most commonly dogs, bats, raccoons, skunks, and foxes. There are only 1-3 reported cases of rabies annually in the US, with an additional 60,000 people who get treated preventatively after potential exposure. Though tetanus is not contagious between people, and rabies requires direct exposure to an infected animal's saliva, both can be devastating without proper treatment.

Antibodies found in plasma are vital for treating tetanus and rabies. Antibodies are protective proteins produced by the body's immune system. They travel through the bloodstream identifying and defending against bacteria toxins and viruses. Antibodies can recognize, bind to, and neutralize these specific harmful microorganisms. 

If an individual has not been vaccinated against the bacteria that causes tetanus, the person's immune system does not have proper antibodies built up to recognize the toxin before it takes hold. Tetanus immune globulin (TIG) provides passive antibody protection, buying the individual time, until the body can make its own antibodies. TIG is manufactured through raw human plasma of donors immunized with tetanus toxoid that undergoes a fractionation process to isolate immunoglobulins and then further purified to extract the anti-tetanus antibodies specifically, before adding stabilizers and preservatives to create the product that patients with tetanus-prone wounds use. 

For rabies, human rabies immune globulin is given along with the rabies vaccine to bite victims. Every year, over 29 million people receive rabies PEP worldwide. The antibodies help neutralize the virus until the vaccine can stimulate active immunity. These medications with a high concentration of antibodies pooled by the plasma of individuals with rabies antibodies can protect the person exposed to rabies before their own body learns what the invader is and how to fight against it. 

On a global scale, the burden remains high despite effective treatments. Over 73,000 tetanus cases occurred in 2019, with 27,000 of those being neonatal tetanus infections. Rabies still causes around 59,000 deaths per year globally, though widespread use of PEP prevents hundreds of thousands more fatalities annually. 

Though often overlooked, tetanus and rabies persist as major public health issues globally. Plasma-derived antibody therapies are essential for both treating those exposed and preventing many more potential cases and deaths each year. Maintaining access to these life-saving antibody products is crucial to getting these diseases under control and saving lives worldwide.

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