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Comment by susam | Hacker News Reader

I had a very minor injury from a broken door handle today. It was barely a little more than a scratch. I did not think much of it but my wife suggested that I get it checked by a doctor to see if I needed a tetanus shot. My last tetanus shot was more than 10 years ago. So I cancelled my meetings for the day and visited a doctor. The doctor indeed prescribed a tetanus shot despite the injury being very small, so I got the shot about an hour ago. Then came back home and sat down to read more about it on the web. That's when I came across this article and thought I might as well share it with the HN community.

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Wait… does that imply people who work in their garage or on their vehicles (car, motorbike, pedal bike, etc., who routinely get nicks and cuts are putting themselves in elevated danger if they don’t get booster shots?

I can say I’ve gotten hundreds of nicks and cuts induced by metal objects since being a kid.

AFAIK the point is not about the cut or scrape being made by metal (or non metal) objects, tetanus (Clostridium tetani[0]) does not live on metals, it lives in the soil/earth, so - say - gardening tools are high risk - a gear taken out of a gearbox or a table knife are - still say - like 0% risk.

As anecdata I know someone that got it (but was treated in time and survived it just fine) while gardening because of a rose thorn prick.

A bite from an animal, even your own pet, might be risky because it may have ben eating earth or however something dirt and the tetanus is still in its mouth.

[0] https://en.wikipedia.org/wiki/Clostridium_tetani

That's interesting(!) because on the other hand there is the thought that kids should play with dirt and eat dirt to acquire immunity against some allergies later in life (which is typically has more sterile environs)

Well, hopefully kids don't have deep wounds inside their mouth/exofagus/stomach/etc.

And anyway a non-deep and well cleaned/sterilized wound (say with oxigen peroxide) has - I believe - very little risks of the bacteria to survive and germinate.

When I was a kid, my Dad was working making prosthetic legs for people. I won’t forget someone who lost their leg because they got fairly small cut going down a metal slide but didn’t get it treated. It resulted in their leg having to be amputated. I’d consider yourself lucky and probably go get a tetanus shot. It’s a really stupid way in modern society to lose a limb. Speaking of which I should probably go get my booster too!

Did the victim not have their tetanus shots at all? That would make sense. But if they did and they still got tetanus despite that, that would be concerning.

The article suggests that no, as long as you had the shot as part of your childhood vaccination series, you're not at higher risk at if you haven't had a booster:

A recent paper published in the journal Clinical Infectious Diseases suggested that tetanus and diphtheria booster vaccines are not necessary for adults who have completed their childhood vaccination series

It's a bacteria, which is typically found in moist soil.

This is often where rusty nails live, hence why people connect the two.

You can get tetanus from ground wasps too, for the same reason.

Who knows with a garage / cars in terms of risk level, realistically you can catch it from literally any cut.

I'd say a higher risk is gardening. Who notices every little cut, when weeding?

>This is often where rusty nails live, hence why people connect the two.

And rusty farm equipment, which gets dragged through manure and nutrient laden soil which is a perfect place for the bacteria. And people who hang around rusty farm equipment tend to have tons of exposure to soil and manure.

And in some places, naturally occurring anthrax, so more to worry about on the farm.

Gardening, especially if you have thorny bushes like roses. No way avoiding cuts even with gloves -but you also have fencing, trellises, frames, etc.

The bacterium is also anaerobic, so puncture wounds such as, again, from a nail are of greater general concern than bleeding cuts.

Tetanus is a nervous system disease caused by a bacteria. Rust has nothing to do with it.

Right, it's just that metal objects have high propensity to induce bruises, nicks, cuts and lacerations and it tends to be dirtier than the rest of the house.

if your tools and stuff you work on is rusty then there would be an increased risk

no, it doesn't imply it. A small nick is not a reason to get a tetanus shot.

What gets my hands in the garage is touching sawdust that's been sitting on the floor. Reliably causes a skin infection.

Sounds like a sawdust allergy.

Maybe it's associated with a particular type of tree/wood as well.

I think it kinda needs to be noted that the article linked (https://academic.oup.com/cid/article-abstract/72/2/285/57416...) does not consider cases like yours (a quickly administered booster shot after getting a cut), only the presence of a regular 10-20 year booster schedule. (They only use data of schedule exists/does not exist, and WHO data of tetanus & diphtheria cases, not whether booster was administered.)

In other words, if getting the irregular tetanus booster shot is a thing that saves people today, it wouldn't show in the data.

It is interesting how vague the timing for the booster shots is.

I had my last shot in 2010,and was told to get one in 10 years. When asking my MD, she told me that the rules changed and it is now a shot at 20, 40 and 65 yo. (and I think this is it).

you should have just washed your hands with soap and warm water.

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