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Oregon Road Conditions & Cams Email Story to a Friend October 22, 2005 Robert Kridel goes through a stack of records in his teepee near Jacksonville. Kridel, who is in constant pain and can barely walk, attributes his failing health to the long-term effects of tetanus. Mail Tribune / Jim Craven Tetanus leaves ‘not much of a life’ Multiple health problems range from flashing lights to pain and nausea By BILL KETTLER Mail Tribune If he had it to do all over again, Robert Kridel would tell the doctors to take his arm. Kridel didn’t know much about tetanus back in December 1997. He knows a lot more about it now than he ever wanted to. How tetanus attacks the nervous system. How quickly it can move from the wound to the nervous system. How little doctors can do to stop it. Kridel was fixing a tractor engine that day almost eight years ago. The crankshaft moved when it shouldn’t have. His hand was in the wrong place. The heavy metal shaft nearly severed his right index finger and drove his hand into a pile of barnyard dirt. Surgeons sewed his finger back on and gave him a tetanus booster shot. Within days he began to feel stiffness in his neck and he came down with a fever — classic symptoms of tetanus, also known as lockjaw. Kridel kept his finger, but his life changed forever. Nearly eight years after the accident, he walks with a cane when he walks at all. Mostly he uses a motorized wheelchair when he has to move any distance from the teepee that’s his home, on a friend’s land outside Jacksonville. Advertisement His vision is interrupted by flashes of bright light, and he suffers from constant pain. Doctors write him prescriptions for pain relievers and muscle relaxants. He takes other drugs to control nausea and side effects of the prescription drugs. Between Kridel’s pain and his limited mobility, work is out of the question. Friends help him gather firewood for his woodstove. "It’s not much of a life for a 51-year-old man," he said, sitting in his teepee. Kridel attributes his failing health to the long-term side effects of exposure to Clostridium tetani, the bacterium that causes tetanus. Doctors are treating his pain, but no one has been able to undo the nerve damage that began soon after the original injury and has increased slowly over time. Looking for answers, Kridel eventually connected with Fred Berman, a toxicologist at the Center for Research on Occupational and Environmental Toxicology at Oregon Health & Science University. Berman is a veterinarian who also earned a doctorate in toxicology. He’s studied tetanus in horses, goats, dogs and other species that are far more vulnerable to the bacterium than humans. "It’s a real interesting toxin," Berman said in a telephone interview. Tetanus spores are found everywhere, and they can lie dormant for decades in soil, dust or manure. The spores germinate in anaerobic conditions such as puncture wounds. When the spores germinate they produce a powerful neurotoxin. The toxin "migrates up the motor and sensory nerves to the spinal cord," Berman said. "It targets specific neurons and inhibits their impulses to other nerves, and blocks the nerves’ ability to transmit messages. "Once the toxin is bonded (to the neuron), it cannot unbind." Unfortunately for Kridel, medical researchers have little interest in tetanus. It became a relatively rare illness in the United States after scientists developed a vaccine in the 1920s. Only 130 cases were reported to the federal Centers for Disease Control and Prevention between 1998 and 2000. Many people who survive the initial illness recover without permanent side effects. Few humans have reported symptoms as unusual and severe as Kridel’s, and there’s been little research on tetanus "sequelae" (long-term effects). To complicate the issue even further, there’s no laboratory test to confirm the presence of tetanus. Physicians make the diagnosis on the basis of symptoms such as inability to move the muscles of the jaw and intense muscle spasms (sometimes violent enough to break bones) in other parts of the body. Some people have questioned whether Kridel’s many health problems are really related to tetanus toxin, but his medical records show physicians have given him a diagnosis of chronic or "cerebral" tetanus. Berman says there’s a "strong possibility" that his nervous system was permanently damaged by the tetanus toxin. "He hadn’t had a tetanus booster since he was a kid," Berman said. "That was 30 years (before the accident). He was given a tetanus booster (in the hospital), but he wasn’t given tetanus antitoxin" until several days later, after the toxin would have had ample time to spread. Berman has seen animals suffer severe side effects from tetanus. A dog he treated survived the tetanus toxin, but "when it went out the door, it went out like a toy soldier — stiff and stilted." Kridel’s current physician, Robert Eckert, declined to discuss his condition, citing his desire to preserve the confidentiality of the patient/physician relationship. "Robert has suffered quite a lot and struggled to get the medical care he deserves," Eckert said. "We’re doing the best we can with that." Kridel said his experience should serve as a warning to anyone who chooses to remain unprotected. He’s moving his teepee to a site near Talent, to be closer to medical care. "I know a lot of people who didn’t know anything about tetanus," he said. "When they heard my story, they got vaccinated." Reach reporter Bill Kettler at 776-4492, or e-mail Tetanus leaves �not much of a life� ">[email protected] . Bacterial disease attacks nervous system Tetanus is a bacterial disease that affects the nervous system. Spores of the bacterium are found all over the world in soil, dust and animal manure. Vaccination provides immunity against tetanus. Most people are vaccinated in infancy with the DPT (diphtheria, pertussis, tetanus) injection. Boosters are recommended every 10 years. Nearly all reported cases of tetanus occur among people who have never been immunized, or who have not had a booster vaccination within the past 10 years. Tetanus cannot be transmitted between humans. Tetanus is still a significant health problem in undeveloped countries around the world. As many as 1 million cases occur worldwide, according to the World Health Organization, and neonatal tetanus kills as many as 500,000 infants and young children every year. — from the National Foundation for Infectious Diseases Mail Tribune Home | Local News | Sports | Business | Obituaries | Life | Opinion AP News | Archives | Site Map | Community | Classified Copyright © 1997-2005 Mail Tribune, Inc. All rights reserved. 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