EnzymeimmunoassayforthequantitativedeterminationofIgG-classantibodiesagainstClostridiumtetanitoxininhumanserumorplasma(citrate).Clostridiaarespore-forminggram-positivebacteria.Theroundsporesarebuildattheterminalendwhichresultsinthemicroscopeina“tennisracket”likeshape.TetanusdevelopsonlywhensporesofClostridiumtetanigerminateunderstrictanaerobicconditionsaftergainingaccesstowoundsandsmalllacerations.Theclinicalmanifestationofthediseaseisprimarynotcausedbytheinvasionoftheexciterbutbythesecretionofapowerfulneurotoxin(tetanospasmin).Thistoxinblockstheinhibitionofthesignaltransductionandhasahighaffinitytothecentralnervoussystem.TheconsequenceishyperexcitABIlityofthemusclestoexternalstimuliincombinationwithaprincipalincreaseofthemuscletonuswithoutinfluenceofconsciousness.Itstartswithtonicspasmofmuscles(trimus),mimicmusclesandgalletmuscles.Neck,backandaBDominalmusculaturefollow.Atthesametimetheappearanceofrefectoryspasmofwholemusclegroupscanhamperbreathing.Hypersalivationandswallowingproblemscauseaspirationandpneumoniawiththenextbreath.Clostridiumtetaniisubiquitouspresentinsoilandintestineofhumansandanimals.Ingestionofbacteriaorgrowthintheintestineofmanoranimaliswithoutharm.Thesporesareextremelyresistanttowardsheatandcanstayinfectiousforalongperiod.Thebacteriacangetundertheskinbyevensmallestwounds.InEuropetetanusmainlyoccursafterinjuriesandsometimespostoperativewhereasindevelopingcountriesTetanusiswidelydisseminated.TheWHOassumesthatonemillionpeoplediebecauseoftetanusworldwideperyear.Tetanustoxinisanexcellentimmunogeninman-onlyoneantigenictypeoftoxin.Theonlyeffectivewaytocontroltetanusisbyprophylacticactiveimmunization.