Deeper into Jeopardy! XLI: Vaccines – $1600

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Jeopardy! category: VACCINES (30-3-2015)

$1600 clue: Immunization against this disease AKA lockjaw has reduced cases in the U.S. to fewer than 50 each year

Correct response

The gist: It’s rare, but don’t go playing along any rusty fences anyway. In fact, the association between rust and tetanus is correlative, not causative. Rust itself doesn’t cause tetanus. Instead, the disease-causing bacteria, Clostridium tetani, can be found pretty in pretty much any non-sterile environment, but it particularly likes living on rusty metal because it provides it with a nice rough surface. Plus, sharp metal combined with soft flesh offer a quick-and-dirty method for the microbe to enter the body and get to work. Once inside, it usually takes a little over a week to incubate, and then it begins with the disease’s nickname lockjaw (or “trismus” is science-speak) – spasms of the facial muscles that can make it impossible to open and close the mouth. Similar spasms spread over the body over time, causing the body to assume a characteristic rigid position known as “opisthotonus” (see the picture below). Before the widespread use of the tetanus vaccine, death rates from tetanus reached into the 90th percentile in the U.S., and it continues to cause tens of thousands of death around the world, with the vast majority of victims bring unvaccinated individuals in the developed world.

The tetanus vaccine has its roots in the late 19th century, when Japanese bacteriologist Kitasato Shibasaburo, better known for co-discovering the bacteria responsible for the bubonic plague, first isolated C. tetani and proved its link to the disease by… injecting it into animals who then got the disease, of course. He also discovered that certain antibodies neutralized the bacteria’s active toxin. The first true vaccine, using formaldehyde-inactivated tetanus toxin, was developed in 1924 by P. Descombey. Its efficacy was clearly observed during its first widespread use during WWII, when routine use of the vaccine prior to deployment reduced incidence of tetanus among wounded U.S. soldiers to about one-thirtieth is WWI rates. At two months, infants now routinely receive the DPT vaccine, which protects against diphtheria, pertussis (AKA whooping cough), and tetanus, with boosters given throughout life. In 2013, tetanus caused just under 60,000 deaths worldwide, down from about 356,000 just 23 years earlier in 1990.

Painting of opisthotonus by Scottish anatomist Charles Bell (known for his namesake palsy), 1809

The clue: Disregard all the interesting if useless epidemiological data this clue presents – the only thing likely to help you as a contestant is “lockjaw.” No other hints here, except that it has a vaccine, but you knew that from the category.

In Jeopardy!: Like it does on old, poorly-maintained playground equipment, tetanus lurks in 22 regular clues in the J!Archive, plus one FJ! clue. Eight of them are about the term “lockjaw.” 13 mention the vaccine (or “shot”) – five of those are about the DPT vaccine specifically, and five also use the word “booster.” The FJ! clue is about Medic Alert, which was founded because of parents’ concerns over their daughter’s tetanus antitoxin allergy.

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