Rare tetanus case hospitalizes Selden teen Joe Heck for 6 weeks
Nineteen-year-old Joe Heck in his Selden home with his mother, Elena, a nurse practitioner, on March 20. He needs a walker to steady himself and struggles to build Lego displays — therapy for the fine motor skills he has lost. Credit: Newsday/J. Conrad Williams Jr.
Nineteen-year-old Joe Heck was whittling wood in his Selden home — a favorite hobby — when the knife slipped and poked a hole in the webbing between his left thumb and forefinger.
He ignored the pain and advice from his mother, Elena Heck, a nurse practitioner, to take antibiotics and keep it clean.
"I just thought it would heal on its own," he recalled during a recent interview at his home.
A little more than a week later, Joe Heck woke up with pain in his jaw. When he tried to stand, a leg gave out.
"It felt like my jaw was on the wrong side of my face," he said.
He had tetanus, a serious and uncommon disease — there are fewer than 50 reported cases every year in the nation, according to the Centers for Disease Control and Prevention.
Tetanus is caused by Clostridium tetani, a bacteria found in soil, dust and manure. It enters through cuts and wounds, producing a neurotoxin that causes muscle spasms starting from the face — also known as lockjaw — and then the rest of the body.
While tetanus has been around for thousands of years, it's uncommon in the United States because vaccinations are typically effective, doctors said.
"I would say every person is exposed to it on a daily basis," said Dr. Dalia Eid, an infectious disease specialist at Stony Brook Children’s Hospital and one of the doctors who consulted on Heck's case. "That's why having that protection against it with vaccination is very important."
The CDC recommends children receive a five-dose vaccination series known as DTaP that protects against tetanus, as well as diphtheria and pertussis, before the age of 7 — followed by another dose at 11 or 12.
Adults are advised to get a booster every 10 years.
Joe Heck had gotten his last vaccine in 2016, and wasn't scheduled to get another booster until next year.
"He hadn’t reached that 10-year mark yet," Eid said.
He spent six weeks at Stony Brook hospital and came home on March 14. The infection and the spasms they caused, along with the medication to ease them, took a heavy toll on his body.
He still needs a walker sometimes to steady himself. He struggles to build Lego displays — therapy for the fine motor skills he lost in his hands. And lollipops help ease the remaining stiffness in his jaw.
Elena and Joe Heck said they're sharing his story so people will understand how serious tetanus can be, the importance of boosters and why you should not ignore a wound.
"If even one person learns something from this, it’s worth it," she said.
He said he's still surprised by how suddenly the symptoms started.
Before he got sick and entered the hospital, Joe Heck was a freshman at Suffolk County Community College. He got a 1400 on his SATs, had plans to become an oncologist and was a bit of a pool shark, winning billiards competitions, according to Elena Heck.
"He’s been healthy his entire life," she said, sitting at the dining room table of her home. "He’s a workhorse in school."
Even his whittling projects are ambitious. The knife slip took place while he was trying to carve Mount Rushmore into a piece of wood.
About 10 days later he started feeling pain in his jaw and went to an urgent care center. They gave him medication but did not diagnose his condition or offer a tetanus shot, Elena Heck said.
When Eid saw him at the hospital shortly after being admitted on Feb. 12, his back was stiff and he could not close his jaw.
The doctor said there are no tests for tetanus but it is identified through a clinical diagnosis.
He started having some spasms in his legs, which progressed to his upper body and arms, Eid said.
He was given Valium to try to decrease the spasms and a tetanus immunoglobulin treatment to battle the toxin in his bloodstream, Eid said.
The muscle relaxant Robaxin and magnesium treatments helped calm the spasms. A feeding tube was inserted through his nose to make sure he received nutrients.
Dr. Erin Muckey, medical director of the Emergency Department at Rutgers NJMS at University Hospital, said most people who get a small or minor wound who have received a tetanus booster in the last 10 years don't have to take extra steps.
"If you have a wound that is contaminated with feces, soil, saliva, puncture wounds — anything considered a dirty wound, we would say you actually need another vaccine within five years," said Muckey, who did not treat Heck and has not seen his wound.
She said for people who get a serious cut, first aid is the first line of defense.
"Wash things out immediately," Muckey said. "Try to remove the bacteria and it's really good for people to know their vaccination status ... if you have any concerns and its been more than five years since your last vaccine, go to your local urgent care or go to your primary care doctor and just ... update your tetanus."
Joe Heck said he doesn’t remember much from that time because he was on and off sleeping.
But Elena Heck remembers.
"I was so worried," she said. "He was so out of it."
She also knew all that time in bed, while necessary, was going to leave him in a weakened state.
Since his release from the hospital, Joe Heck is slowly recovering at home. Elena Heck, who has two younger children, has stopped working since he got sick.
She tries to keep his spirits up but he is frustrated by the slow pace.
He’s looking forward to "putting on my clothes myself," he said.
Nineteen-year-old Joe Heck was whittling wood in his Selden home — a favorite hobby — when the knife slipped and poked a hole in the webbing between his left thumb and forefinger.
He ignored the pain and advice from his mother, Elena Heck, a nurse practitioner, to take antibiotics and keep it clean.
"I just thought it would heal on its own," he recalled during a recent interview at his home.
A little more than a week later, Joe Heck woke up with pain in his jaw. When he tried to stand, a leg gave out.
WHAT NEWSDAY FOUND
- A 19-year-old from Selden contracted a rare case of tetanus after cutting himself while whittling wood.
- Joe Heck spent about six weeks in the hospital, receiving medicine to stop the infection, lockjaw and muscle spasms caused by tetanus. He still sometimes need a walker.
- Experts say you should keep track of your tetanus vaccinations to know if you need one due to a cut or wound.
"It felt like my jaw was on the wrong side of my face," he said.
He had tetanus, a serious and uncommon disease — there are fewer than 50 reported cases every year in the nation, according to the Centers for Disease Control and Prevention.
Tetanus is caused by Clostridium tetani, a bacteria found in soil, dust and manure. It enters through cuts and wounds, producing a neurotoxin that causes muscle spasms starting from the face — also known as lockjaw — and then the rest of the body.
While tetanus has been around for thousands of years, it's uncommon in the United States because vaccinations are typically effective, doctors said.
"I would say every person is exposed to it on a daily basis," said Dr. Dalia Eid, an infectious disease specialist at Stony Brook Children’s Hospital and one of the doctors who consulted on Heck's case. "That's why having that protection against it with vaccination is very important."
The CDC recommends children receive a five-dose vaccination series known as DTaP that protects against tetanus, as well as diphtheria and pertussis, before the age of 7 — followed by another dose at 11 or 12.
Adults are advised to get a booster every 10 years.
Joe Heck had gotten his last vaccine in 2016, and wasn't scheduled to get another booster until next year.
"He hadn’t reached that 10-year mark yet," Eid said.
Six weeks in hospital
He spent six weeks at Stony Brook hospital and came home on March 14. The infection and the spasms they caused, along with the medication to ease them, took a heavy toll on his body.
He still needs a walker sometimes to steady himself. He struggles to build Lego displays — therapy for the fine motor skills he lost in his hands. And lollipops help ease the remaining stiffness in his jaw.
Elena and Joe Heck said they're sharing his story so people will understand how serious tetanus can be, the importance of boosters and why you should not ignore a wound.
"If even one person learns something from this, it’s worth it," she said.
He said he's still surprised by how suddenly the symptoms started.
Before he got sick and entered the hospital, Joe Heck was a freshman at Suffolk County Community College. He got a 1400 on his SATs, had plans to become an oncologist and was a bit of a pool shark, winning billiards competitions, according to Elena Heck.
"He’s been healthy his entire life," she said, sitting at the dining room table of her home. "He’s a workhorse in school."
Even his whittling projects are ambitious. The knife slip took place while he was trying to carve Mount Rushmore into a piece of wood.
About 10 days later he started feeling pain in his jaw and went to an urgent care center. They gave him medication but did not diagnose his condition or offer a tetanus shot, Elena Heck said.
When Eid saw him at the hospital shortly after being admitted on Feb. 12, his back was stiff and he could not close his jaw.
The doctor said there are no tests for tetanus but it is identified through a clinical diagnosis.
He started having some spasms in his legs, which progressed to his upper body and arms, Eid said.
He was given Valium to try to decrease the spasms and a tetanus immunoglobulin treatment to battle the toxin in his bloodstream, Eid said.
The muscle relaxant Robaxin and magnesium treatments helped calm the spasms. A feeding tube was inserted through his nose to make sure he received nutrients.
First aid is key
Dr. Erin Muckey, medical director of the Emergency Department at Rutgers NJMS at University Hospital, said most people who get a small or minor wound who have received a tetanus booster in the last 10 years don't have to take extra steps.
"If you have a wound that is contaminated with feces, soil, saliva, puncture wounds — anything considered a dirty wound, we would say you actually need another vaccine within five years," said Muckey, who did not treat Heck and has not seen his wound.
She said for people who get a serious cut, first aid is the first line of defense.
"Wash things out immediately," Muckey said. "Try to remove the bacteria and it's really good for people to know their vaccination status ... if you have any concerns and its been more than five years since your last vaccine, go to your local urgent care or go to your primary care doctor and just ... update your tetanus."
Joe Heck said he doesn’t remember much from that time because he was on and off sleeping.
But Elena Heck remembers.
"I was so worried," she said. "He was so out of it."
She also knew all that time in bed, while necessary, was going to leave him in a weakened state.
Since his release from the hospital, Joe Heck is slowly recovering at home. Elena Heck, who has two younger children, has stopped working since he got sick.
She tries to keep his spirits up but he is frustrated by the slow pace.
He’s looking forward to "putting on my clothes myself," he said.
Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.
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