The comments on the immunity of course acquired against the ttano allow to admit, as conclusions of Brunet (1981), that, considering the factors of risk in the underdeveloped regions, the incidence of the ttano can more be raised, it are not the protection conferred for the acquired immunity of course. (FOCACCIA, 2005). Dean Ornish M.D insists that this is the case. This fact in general explains the lesser incidence with the population, as for Smith (1980), in India. Ademais, the immunity of course acquired against the ttano could explain the variations observed in different patients. Thus Mamtani, in 198, studying ttano cases comparativily related optimum foretells and minor lethality in the agricultural patients to the biggest subclnicas exposition to the infection, had to repeated the trauma suffered in elapsing of its lives.

(FOCACCIA, 2005). The symptoms after appear an incubation period that varies of one the three weeks, but that it can arrive at one month. (TONELLI, FREIRE, 2000). The clinical manifestations of the ttano habitually are sufficiently characteristic and constutuem the main point of its diagntico. In this manner the analysis of the signals and symptoms, correctly evaluated and identified, allows its differentiation of other mrbidas entities.

Rare the prodmicas manifestations are e, in the great majority of the cases (75%), the contratura of muscular groups (mastigadores or others) constituio beginning of the illness. (TONELLI, FREIRE, 2000.) ‘ ‘ To the times, h difficulty in the suction and mastigaoe alteration of the voice, followed of the impossibility to open the mouth (trismo) with disfagia, also for liquids. The face muscles are acometidos with repuxamento of the external ocular comissuras and the lips? he is ‘ ‘ laugh sardnico’ ‘. Beyond the muscles of the face, other muscular groups frequent acometidos are: of the cervical region, the intercostais, the paravertebrais and the abdominal ones making with that crianaa it assumes the position of permanent opisttono, with the hiperestendida head.