Tetanus

What is tetanus?

Tetanus is a sometimes fatal disease of the central nervous system. It's caused by a poison (toxin) made by the tetanus bacterium. The bacterium usually enters the body through an open wound. Tetanus bacteria live in soil and manure. They can also be found in the human intestine and other places.

• Tetanus occurs more often in warmer climates or during the warmer months.

• Tetanus is very uncommon in the U.S. due to widespread immunization.

What causes tetanus?

Tetanus is caused by the toxin of the bacterium Clostridium tetani. It’s not spread from person to person. It occurs in people who have had a skin or deep tissue wound or puncture. It’s also seen in the umbilical stump of infants in developing countries. This occurs in places where vaccines for tetanus are not widespread and where parents may not know how to care for the stump after the baby is born. After a person is exposed to tetanus, it may take from 3 to 21 days for symptoms to develop. On average, symptoms appear around day 8. In babies, symptoms may take from 3 days to 2 weeks to develop.

What are the symptoms of tetanus?

These are the most common symptoms of tetanus:

• Stiff jaw (also called lockjaw)

• Stiff abdominal and back muscles

• Contraction of the facial muscles

• Fast pulse

• Fever

• Sweating

• Painful muscle spasms, especially near the wound area (if these affect the throat or chest wall, breathing may be stopped)

• Trouble swallowing

These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.

How is tetanus diagnosed?

Your healthcare provider will ask about your health history and do a physical exam.

How is tetanus treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment for tetanus or to reduce the risk of tetanus after an injury may include:

• Medicines to control spasms

• Thorough cleaning of the wound

• Antitoxin injections

• Use of a ventilator (breathing machine) if you have trouble breathing on your own 

• Antibiotics

• Other medicines to control pain and other symptoms such as a fast heartbeat

What are possible complications of tetanus?

Complications of tetanus can include:

• Vocal cord spasms

• Broken bones due to severe muscle spasms

• Breathing problems

• Pneumonia

• High blood pressure or abnormal heart rhythms 

• Blood clot in the lung (pulmonary embolism )

• Death

Can tetanus be prevented?

A DTaP shot is a combination vaccine that protects against 3 diseases: diphtheria, tetanus, and pertussis. The CDC recommends that children get 5 DTaP shots. The first 3 shots are given at 2, 4, and 6 months of age. Between 15 and 18 months of age, the child gets the fourth shot. A fifth shot is given when a child enters school at 4 to 6 years of age. At regular checkups for 11- or 12-year-olds, a preteen should get a dose of Tdap. The Tdap booster is a tetanus, diphtheria, and pertussis vaccine.

If an adult did not get a Tdap as a preteen or teen, that person should get a dose of Tdap instead of the Td booster. Adults should get a Td booster every 10 years. But it can be given before the 10-year mark. Always see your healthcare provider for advice.

When should I call my healthcare provider?

If you get a wound from an object that is contaminated with dirt, animal feces, or manure, you should see your healthcare provider. You may need a tetanus booster shot if it has been more than 5 years since your previous vaccine or you can’t remember your last vaccine.

If you have any of the symptoms listed in the symptoms section, get medical care right away. Tetanus requires urgent attention.

Key points about tetanus

• Tetanus is an acute disease of the central nervous system. It is sometimes fatal. It is caused by the toxin of the bacterium Clostridium tetani.

• The bacterium Clostridium tetani usually enters the body through an open wound.

• Tetanus bacteria live in soil and manure. It can also be found in the human intestine and other places.

• Symptoms of tetanus may include stiffness in the jaw and the abdominal and back muscles. It may also cause a fast pulse, fever, sweating, painful muscle spasms, and trouble swallowing.

• The tetanus vaccine can reduce the risk of the disease after an injury.

• Tetanus requires medical care right away. Treatment may include medicines and antitoxin injections.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions, especially after office hours and on weekends and holidays.