Tetanus

Topic Overview

What is tetanus?

Tetanus is a disease caused by a bacterial infection. The bacteria make a toxin, or poison, that causes severe muscle spasms. Tetanus can be very dangerous, but you can get a shot to prevent it. Tetanus is also called "lockjaw" because muscle spasms in your jaw make it hard to open your mouth. Tetanus also causes seizures and makes it hard for you to swallow or breathe.

In the United States, most people have had shots to prevent tetanus, so the disease is relatively rare. People who have never been immunized or haven't had a booster in the last 10 years are more likely to get tetanus. This includes people who recently moved to the U.S. from countries where tetanus shots are rare.

The risk of tetanus is higher for unimmunized people who come in contact with soil mixed with animal waste. If they have a wound that’s exposed to the dirty soil, they could get tetanus. People who inject illegal drugs and haven't been immunized also have a greater chance of getting tetanus.

How can you prevent tetanus?

You can prevent tetanus by getting all of your recommended immunizations (shots). There are three different combination immunizations that include a vaccine for tetanus.

DTaP(diphtheria, tetanus, and pertussis) (What is a PDF document?) DTaP is given in a series of 5 shots beginning at age 2 months and ending between ages 4 and 6 years.

Tdap(tetanus, diphtheria, and pertussis) (What is a PDF document?) Tdap is the first booster shot for tetanus and is recommended for children ages 11 or 12 who have completed the DTaP immunization series. It's also recommended for teens and adults who are due for a tetanus booster and have never had the Tdap shot.

Td(tetanus and diphtheria) (What is a PDF document?) Td is given as a booster shot every 10 years.

If you never had tetanus shots as a child, or if you're not sure if you had them, you'll need to get 3 tetanus shots in about a 1-year time span. After that, 1 booster shot every 10 years will work for you.

Get a tetanus shot as soon as possible if you have a dirty cut or wound and 5 or more years have passed since your last tetanus shot. Some people may need tetanus immune globulin (TIG) for a wound that is at high risk for developing tetanus. The immune globulin is usually only needed if you have not (or do not know whether you have) completed the tetanus shot series.

What causes tetanus?

The bacteria that cause tetanus are called Clostridium tetani. They are usually found in dirt and soil, most often in areas with animal waste such as farms and ranches. These bacteria typically enter the body through a wound or cut. They grow best when they are not around oxygen. The deeper and narrower the wound, the less oxygen there is around it, and so tetanus is more likely. For example, the bacteria can thrive in a puncture wound from a dirty nail. The dirtier the wound, the higher the risk of getting tetanus. But tetanus can also grow in a clean wound.

What are the symptoms?

Tetanus symptoms appear slowly and get worse over time. The time it takes for symptoms to appear after a cut or injury ranges from days to months. In most cases, symptoms of tetanus appear within 14 days.

Tetanus symptoms often begin with a headache and trouble opening your mouth (lockjaw). You also may have trouble swallowing and/or a stiff neck, back, or shoulders.

As the toxin spreads, it can be deadly. It can cause problems with your blood pressure and heart rate. It can cause severe and painful muscle spasms in your neck, arms, legs, and belly. If spasms continue and get worse, they can break bones, including the spine.

How is tetanus diagnosed?

There is no lab test for tetanus. A doctor can usually diagnose tetanus after asking questions about your symptoms and past health and doing a physical exam. Because other problems can cause muscle spasms like tetanus, your doctor will do tests to make sure your symptoms are not caused by something else.

Your doctor will do tests to decide how to treat the symptoms of tetanus. For example, he or she may order a blood test (arterial blood gases) to see how well you are breathing.

How is it treated?

If you are infected with tetanus, you will need to stay in a hospital so you can get medicines and fluids to control muscle spasms and pain. You also may need treatment to help you breathe. Your doctor will fully clean any wound or cut to remove bacteria. Cleaning the affected area stops bacteria from making toxin. Treatment also includes:

  • Antibiotics . These medicines kill bacteria.
  • Tetanus immune globulin (TIG). This is a protein that helps your body's immune system find and destroy bacteria. TIG boosts your immunity while your body fights the infection.
  • Medicines to decrease muscle spasms. You also may be treated in an intensive care unit (ICU) with medicines that paralyze your muscles for a while until your body begins to recover. In this case, you will need treatment to help with breathing and other body functions.

After you've had tetanus, you are not immune to the disease. You could get infected again. So keep getting routine tetanus shots after you get better.

Other Places To Get Help

Organizations

Centers for Disease Control and Prevention (CDC): National Center for Immunization and Respiratory Diseases
1600 Clifton Road
Atlanta, GA  30333
Phone: 1-800-CDC-INFO (1-800-232-4636)
TDD: 1-888-232-6348
E-mail: cdcinfo@cdc.gov
Web Address: www.cdc.gov/vaccines
 

The CDC's National Center for Immunization and Respiratory Diseases has information about vaccines and the diseases that can be prevented by immunization. The Web site includes the recommended immunization schedules for children, teens, and adults. There is also information about vaccine side effects and safety, school and state requirements, and immunization records. Interactive schedules are also available.


KidsHealth for Parents, Children, and Teens
10140 Centurion Parkway North
Jacksonville, FL  32256
Phone: (904) 697-4100
Fax: (904) 697-4125
Web Address: www.kidshealth.org
 

This Web site is sponsored by the Nemours Foundation. It has a wide range of information about children's health, from allergies and diseases to normal growth and development (birth to adolescence). This Web site offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly e-mails about your area of interest.


References

Other Works Consulted

  • American Academy of Pediatrics (2006). Tetanus (Lockjaw). In LK Pickering, ed., Red Book: 2006 Report of the Committee on Infectious Diseases, 27th ed., pp. 648–653. Elk Grove Village, IL: American Academy of Pediatrics.
  • Bleck TP (2005). Clostridium tetani (Tetanus). In GL Mandell et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 6th ed., vol. 1, pp. 2817–2821. Philadelphia: Elsevier/Churchill Livingstone.
  • Centers for Disease Control and Prevention (2008). Tetanus. In W Atkinson et al., eds., Epidemiology and Prevention of Vaccine-Preventable Diseases, 10th ed., pp. 71–80. Washington, DC: Public Health Foundation. Also available online: http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/tetanus.pdf.
  • Centers for Disease Control and Prevention (2010). Recommended immunization schedules for persons aged 0 through 18 years—United States, 2010. MMWR, 58(51 and 52): 1–4. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5851a6.htm?s_cid=mm5851a6_e.
  • Centers for Disease Control and Prevention (2010). Recommended adult immunization schedule—United States, 2010. MMWR, 59(01): 1–4. Also available online: http://www.cdc.gov/mmwr/PDF/wk/mm5901-Immunization.pdf.

Credits

Author Debby Golonka, MPH
Editor Susan Van Houten, RN, BSN
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer W. David Colby IV, MSc, MD - Infectious Disease
Last Updated January 29, 2009

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