tetanus

Overview

Tetanus is a serious bacterial disease that affects your nervous system, leading to painful muscle contractions, particularly of your jaw and neck muscles. Tetanus can interfere with your ability to breathe and can threaten your life. Tetanus is commonly known as "lockjaw."

Thanks to the tetanus vaccine, cases of tetanus are rare in the United States and other parts of the developed world. However, the disease remains a threat to those who aren't up to date on their vaccinations, and is more common in developing countries.

There's no cure for tetanus. Treatment focuses on managing complications until the effects of the tetanus toxin resolve.

Symptoms

Signs and symptoms of tetanus appear anytime from a few days to several weeks after tetanus bacteria enter your body through a wound. The average incubation period is seven to 10 days.

Common signs and symptoms of tetanus include:

• Spasms and stiffness in your jaw muscles (trismus)
• Stiffness of your neck muscles
• Difficulty swallowing
• Stiffness of your abdominal muscles
• Painful body spasms lasting for several minutes, typically triggered by minor occurrences, such as a draft, loud noise, physical touch or light

Possible other signs and symptoms include:

• Fever
• Sweating
• Elevated blood pressure
• Rapid heart rate

When to see a doctor

See your doctor for a tetanus booster shot if you have a deep or dirty wound and you haven't had a booster shot in five years. If you aren't sure of when your last booster was, get a booster.

Or see your doctor about a tetanus booster for any wound — especially if it might have been contaminated with dirt, animal feces or manure — if you haven't had a booster shot within the past 10 years or aren't sure of when you were last vaccinated.

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Causes

Spores of the bacteria that cause tetanus, Clostridium tetani, are found in soil, dust and animal feces. When they enter a deep flesh wound, spores grow into bacteria that can produce a powerful toxin, tetanospasmin, which impairs the nerves that control your muscles (motor neurons). The toxin can cause muscle stiffness and spasms — the major signs of tetanus.

Nearly all cases of tetanus occur in people who have never been vaccinated or adults who haven't kept up with their 10-year booster shots. You can't catch tetanus from a person who has it.

Risk factors

The following increase your likelihood of getting tetanus:

• Failure to get vaccinated or to keep up to date with booster shots against tetanus
• An injury that lets tetanus spores into the wound
• A foreign body, such as a nail or splinter

Tetanus cases have developed from the following:

• Puncture wounds — including from splinters, body piercings, tattoos, injection drugs
• Gunshot wounds
• Compound fractures
• Burns
• Surgical wounds
• Injection drug use
• Animal or insect bites
• Infected foot ulcers
• Dental infections
• Infected umbilical stumps in newborns born of inadequately immunized mothers

Complications

Once tetanus toxin has bonded to your nerve endings it is impossible to remove. Complete recovery from a tetanus infection requires new nerve endings to grow, which can take up to several months.

Complications of tetanus infection may include:

• Broken bones. The severity of spasms may cause the spine and other bones to break.
• Blockage of a lung artery (pulmonary embolism). A blood clot that has traveled from elsewhere in your body can block the main artery of the lung or one of its branches.
• Death. Severe tetanus-induced (tetanic) muscle spasms can interfere with or stop your breathing. Respiratory failure is the most common cause of death. Lack of oxygen may also induce cardiac arrest and death. Pneumonia is another cause of death.

Prevention

You can easily prevent tetanus by being immunized.

The primary vaccine series

The tetanus vaccine usually is given to children as part of the diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. This vaccination provides protection against three diseases: a throat and respiratory infection (diphtheria), whooping cough (pertussis) and tetanus.

The DTaP vaccine is a series of five shots, typically given in the arm or thigh to children at ages:

• 2 months
• 4 months
• 6 months
• 15 to 18 months
• 4 to 6 years

The booster

A booster of the tetanus vaccine is typically given in combination with a booster of diphtheria vaccine (Td). In 2005, a tetanus, diphtheria and pertussis (Tdap) vaccine was approved for use in teens and adults under age 65 to ensure continuing protection against pertussis, too.

It's recommended that adolescents get a dose of Tdap, preferably between the ages of 11 and 12, and a Td booster every 10 years thereafter. If you've never received a dose of Tdap, substitute it for your next Td booster dose and then continue with Td boosters.

If you're traveling internationally, particularly to a developing country where tetanus might be common, make sure your immunity is current.

To stay up to date with all of your vaccinations, ask your doctor to review your vaccination status regularly.

If you weren't vaccinated against tetanus as a child, see your doctor about getting the Tdap vaccine.