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
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.
You can prevent tetanus by getting
all of your recommended
immunizations (shots). There are three different
combination immunizations that include a vaccine for tetanus.
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
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 immunoglobulin (TIG) for a wound that is at high risk
for tetanus. The
immunoglobulin is usually only needed if you have not
(or do not know whether you have) completed the tetanus shot series.
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, cut, or splinter. They can also enter the body through an unclean injection, such as when a person injects an illegal drug.
The bacteria grow best when they are not around oxygen. The deeper and narrower
the wound, the less oxygen there is around it, 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.
Tetanus is not contagious, so you can't get it from a person who has it.
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.
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 your symptoms. For example, he or she may order a blood
test (arterial blood gases) to see how well
you are breathing.
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:
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.
This CDC website has information about vaccines and the diseases that can
be prevented by immunization. It includes the recommended
immunization schedules for children, teens, and adults. You can also find
information about vaccine side effects and safety, school and state
requirements, and immunization records. Interactive schedules are also
The Immunization Action Coalition (IAC) works to raise awareness of the need for immunizations to help prevent disease. The website has videos and photos about how vaccines work and the diseases the vaccines prevent.
The site also offers information about vaccine safety and common concerns and myths about
This website 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 website
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 emails about your area of interest.
Other Works Consulted
American Academy of Pediatrics (2009). Tetanus (lockjaw). In LK Pickering et al., eds., Red Book: 2009 Report of the Committee on Infectious Diseases, 28th ed., pp. 655–660. Elk Grove Village, IL: American Academy of Pediatrics.
Centers for Disease Control and Prevention (2011). Tetanus. In W Atkinson et al., eds., Epidemiology and Prevention of Vaccine-Preventable Diseases, 12th ed., pp. 291–300. Washington, DC: Public Health Foundation. Also available online: http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/tetanus.pdf.
Centers for Disease Control and Prevention (2011). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine from the Advisory Committee on Immunization Practices, 2010. MMWR, 60(01): 13–15. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6001a4.htm?s_cid=mm6001a4_w.
Reddy P, Bleck TP (2010). Clostridium tetani (tetanus). In GL Mandell et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th ed., vol. 2, pp. 3091–3096. Philadelphia: Churchill Livingstone Elsevier.
August 14, 2013
John Pope, MD - Pediatrics
& W. David Colby IV, MSc, MD, FRCPC - Infectious Disease
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