Tetanus

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Tetanus (also called lockjaw or trismus) is a serious, often fatal disease that affects the muscles and nerves. Although tetanus can be serious, the good news is that it's rare in the United States.

What Is Tetanus?

Tetanus is caused by a type of bacteria called Clostridium tetani that usually live in soil. The bacteria produce a toxin (a chemical or poison that harms the body). This toxin attaches to nerves around a wound area and is carried inside the nerves to the brain or spinal cord. There it interferes with the normal activity of nerves, especially the motor nerves that send direct messages to our muscles. Tetanus is not contagious — you can't catch it from someone who has it.

Starting at 2 months of age, all babies in the United States are routinely vaccinated against tetanus. But in developing countries where there's no effective prevention and immunization program against tetanus, the disease is much more common than it is in the United States.

Signs and Symptoms

Tetanus often begins with muscle spasms in the jaw and face, together with difficulty swallowing and stiffness or pain in muscles in the neck, shoulder, or back. The muscle spasms can be severe and can quickly spread to muscles of the abdomen, upper arms, and thighs.

The symptoms of tetanus usually appear anywhere from 3 to 14 days after the person has become infected.

Can I Prevent Tetanus?

The best way to prevent tetanus is to make sure that your immunizations against the disease are up-to-date. Before you started school, around age 5, you should have received a full series of tetanus immunizations (shots). You should get an additional shot at age 11-12 and then again about every 10 years throughout adulthood. If you didn't get your tetanus shot when you were 11 or 12, it's not too late to get it now.

If you're not sure whether you've been properly immunized against tetanus, ask a parent or call your doctor. If it's been more than 10 years since you had a tetanus booster, schedule an office visit with your doctor as soon as possible to bring your immunizations up to date.

Most cases of tetanus in the United States happen when people who haven't been properly immunized get a cut or puncture wound. In rare cases the injury is so small that a person doesn't see a doctor for treatment, and the tetanus bacteria grow unobserved. (Animal bites, burns, frostbite, and injecting drugs can also sometimes lead to someone developing tetanus.)

If you get a deep cut or puncture wound and it's been more than 5 years since your last tetanus shot, see a doctor since you may need a tetanus booster to ensure that you're fully immunized.

You can also help prevent tetanus by protecting the bottoms of your feet against deep or dirty wounds (such as being punctured by a nail) by wearing thick-soled shoes or sandals instead of going barefoot, especially when outdoors.

If you do get a wound, keep it clean. Apply an over-the-counter antibacterial or antiseptic treatment that can help prevent bacteria from growing, change the dressing once a day, and ask your parent or doctor whether you need a tetanus shot. Deep puncture wounds, especially on the bottom of a foot, must be seen by a doctor because they are more likely to become infected without proper treatment.

Neonatal tetanus can be prevented by making sure that all pregnant women have appropriate immunizations before delivery and by delivering their babies in sanitary conditions.

How Is Tetanus Treated?

In rare cases where a person does develop tetanus, recovery is possible. When the infection is diagnosed and treated early, the recovery period usually takes at least 4 to 6 weeks.

People who are infected with tetanus and develop the disease are treated in a hospital, usually in an intensive care unit (ICU). They receive large doses of antibiotics to kill the tetanus bacteria and tetanus antitoxin (a medicine that neutralizes the toxin produced by the bacteria). Other medicines may be needed to control muscle spasms.

No one likes shots, but getting tetanus — and the treatment for it — is more painful and long lasting than a shot. So make sure that your tetanus immunization status is up to date, and if you get a bad cut, see your doctor in case you need a booster.