Tetanus, also known as lockjaw, is a serious but preventable disease
that affects the body's muscles and nerves.
Starting at 2 months of age, all babies in the United States are vaccinated
against tetanus. The disease is much more common in developing countries than it is
in the United States.
What Causes Tetanus?
Tetanus is caused by a type of
called Clostridium tetani that usually live in soil. The bacteria
make a toxin (a chemical or poison that harms the body). This toxin attaches to nerves
around a wound area and travels 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 muscles.
In the United States, most cases of tetanus follow a contaminated cut or deep puncture
injury, such as a wound caused by stepping on a nail. Sometimes the injury is so small
the person never even sees a doctor.
Tetanus is most common in:
injuries that involve dead skin, such as burns,
frostbite, gangrene, or crush
wounds contaminated with
soil, saliva (spit), or feces, especially if not cleaned well
skin punctures from nonsterile needles, such as with drug use or self-performed
tattooing or body piercing
What Is Neonatal Tetanus?
Another form of tetanus, neonatal tetanus, happens in newborns
born in unsanitary conditions, especially if the umbilical cord stump becomes contaminated.
Routine immunizations and sanitary cord care have made newborn tetanus very rare in
What Are the Signs & Symptoms of Tetanus?
Tetanus often begins with muscle spasms in the jaw (called trismus).
Someone also can have trouble swallowing and stiffness or pain in the muscles of the
neck, shoulders, or back. The spasms can spread to the muscles of the belly, upper
arms, and thighs. The symptoms can happen days to months after exposure to the bacteria.
How Is Tetanus Treated?
Someone who has tetanus will be treated in a hospital, usually in the intensive
care unit (ICU). There, they usually get antibiotics to kill bacteria and tetanus
immune globulin (TIG) to neutralize the toxin already released. They'll also get medicines
to control muscle spasms and may need treatment to support vital body functions.
Can Tetanus Be Prevented?
Yes. The two most important ways to prevent tetanus are:
getting vaccinated against tetanus
getting a shot (post-exposure tetanus prophylaxis) after an injury
that could cause tetanus
Tetanus immunization is part of the DTaP (diphtheria,
tetanus, and acellular pertussis) vaccinations. Kids usually get:
a series of four doses of DTaP vaccine before 2 years of age
another dose at 4–6 years of age
a booster (Tdap) at 11–12 years of age, or later if it was missed
Then, they should get a tetanus and diphtheria (Td) booster every 10 years through
The Tdap vaccine is also recommended for all pregnant women during
the second half of each pregnancy, regardless of whether they had the vaccine before,
or when it was last given.
Neonatal tetanus can be prevented by making sure that all pregnant women have had
their tetanus immunizations, by delivering babies in sanitary conditions, and by proper
umbilical cord care.
Post-exposure tetanus prophylaxis involves getting tetanus shots after an injury.
Shots given will depend on:
when the patient last had a booster
the total number of tetanus vaccinations the patient has had
the nature of the wound
Any skin wound — especially a deep puncture or a wound that may be contaminated
with feces, soil, or saliva — should be cleaned and dressed right away.
When Should I Call the Doctor?
If you're not sure whether your kids have gotten their tetanus vaccinations, or
if you know they're not fully immunized, call your doctor. If it's been more than
10 years since someone in your family got a tetanus booster, see your doctor to bring
immunizations up to date.
If a puncture or other deep wound happens, clean the wound and call the doctor
to ask about post-exposure tetanus prophylaxis. If your child develops lockjaw or
muscle spasms — particularly after a wound — get medical care right away.