Tetanus

What Is Tetanus?

Tetanus (also called lockjaw) is a serious disease that affects the muscles and nerves.

The good news is that it's rare in the United States because all babies are vaccinated against it. 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 injuries
• 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 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 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?

The best way to prevent tetanus is to make sure that your immunizations against it are up-to-date. You should have had:

• 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, you should have a Tdap or a tetanus and diphtheria (Td) booster every 10 years through adulthood.

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). Wear 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.
• Change the dressing once a day.
• Ask your parent or doctor whether you need a tetanus shot.

See your doctor for any deep puncture wounds, especially on the bottom of a foot. These are more likely to become infected without proper treatment.

When Should I Call the Doctor?

If you're not sure whether you've had all your tetanus vaccinations, ask a parent or call your doctor. If it's been more than 10 years since you had a Td booster, see your doctor as soon as possible to bring your immunizations up to date.

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

No one likes shots, but getting tetanus 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.