Tetanus

What is tetanus? 

Tetanus is a serious bacterial infection, caused by Clostridium tetani. It creates a toxin that affects the central nervous system, leading to muscle stiffness, spasms, trouble swallowing and breathing and rigid posture. 

Untreated, tetanus can lead to serious complications that affect the entire body. Get immediate medical attention if you think you might have tetanus. One in 10 cases of tetanus in the United States is deadly.

How tetanus spreads

The germs that cause tetanus are found in soil, dust and animal manure. They can enter your body through cuts, punctures or scrapes in your skin. Once inside, they produce a toxin that affects the nervous system.

You could get tetanus from:

• Cuts or punctures from nails, splinters or other sharp objects that penetrate deeply into the skin.
• Animal bites that cause deep punctures.
• Severe burns that damage the skin.
• Infections in wounds contaminated with dirt, soil or manure.
• Chronic skin conditions or infections that create open sores.

Tetanus does not spread person to person. You cannot get tetanus from someone that has it.

What are risk factors for tetanus?

You are at higher risk for a tetanus infection if you are:

• Unvaccinated: People who have not received the tetanus vaccine or have not kept up with their booster shots.
• Injury prone: If you injure yourself often or work in a field like construction, where cuts and wounds are likely.
• A farmer: Being exposed to soil and animal manure.
• Older: Adults over age 70 may not have received recent tetanus booster shots.   
• Immunocompromised: Conditions or treatments that weaken the immune system, like certain cancers, HIV/AIDS, autoimmune diseases or medications, can reduce your ability to fight off infections.

Tetanus symptoms

These signs of tetanus usually appear within seven to 10 days after infection but could show up between three and 21 days:

• Muscle stiffness: Stiffness often begins in the jaw and neck and makes it difficult to open your mouth or move your neck.
• Trouble swallowing: The muscles involved in swallowing may become stiff, so it may be difficult to eat or drink.
• Jaw clenching: Stiffness may cause the jaw to lock in place or the facial muscles to tighten. Because of this, tetanus is sometimes called lockjaw.

Tetanus can get worse over about two weeks and may cause:

• Fever and sweating
• Seizures
• Headache
• Changes in blood pressure and heart rate
• Muscle spasms that can spread to other areas of the body. You may find that your neck and back arch, your arms pull up to your body, your hands clench into fists and your legs are stiff. Spasms can be strong enough to break your bones.
• Rigid muscles in your torso and limbs, creating a “board-like” posture.
• Difficulty breathing and possibly life-threatening complications like blockage in a lung artery (pulmonary embolism) or pneumonia.

If you have symptoms or you have a wound that could be infected with tetanus, clean the wound with soap and water and contact a health care provider or go to the emergency room right away.

Diagnosing tetanus

To diagnose tetanus, your health care provider may evaluate your:

• Medical history, including your vaccination status and any recent injuries or wounds.
• Symptoms such as muscle stiffness and spasms. 
• Laboratory tests, which can rule out other conditions and show signs of infection.

Conditions that may seem similar to tetanus include:

• Lockjaw (trismus): In some cases of lockjaw, the jaw muscles are tight due to dental issues, trauma, medication or other causes. It does not usually cause widespread muscle stiffness or spasms.
• Muscle spasms: Dehydration, electrolyte imbalances or conditions like cerebral palsy or multiple sclerosis can cause muscle stiffness and spasms.
• Meningitis: This inflammation of the protective membranes covering the brain and spinal cord (meninges) usually has other symptoms such as severe headache, fever, nausea and vomiting, sensitivity to light and altered mental status.

Treatment for tetanus

If you’re diagnosed with tetanus, you’ll probably be hospitalized and you may need to be in an intensive care unit (ICU). Treatment may include:

• Antibiotics: Your provider may prescribe penicillin or metronidazole to kill the bacteria so it can’t produce any more toxin.
• Antitoxin therapy: Tetanus immune globulin (TIG) can neutralize the tetanus toxin that is already in your body. This treatment helps make the symptoms less severe and may prevent further complications.
• Muscle relaxants and sedatives: These medications may reduce muscle spasms and stiffness and make you more comfortable.
• Mechanical ventilation: If muscle spasms affect your breathing, you may need to be put on a ventilator.
• Wound care: Treatment can help your wounds heal and keep them from developing other infections.
• Physical therapy: As you recover, physical therapy can help restore your muscle function and mobility.

It can take about a month to recover from tetanus and longer if you have complications.

Preventing tetanus

Vaccination is one of the most effective ways to prevent tetanus. The tetanus vaccination is commonly part of the DTaP (diphtheria, tetanus, and pertussis) or Tdap (tetanus, diphtheria and diphtheria) vaccines. Children usually receive the DTaP vaccine in a series of doses during early childhood. The Tdap vaccine is given to older children at age 11 or 12. 

You need a booster shot every 10 years to stay immune. You may need a booster if you have a wound that’s likely to cause tetanus and you haven’t had a booster within five years. Pregnant women should also have a booster in the third trimester, since tetanus is especially dangerous for newborns.

Even if you’ve had tetanus before, you still need to be immunized. Your health care provider can give you personalized advice on your vaccination schedules and wound care.

Good wound care can also help prevent tetanus: 

• Wash all cuts, scrapes and punctures with soap and water as soon as possible to remove dirt and bacteria.
• Use an antiseptic to reduce the risk of infection.
• Apply a clean bandage to protect the wound from dirt and germs.
• For deep, dirty or large wounds, or if you aren’t sure if your vaccinations are up to date, get medical attention right away.

Getting care

Tetanus is a bacterial infection that can cause muscle stiffness and spasms. Left untreated, it can lead to breathing problems and may be life-threatening. If you’re diagnosed with tetanus, antibiotics and antitoxin therapy can help. The best strategy, though, is prevention with vaccination followed by boosters every 10 years. 

At Banner Health, we are committed to providing top-quality care for people with tetanus. Our health care providers have extensive experience in infectious diseases and wound care, and our medical technologies and treatments help ensure you receive the best possible care throughout your treatment journey.