What is Tetanus? Causes, Symptoms, Treatments, and Prevention

Tetanus is a bacterial infection that’s sometimes known as “lockjaw.” The condition gets its nickname because it typically causes the muscles in the jaws to tighten up, in addition to other symptoms. Even when treated, tetanus is a life-threatening infection. Because an effective vaccine is available, tetanus is rare in countries like the United States. It causes a large number of deaths worldwide every year in areas where there is little access to the vaccine. You can pick up the bacteria that causes tetanus from a puncture wound or any other break in the skin. This is why it’s important that you protect yourself. Get a tetanus shot well before you step on a thorn or rusty nail or puncture your skin in some other way.

If you do not have a tetanus vaccine within the last 10 years, you could be at risk of getting tetanus.

Signs & Symptoms of Tetanus

People who get tetanus usually start showing symptoms 3-21 days after picking up the bacteria. The average time between first exposure and showing symptoms is 10 days. Early signs of tetanus include:

Tight or rigid muscles in the jaw, lips, and neck
Painful muscle spasms in the neck and jaw
Rigid abdominal muscles
Trouble swallowing

As the infection progresses, tetanus causes painful, full-body spasms. These can last for minutes at a time and resemble seizures. Sometimes a loud sound, a draft, or a bright light can trigger it—any event that affects the senses. These spasms can be severe enough to cause broken bones.

In later stages of the infection, a person can develop a fever, high or low blood pressure, heavy sweating, and an extremely fast heart rate. Breathing problems from tetanus can cause pneumonia and may even be life-threatening.

The infection can also result in a pulmonary embolism–a blood clot that blocks an artery in the lungs. Pulmonary embolisms are serious and can severely damage internal organs.

What Causes Tetanus?

The Clostridium tetani bacterium causes tetanus. The bacteria protect themselves in spores, which are in the soil and other organic matter. When tetanus enters a person’s bloodstream, the bacteria multiply and target nerves all over the body, causing tetanus symptoms. You can come into contact with spores of the bacteria from many different sources, including:

Dirt
Manure or other animal feces
Rust on tools, nails, barbed wire, and other metal objects
Ash

Clostridium tetani bacteria will only cause you to develop tetanus if they get into your bloodstream through a wound in your skin. Unfortunately, even a very small cut or scrape can be enough to allow the bacteria to enter your body. You can even get tetanus through bug bites since they break the skin. Once inside, the bacteria start producing the toxins that cause illness.

Tetanus isn’t contagious, and you can’t catch it from another person, only from exposure to the bacteria.

Risk Factors

Risk factors for tetanus include:

Having a wound that has been contaminated by dirt or manure
Having a puncture wound due to a foreign body
Being immunosuppressed (your immune system is not functioning properly)
Having skin lesions because you have diabetes
Using dirty needles used to inject drugs or to get a tattoo

How to Prevent Tetanus

Preventing tetanus is very simple and reliable if you have access to the vaccine. Tetanus shots are extremely effective and make it highly unlikely that you’ll get an infection if you encounter the bacteria.

The American Academy of Pediatrics recommends that children get their first tetanus vaccine at two months old. The combined Tdap vaccine protects children against tetanus, diphtheria, and pertussis (whooping cough).

Aside from getting the vaccine, the best way to prevent tetanus is to avoid getting minor wounds dirty. Unfortunately, the bacteria that cause tetanus are everywhere in our environment, especially in dirt, dust, and manure, and can easily enter your body through small cuts or even tiny scratches. You don’t have to step on a rusty nail to get tetanus; any break in the skin that comes into contact with the bacteria can result in infection.

Keeping cuts, scratches, and other wounds clean is important. However, it won’t necessarily keep you from getting tetanus if you aren’t vaccinated. Keeping up on your routine boosters is critical for eliminating your risk.

How Often Do You Get a Tetanus Shot?

The tetanus vaccine is long-lasting. Doctors recommend getting a booster shot every 10 years to guarantee that you’re protected from the bacteria in case you come into contact with it. The risk of tetanus never goes away.

Contact your doctor if you get a puncture wound or cut that puts you at risk. If you did not get the vaccine in the last 10 years, it’s important to get it again right away. Also, if you have a high-risk wound, your doctor might recommend a booster if you haven’t had a tetanus shot in the last 5 years.

If you are pregnant should get a tetanus booster. This gives newborn babies immunity against tetanus until they are old enough to start their own immunizations. Babies who get tetanus and survive may develop a range of health and behavioral problems.

If you have children, follow your pediatrician’s recommendations and vaccine schedule for Tdap boosters. Don’t skip any doses. Kids are always getting scrapes and cuts, dirty knees, and plenty of other opportunities for a tetanus infection to set in.

Diagnosis

There is no test for tetanus, so your doctor will only run lab tests if they think another health condition might be causing your symptoms. Generally, your doctor will perform an exam, review your vaccination and health history, and ask about recent injuries that could have put you at risk of tetanus.

If you have the tetanus vaccine, there’s almost no risk of tetanus. Your doctor will likely want to explore other possible causes of your symptoms. If you do not have the vaccine and showing signs, your doctor will likely start tetanus treatment immediately.

Tetanus Treatments

A diagnosis of tetanus is a medical emergency. Most people showing symptoms must stay in the hospital while they recover. Your doctor will start a solution of tetanus immune globulin as quickly as possible. This gives you passive immunity until your body can produce antibodies against the tetanus infection on its own.

You may also get other medications including antibiotics and drugs to help control muscle spasms.

There is no single medicine that cures the disease. Tetanus treatment involves supportive care that helps the patient’s body fight off infection. Some patients temporarily need breathing assistance if their symptoms affect breathing or swallowing. The condition can be fatal even with intensive care, especially for older adults.

Next Steps

You should call your doctor if you are at risk for tetanus because of a recent puncture wound or cut. A booster shot should be your top priority if you did not get the tetanus vaccine within the last 10 years. The earlier you get the vaccine, the more likely you are to prevent tetanus.

Resource Links:

“Tetanus” via the Mayo Clinic
“How to Protect Yourself Against a Tetanus Infection” via the Cleveland Clinic
“Fast Facts On Global Tetanus” via the Centers for Disease Control
“Tetanus” via Johns Hopkins Medicine
“Immunization Schedules for 2022” via American Academy of Pediatrics