Tetanus

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KEY POINTS

• Tetanus is a life-threatening bacterial infection caused by bacteria that get into the body through a cut or wound in the skin. Tetanus is also called lockjaw, because the most common early symptom is tightening of your jaw muscles and spasms or stiffness in your neck.
• Treatment includes antibiotic and muscle relaxing medicines. You may need to be in the hospital if you have trouble breathing.
• Stay up to date on your tetanus shots. It’s much easier to prevent tetanus than to treat it. All wounds are possible sites for a tetanus infection.

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What is tetanus?

Tetanus is a life-threatening bacterial infection. The bacteria usually get into the body through a cut or wound in the skin. The bacteria make a poison (toxin) that irritates the nerves and causes muscle spasms you cannot control. Tetanus is also called lockjaw because the most common early symptom is tightening of your jaw muscles and spasms or stiffness in your neck.

Tetanus can cause death, especially in older adults and people who have never been vaccinated. It is much easier to prevent tetanus than to treat it. This makes it important to stay up to date with your tetanus shots.

What is the cause?

The bacteria that cause tetanus are found in soil, dust, and manure. It can be easy for the bacteria to get into any wound. The poison made by the bacteria travels in the bloodstream to nerves. The poison then irritates the nerves and causes muscle spasms. When the breathing muscles are affected, tetanus can be deadly.

Tetanus does not spread from one person to another.

What are the symptoms?

Symptoms may appear 3 days to 3 weeks after an injury. The first symptom is usually stiffness of the jaw caused by muscle spasms. Other symptoms may include:

• Headache
• Jaw pain
• Stiffness and cramping of muscles
• Trouble swallowing
• Trouble breathing
• Fever
• Sweating
• Fast pulse
• Seizures

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. There are no tests to diagnose tetanus.

How is it treated?

Treatment usually includes:

• Thorough cleaning of wounds
• A shot of tetanus immune globulin to keep the infection from getting worse
• A tetanus booster shot to prevent future infection
• Antibiotics

If your symptoms are serious, you may need to stay in the hospital. Treatment may include:

• Muscle relaxants to relieve spasms
• Use of a machine to breathe for you (ventilator)
• Physical therapy to prevent tightening of muscles and tendons caused by constant spasms

The spasms can last for several weeks. It can take weeks or months for damaged nerves to heal. During this time, you may keep having muscle spasms and trouble breathing.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Ask your healthcare provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I prevent tetanus?

It’s much easier to prevent tetanus than to treat it. All wounds are possible sites for a tetanus infection. Clean any wound well with soap and water.

Stay up to date on your tetanus shots:

• In the US, shots of a vaccine to protect against tetanus, diphtheria, and pertussis (whooping cough) are routinely given during childhood. After childhood, you need a tetanus booster shot every 10 years even if you never have a dirty cut or puncture wound. You can get a Tdap booster shot that protects you against both tetanus and whooping cough. Talk with your healthcare provider about this. The Tdap not only protects you from whooping cough, but it also keeps you from being a carrier and infecting infants.
• If you have an animal bite, or a cut or puncture wound that has dirt or rusty metal in it, and your last tetanus shot was more than 5 years ago (or you don't know when you had your last shot), get a tetanus shot as soon as possible after the injury.

Check with your healthcare provider before getting the shot if you:

• Are ill or have a fever
• Have had an allergic reaction to a previous tetanus shot or know that you are allergic to the vaccine