Tetanus

 

• Tetanus [TET-nus] is a condition that affects the nervous system and causes painful, uncontrolled muscle spasms.
• People get tetanus when spores of the tetanus bacteria enter the body through an open wound and produce a powerful nerve poison.
• Tetanus spores are found throughout the environment, usually in soil, dust, and animal waste.
• Tetanus is preventable through immunization. Because of widespread use of tetanus vaccine, the condition is now rare.

 

What is tetanus?

Tetanus is a condition that affects the nervous system and causes painful, uncontrolled muscle spasms. Because of widespread immunization, tetanus is now rare. Another name for tetanus is lockjaw.

 

What is the infectious agent that causes tetanus?

Tetanus is caused by a toxin (poison) produced by spores of the bacterium Clostridium tetani. Spores are hardy forms of the bacteria that can survive in the environment in an inactive state for a long time.

 

Where is tetanus found?

Tetanus occurs worldwide. Tetanus spores are found throughout the environment, usually in soil, dust, and animal waste.

 

How do people get tetanus?

Tetanus spores can enter the body through a wound that is contaminated with soil, dust, or animal waste. Spores can get into the body through even a tiny pinprick or scratch, but they usually enter through deep puncture wounds or cuts, like those made by nails or knives. Tetanus spores can also get into the body when skin is damaged by burns or by injecting contaminated street drugs. Once the spores enter a wound, they produce a powerful nerve poison that spreads through the body and causes painful symptoms.

 

What are the signs and symptoms of tetanus?

The first signs of tetanus infection are usually a headache and spasms or cramping of the jaw muscles (lockjaw). As the poison spreads, it progressively attacks more groups of muscles, causing spasms in the neck, arms, legs, and stomach, and sometimes violent convulsions (seizures).

 

How soon after exposure do symptoms appear?

The time between the contamination of a wound and the first symptoms is usually less than 2 weeks but can range from 2 days to months. In general, the shorter the time between exposure and symptoms, the more severe the disease.

 

How is tetanus diagnosed?

Tetanus is diagnosed by its symptoms.

 

Who is at risk for tetanus?

In the United States, tetanus occurs mostly in newborns, children, young adults, and older adults who are either not immunized or not adequately immunized. Injecting drug users are also at risk.

 

What complications can result from tetanus?

In the United States, 3 of every 10 persons who get tetanus die from it. For those who survive, recovery can be long (1-2 months) and difficult. Muscle spasms usually decrease after about 2 weeks and disappear after another week or two, but the person may be weak and stiff for a long time. Other complications include breathing problems, bone fractures, high blood pressure, abnormal heartbeats, clotting in the blood vessels of the lung, pneumonia, and coma.

 

What is the treatment for tetanus?

Persons with tetanus usually must spend several weeks in the hospital in intensive care to manage the complications.

 

How common is tetanus?

Tetanus is a major problem in developing countries where immunization of children is not required or enforced. In the United States, most states require tetanus immunization for entry to school. Cases average between 50 and 100 per year, mostly in under-immunized older adults.

 

Is tetanus an emerging infectious disease?

No. Cases have been decreasing since the 1940s. However, getting children immunized and guaranteeing that they get the complete series of shots is still a challenge, especially among poor children and in areas of the country where under-immunization is a problem.

 

How can tetanus be prevented?

The most important way to prevent tetanus is through complete immunization and proper wound care.

1. Prevent tetanus through immunization -- An effective vaccine against tetanus has been available for many years. It is usually given to children combined with diphtheria and pertussis vaccines in a shot called DTP. A child needs five DTP shots, given at specified intervals, for complete protection. Tetanus booster shots are recommended every 10 years.

2. Prevent tetanus through proper care of wounds -- Cleaning all wounds, removing dead tissue, and using antibiotics for contaminated or infected wounds can reduce the likelihood of getting tetanus.

Persons with wounds that are deep or dirty may need a tetanus booster shot if more than 5 years have passed since the last dose. An injection of tetanus immune globulin (TIG) given as soon as possible after a tetanus-prone injury can also help neutralize the poison that has not entered the nervous system.

 

This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health-care provider. If you have questions about the disease described above, consult a health-care provider.