Tetanus
is a bacterial infection that attacks the nervous system. Tetanus may result in severe muscle spasms, and this can lead to a condition known as lockjaw, which prevents the mouth from opening and closing. Tetanus can be fatal.
Tetanus is caused when the bacterium,
Clostridium tetani
that comes from soil, dust, or manure, enters the body through a break in the skin. The bacterium produces a toxin that causes the illness.
This infection is most common in people 50-years-old or older. Also, people who have not been immunized for tetanus, who do not update their tetanus shot regularly, who use intravenous (IV) drugs, who have skin sores or wounds, or who have had burns or open wounds exposed to soil or animal feces are at increased risk of developing tetanus.
In the United States and other countries with tetanus vaccination programs, tetanus is rare. In fact, there have been fewer than 50 cases of tetanus reported each year in the United States since 1995.
Symptoms include:
- Headache
- Stiff jaw or neck muscles
- Drooling or trouble swallowing
- Muscle spasticity or rigidity
- Sweating
- Fever
- Irritability
- Pain or tingling at the wound site
- High
or low blood pressure
- Seizures
- Difficulty breathing
- Irregular heartbeat
- Cardiac arrest
- Dehydration
- Pneumonia
Symptoms usually begin seven days after the bacteria enter the body, but can begin anywhere from three days to three weeks after infection occurs.
Treatment for tetanus may include:
- Hospitalization to manage complications of the infection
- Opening and cleaning of the wound
- Surgical removal of the entire wound
- Antibiotics
- Tetanus immune globulin (antibodies against tetanus that help neutralize the tetanus toxin)
- A tetanus shot, if tetanus vaccines are not up-to-date
-
A breathing tube or
tracheotomy
in cases of troubled breathing or swallowing
The tetanus vaccine in an inactivated toxoid (a substance that can create an antitoxin). It is made by growing the tetanus bacteria and purifying and inactivating the toxin it produces. Although the tetanus vaccine is available as a single vaccine; it is most commonly given in combination with
diphtheria
vaccine (referred to as "DT" and "Td"). Other combinations, referred to as "DTaP" and "Tdap," contain tetanus, diphtheria, and
pertussis
vaccines. These vaccines are given as injections into the muscle, usually in the arm or thigh. They must be stored in a refrigerator before they’re given.
The DTaP vaccine, which protects against diphtheria, tetanus, and pertussis, can be given to children younger than seven years old. It is generally required before starting school and is given in a five-dose series at ages two, four, six, and 15-18 months, followed by a booster that is given between ages 4-6. The US Food and Drug Administration (FDA) recently approved new booster vaccines against tetanus, diphtheria, and pertussis for adolescents and adults. These vaccines are referred to as Tdap; one is recommended for adolescents ages 11-18 and one for adults ages 19-64.
Adolescents who have already had a booster dose of Td (tetanus-diphtheria) are encouraged to get a dose of Tdap as well, but with a waiting period of at least five years between Td and Tdap.
It is recommended that adults who expect to have close contact with an infant younger than 12 months get a dose of Tdap, with an encouraged, but not required, waiting time of two years since the last dose of Td. Also, healthcare workers who have direct patient contact with hospitals or clinics should get a dose of Tdap, with a recommended two-year waiting period since the last dose of Td. Finally, new mothers who have never received a dose of Tdap should get a dose as soon as possible after delivery.
For an adolescent or adult who gets a severe cut or burn, a dose of Tdap or Td is recommended to protect against tetanus infection. Td is recommended in place of Tdap if Tdap is not available, for anyone who has already had a dose of Tdap, for adults ages 65 and older, and for children ages 7-9 years old. Also, Td is usually preferred over Tdap for pregnant women.
Most people tolerate the tetanus-containing vaccines without any trouble. The most common side effects are pain, redness, or swelling at the injection site; mild fever; headache; tiredness; nausea, vomiting,
diarrhea, or stomach ache.
A fever more than 102 ºF, severe gastrointestinal problems, or severe headache may uncommonly occur. Nervous system problems and severe allergic reactions are extremely rare. Localized allergic reactions (redness and swelling) at the injection site may uncommonly occur, while anaphylaxis (life-threatening, widespread allergic reaction) is extremely rare.
The vast majority of people should receive their tetanus-containing vaccinations on schedule. However, individuals in whom the risks of vaccination outweigh the benefits include:
- People who have had a life-threatening allergic reaction to DTP, DTap, DT, Tdap, or Td vaccine
- People who have had a severe allergy to any component of the vaccine to be given
-
People who have gone into a
coma
or long seizure within seven days after a dose of DTP or DTaP
If you have an allergy to latex,
epilepsy, or other nervous system problem; severe swelling or severe pain after a previous dose of any component of the vaccination to be given; or
Guillain-Barre Syndrome, talk with your doctor before getting the vaccine.
Wait until you recover to get the vaccine if you have moderate or severe illness on the day your shot is scheduled.
Caring properly for wounds, including promptly cleaning them and seeing a doctor for medical care, can prevent a tetanus infection.
