Tetanus (Lockjaw)

What is tetanus?

Tetanus (pronounced “teh-tuh-nuhs”) is a bacterial infection that affects your nervous system. When the bacteria enter your body, they create a poison (toxin) that causes painful muscle contractions. Tetanus is commonly called lockjaw because it causes your neck and jaw muscles to lock up. A vaccine can prevent tetanus.

Who does tetanus affect?

Anyone can get tetanus, but the disease is more common in developing countries that don’t have widespread vaccination programs in place. In these countries, tetanus is typically seen in newborn babies and their unvaccinated birth parents. Tetanus is also more frequently seen in warm climates, on farms and among males.

In the U.S., tetanus infections usually occur in people who aren’t vaccinated against the disease. Tetanus is also seen in people who are elderly with lower immunity to the disease.

How common is tetanus?

Tetanus is very rare in the U.S. About 30 cases of tetanus are reported in the U.S. each year.

What are the signs and symptoms of tetanus?

Early signs of a tetanus infection include headache and muscle spasms in your jaw. Tetanus is often called lockjaw because one of the early symptoms of the condition includes jaw cramping. Your jaw muscles may tighten. This makes it difficult to open your mouth.

Other symptoms may include:

• Difficulty swallowing or breathing.
• Drooling.
• Neck muscle stiffness.
• Muscle spasms in your stomach, back, arms and legs.
• Seizures.
• Fever and sweating.
• High blood pressure.
• Fast heart rate (tachycardia).
• Uncontrolled peeing (urination) and pooping (defecation).

What does tetanus look like?

If you have a tetanus infection, your muscles spasm or tighten. Your facial muscles may lock into a rigid smile. Your back may arch uncontrollably.

What is the incubation period for tetanus?

The incubation period is the time from your exposure to the bacteria to when symptoms begin. The incubation period for tetanus is typically between three and 21 days. The illness usually occurs within 14 days of exposure. But the range varies widely based on what kind of wound you have. Illness may develop within a day or it could take months.

What causes tetanus?

A type of bacteria called Clostridium tetani causes tetanus. The spores of these bacteria are found in soil, dust and manure. The spores enter your body through breaks in your skin. Once the spores enter your body, they become active bacteria. The bacteria spread in your body and make a poison called tetanus toxin. This poison blocks the nerve signals from your spinal cord to your muscles. This causes severe muscle spasms. The spasms can be so strong they tear your muscles or cause spinal fractures.

Tetanus bacteria most commonly enter your body through deep cuts or puncture wounds. This includes stepping on a rusty nail or getting a wood or metal splinter. Other ways the bacteria can enter your body include:

• Burns.
• Exposed broken bones (compound fractures).
• Crush injuries.
• Insect bites and dog bites.
• Using infected syringes.
• Surgical procedures.
• Dental infections.

Tetanus isn’t spread from person to person.

How is tetanus diagnosed?

Your healthcare provider will diagnose tetanus based on your symptoms. They will perform a physical examination and ask you about your medical history. There are no laboratory tests to diagnose or confirm tetanus.

Is tetanus curable?

Tetanus isn’t curable. Once you’ve developed symptoms, the disease needs to run its course. But proper treatment can help manage symptoms and prevent complications.

How is tetanus treated?

Treatment for tetanus (lockjaw) depends on the severity of your condition. But if you have tetanus, you need immediate medical care. Your healthcare provider may treat tetanus with:

• Wound care: Your healthcare provider may need to perform surgery to clean your wound and remove the source of the toxin.
• Medications: Your provider will treat tetanus with various medications.
• Bed rest: Your provider may recommend a calm environment with dim lights and low noise. Bright lights and loud noises can trigger muscle spasms.
• Breathing support: If needed, your provider will give you oxygen. The oxygen will be through a breathing tube or breathing machine (ventilator).

What medications are used to treat tetanus?

Your healthcare provider may use various medicines to treat tetanus. These medications include:

• Tetanus immune globulin (TIG): TIG is also called tetanus antitoxin. It helps remove some of the toxin. This helps reduce the course and severity of your illness. But it can’t remove the toxin that’s already affecting your central nervous system.
• Antibiotics: Your healthcare provider may use antibiotics if they see signs of infection around your wound.
• Muscle relaxers: Your provider may give you medication to help control your muscle spasms.
• Vaccine booster: Your provider will give you a tetanus vaccination or booster shot. Having tetanus doesn’t provide future protection (immunity) from the disease.

How long does it take to recover from tetanus?

Once tetanus symptoms develop, it can take two to three weeks for the disease to run its course. With proper treatment, most people recover. But it can take several months to fully recover from tetanus.

How can I reduce my risk of tetanus?

You can reduce your risk of tetanus by practicing good wound care. Seek immediate first aid treatment for cuts, injuries and other wounds. Even minor injuries such as scrapes, blisters and splinters should be cared for right away.

Wash your hands with soap and water to prevent bacteria from entering any wounds. Contact your healthcare provider if you have any concerns.

How can I prevent tetanus?

The best way to prevent tetanus is to get a vaccine. Tetanus toxoid is the name of the tetanus vaccine. Side effects of the tetanus vaccine are usually mild. They include redness, swelling, soreness, tenderness and fever.

Most infants in the U.S. receive a tetanus vaccine in a 3-in-1 vaccine called DTaP. DTap is an abbreviation for diphtheria-tetanus-acellular pertussis. DTap protects your child against diphtheria, tetanus and pertussis. Your child’s healthcare provider will give them the tetanus injection. It’s part of their childhood immunization schedule.

Adults need to stay up to date on their tetanus booster schedule. They should receive a Tdap (tetanus-diphtheria-acellular pertussis) or Td (tetanus-diphtheria) booster shot every 10 years.

What can I expect if I have tetanus?

If tetanus symptoms have developed, the disease has to run its course. This can take several weeks. With proper treatment, most people recover. But it can take several months to fully recover.

Is tetanus fatal?

Worldwide, one in four people infected with tetanus will die without treatment. The death rate for newborns with untreated tetanus is even higher. With proper treatment, less than 15% of infected people die. In the U.S., tetanus is rarely fatal with proper treatment.

When should I see my healthcare provider?

If you injure yourself and have an open would, you should seek medical care right away. It’s especially important if:

• Your injury occurred outdoors.
• Your wound has been in contact with soil or manure.
• You haven’t received a tetanus booster shot within the past 10 years.
• You’re unsure of your vaccination status.

What’s the difference between complete tetanus and incomplete tetanus?

Tetanus causes painful muscle contractions. Complete tetanus is also called fused tetanus. During complete tetanus, there’s no relaxation period between muscle contractions. Your muscle contractions completely fuse to create one continuous muscle contraction.

Incomplete tetanus is also called unfused tetanus. During incomplete tetanus, your muscles go through quick cycles of contractions followed by relaxation periods.