Public Health

What is tetanus? Tetanus, commonly called lockjaw; is a bacterial disease that affects the nervous system. It is contracted through a cut or wound that becomes contaminated with tetanus bacteria. The bacteria can get in through even a tiny pinprick or scratch, but deep puncture wounds or cuts like those made by nails or knives are especially susceptible to infection with tetanus. Tetanus bacteria are present worldwide and are commonly found in soil, dust, and manure. Infection with tetanus causes severe muscle spasms, leading to "locking" of the jaw so the patient cannot open his/her mouth or swallow; and may even lead to death by suffocation.

Who gets tetanus and how is it spread? 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. Tetanus is not transmitted from person to person.

What are the symptoms of tetanus and when do they start? Common first signs of tetanus are a headache and muscular stiffness in the jaw (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). Symptoms usually begin eight days after the infection, but may range in onset from three days to three weeks.

What complications can result from tetanus? In the United States, three of every 10 persons who get tetanus die. For those who survive, recovery can be long (1-2 months) and difficult. Muscle spasms usually decrease after about two 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.

Persons with tetanus usually must spend several weeks in the hospital in intensive care to manage the complications. A tracheotomy (a temporary opening in the windpipe) may be performed and the patient may be given mechanical artificial respiration to aid breathing. Antitoxin in the form of gamma globulin is given to reduce the effect of the tetanus toxin. Muscle relaxant drugs will reduce the muscle spasms and drugs that cause complete paralysis may be used when the patient is maintained on artificial respiration.

Is there a vaccine for tetanus? Yes. An effective vaccine called tetanus toxoid has been available for many years. Tetanus toxoid, in combination with diphtheria toxoid and pertussis vaccine (DTaP), is given at two, four, six, and 15 months of age, and between four and six years of age. Children who are seven years of age and older should receive Td (tetanus and diphtheria) toxoid. An attack of tetanus does NOT confer immunity. A tetanus booster shot is recommended every 10 years. The most important way to prevent tetanus is through complete immunization and proper wound care.

Wyoming Department of Health
2300 Capitol Ave.
Cheyenne WY 82002
(307) 777-7172

(Photo courtesy of Cemters for Disease Control and Prevention)