Tetanus is an infection caused by bacteria called Clostridium tetani. When these bacteria infects the body, they produce a toxin that creates painful muscle contractions. The infections affect the muscles located in the jaw (lockjaw), chest, neck, back and abdomen. The irregular contractions of muscles can also affect abdominal muscles such as the diaphragm which can lead to breathing problems.

There is currently no cure for tetanus, A tetanus infection requires emergency and long-term supportive care while the disease runs its course. Treatment consists of wound care, medications to relieve symptoms, usually in an intensive care unit.

WHO IS AT RISK?

Although nearly all cases of tetanus in the United States are among people who have never received a tetanus vaccine or did not stay up to date on their 10-year booster shots, the risk of death from tetanus is highest among people 60 years of age or older. Other populations at risk include people who are diabetic, immunosuppressed, and regular users of intravenous drugs.

HOW IS TETANUS SPREAD?

Unlike other vaccine-preventable diseases, tetanus is not spread from person to person. The only way for tetanus to infect the body is through a skin wound that becomes contaminated by the tetanus bacteria. Tetanus bacteria are more likely to infect certain breaks in the skin through:

• Wounds contaminated with dirt, feces, or saliva
• Puncture wounds
• Crush injuries
• Injuries with dead tissue
• Burns

Vaccine and good wound care are imperative to help prevent tetanus infection. Doctors can also use medication to help prevent tetanus when someone is seriously hurt and isn’t up to date with tetanus vaccination.

WHAT ARE THE SYMPTOMS?

Tetanus is often referred to as “lockjaw: because one of the most common signs of the infection is the tightening of jaw muscles. Symptoms of tetanus include:

• Lockjaw
• Sudden, involuntary muscle spasms- often in the stomach
• Headache
• Fever and sweating
• Changes in blood pressure and heart rate
• Seizures
• Trouble swallowing

Serious health problems can also occur because of tetanus such as:

• Laryngospasm (uncontrolled/involuntary tightening of the vocal cords)
• Fractures (broken bones)
• Blood clots
• Pneumonia
• Breathing difficulty

Extreme cases of tetanus can lead to death (1-2 in 10 cases are fatal)

WHEN IS THE VACCINE GIVEN?

Being up to date with tetanus vaccination is the best tool to prevent tetanus. The vaccine does not last a lifetime, so it is recommended that people get vaccinated throughout all ages to keep a high level of protection.

There are currently 4 vaccines used in the United States that help protect against tetanus, all of which provide protection for various disease:

• Diphtheria and tetanus (DT) vaccines
• Diphtheria, tetanus, and pertussis (DTaP) vaccines
• Tetanus and diphtheria (Td) vaccines
• Tetanus, diphtheria, and pertussis (Tdap) vaccines

It is recommended that the first dose DTaP is given to young children at 2-6 months, a second dose at 15-18 months, and a third dose from 4-6 years old. For preteens, a dose of Tdap is recommended from ages 11-12. For adults, they are recommended a dose of Td or Tdap once every 10 years.

HISTORY OF TETANUS

• 1884- Tetanus was first introduced in animals by injection them with pus from a fatal human case
• 1889- Kitasato Shibasaburo isolated the organism from a human, and showed that it produced disease when injected into animals
• 1920- A method for inactivating tetanus toxin with formaldehyde was developed
• 1924- A vaccine to prevent tetanus -tetanus toxoid- was developed and given to all US soldiers prior entering WWII
• 1940- National reports of tetanus cases began, and the toxoid was widely distributed in the United States