On-Call Advice

What is tetanus?

Should adults be vaccinated?

Tetanus is a serious disease that occurs when spores from the bacterium Clostridium tetani enter the body and create a toxin that affects the nervous system. The infection typically leads to painful and often severe muscle spasms—especially in the neck and jaw, which is why tetanus is commonly called lockjaw. Spasms can be so severe, in fact, that they fracture the spine, and the infection can be life-threatening if it interferes with a person’s breathing. Other symptoms may include muscle stiffness, trouble swallowing, headache, seizures, rapid heart rate and elevated blood pressure.

Tetanus spores are present almost everywhere, but especially in dust, soil and feces. They usually enter the body through a wound, especially one contaminated with dirt or caused by a rusty or dirty object, such as a nail or splinter. Other possible entry points are burns, crush wounds, insect bites, or intravenous drug or intramuscular injections—particularly if the needle is dirty or the injection site isn’t cleaned properly. Tetanus cannot be transmitted by casual contact with an infected person.

Tetanus should always be considered a medical emergency, and is diagnosed by a physician based upon symptoms. An infected person should be treated immediately in a hospital setting with tetanus immune globulin, a medication to help remove any toxin from the blood that has not bound to nerve endings; medications to relieve muscle spasms; and appropriate wound care. In cases involving severe spasms, a breathing machine may be required. In time, as new nerve endings grow, the effect of the toxin on nerves decreases.

According to the Centers for Disease Control and Prevention (CDC), up to 20 percent of tetanus cases lead to death. Fortunately, tetanus is rare in the United States and in other developed nations, primarily because of effective vaccination programs. People in the U.S. typically get tetanus because they have never been vaccinated or have not kept up with their booster shots every 10 years.

The CDC recommends that people of all ages be vaccinated against tetanus and receive the appropriate boosters. Several vaccines are available to protect against tetanus and other diseases, with the appropriate vaccine depending upon a person’s age and prior vaccination history. Talk to your healthcare provider about your vaccination status and whether you may need a booster.

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