Tetanus

What is tetanus

Tetanus is an infection caused by bacteria called Clostridium tetani. When the bacteria invade the body, they produce a poison (toxin) that causes painful muscle contractions. Another name for tetanus is “lockjaw”. It often causes a person’s neck and jaw muscles to lock, making it hard to open the mouth or swallow. Spores of Clostridium tetani bacteria are everywhere in the environment, including soil, dust, and manure. The spores develop into bacteria when they enter the body.

If the Clostridium tetani bacteria enter the body through a wound, they can quickly multiply and release a toxin that affects the nerves, causing symptoms such as muscle stiffness and spasms.

Common Ways Tetanus Gets Into Your Body

  • cuts and scrapes
  • tears or splits in the skin
  • burns
  • animal bites
  • body piercings, tattoos and injections
  • eye injuries
  • injecting contaminated drugs
  • wounds contaminated with dirt, poop (feces), or spit (saliva)
  • wounds caused by an object puncturing the skin (puncture wounds), like a nail or needle
  • crush injuries
  • injuries with dead tissue

Rare Ways Tetanus Gets Into Your Body

Rarely, tetanus has also been linked to breaks in the skin caused by:

  • Clean superficial wounds (when only the topmost layer of skin is scraped off)
  • Surgical procedures
  • Insect bites
  • Dental infections
  • Compound fractures (a break in the bone where it is exposed)
  • Chronic sores and infections
  • Intravenous (IV) drug use
  • Intramuscular injections (shots given in a muscle)

Tetanus can’t be spread from person to person.

The incubation period — time from exposure to illness — is usually between 3 and 21 days (average 10 days), although it may range from one day to several months, depending on the kind of wound. Most cases occur within 14 days. In general, shorter incubation periods are seen with more heavily contaminated wounds, more serious disease, and a worse outcome (prognosis).

The Centers for Disease Control and Prevention (CDC) recommends vaccines for infants, children, teens, and adults to prevent tetanus.

Today, tetanus is uncommon in the United States, with an average of 30 reported cases each year. Nearly all cases of tetanus are among people who have never received a tetanus vaccine, or adults who don’t stay up to date on their 10-year booster shots.

When to see a doctor

See your doctor for a tetanus booster shot if you have a deep or dirty wound and you haven’t had a booster shot in five years. If you aren’t sure of when your last booster was, get a booster.

Or see your doctor about a tetanus booster for any wound — especially if it might have been contaminated with dirt, animal feces or manure — if you haven’t had a booster shot within the past 10 years or aren’t sure of when you were last vaccinated.

Tetanus complications

Serious health problems that can happen because of tetanus include:

  • Uncontrolled/involuntary tightening of the vocal cords (laryngospasm)
  • Broken bones (fractures)
  • Infections gotten by a patient during a hospital visit (hospital-acquired infections)
  • Blockage of the main artery of the lung or one of its branches by a blood clot that has traveled from elsewhere in the body through the bloodstream (pulmonary embolism)
  • Pneumonia, a lung infection, that develops by breathing in foreign materials (aspiration pneumonia)
  • Breathing difficulty, possibly leading to death (1 to 2 in 10 cases are fatal)
  • Death. Severe tetanus-induced (tetanic) muscle spasms can interfere with or stop your breathing. Respiratory failure is the most common cause of death. Lack of oxygen may also induce cardiac arrest and death. Pneumonia is another cause of death.

What causes lockjaw / tetanus

Spores of the bacteria that cause tetanus, Clostridium tetani, are found in soil, dust and animal feces. When they enter a deep flesh wound, spores grow into bacteria that can produce a powerful toxin, tetanospasmin, which impairs the nerves that control your muscles (motor neurons). The toxin can cause muscle stiffness and spasms — the major signs of tetanus.

Nearly all cases of tetanus occur in people who have never been vaccinated or adults who haven’t kept up with their 10-year booster shots. You can’t catch tetanus from a person who has it.

Risk factors for tetanus

The following increase your likelihood of getting tetanus:

  • Failure to get vaccinated or to keep up to date with booster shots against tetanus
  • An injury that lets tetanus spores into the wound
  • A foreign body, such as a nail or splinter

Tetanus cases have developed from the following:

  • Puncture wounds — including from splinters, body piercings, tattoos, injection drugs
  • Gunshot wounds
  • Compound fractures
  • Burns
  • Surgical wounds
  • Injection drug use
  • Animal or insect bites
  • Infected foot ulcers
  • Dental infections
  • Infected umbilical stumps in newborns born of inadequately immunized mothers.

What is a tetanus shot

Tetanus vaccines or tetanus shots are recommended throughout your life. There are four kinds of tetanus vaccines used to protect against tetanus, all of which are combined with vaccines for other diseases:

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

All diphtheria, tetanus, and pertussis vaccines (DT, DTaP, Td, and Tdap) should be administered by the intramuscular route. The preferred injection site in infants and young children is the vastus lateralis muscle of the thigh. The preferred injection site in older children and adults is the deltoid muscle in the upper arm. Use a needle length appropriate for the age and size of the person receiving the vaccine.

Tetanus vaccination is recommended for all babies, children, teens, and adults.

  • DTaP and DT are given to children younger than 7 years old, while Tdap and Td are given to older children and adults 1).

Tetanus vaccine

Tetanus vaccines used today against tetanus and diphtheria (i.e., Td and DT) sometimes also include protection against whooping cough or pertussis (i.e., DTaP and Tdap).

What Types of Diphtheria, Tetanus, and Whooping Cough Vaccines Are There?

There are 11 combination vaccines licensed for use in the United States by the Food and Drug Administration (FDA) that help protect against diphtheria and tetanus. Eight of these vaccines also help protect against whooping cough (pertussis).

  • DT (generic) and Td (Tenivac® and generic) provide protection against diphtheria and tetanus.
  • DTaP (Daptacel®, Infanrix®, Kinrix®, Pediarix®, Pentacel®, and Quadracel®) provides protection against diphtheria, tetanus, and whooping cough.
  • Tdap (Adacel®and Boostrix®) provides protection against tetanus, diphtheria, and whooping cough.

Upper-case letters in these abbreviations denote full-strength doses of diphtheria (D) and tetanus (T) toxoids and whooping cough (P) vaccine. Lower-case “d” and “p” denote reduced doses of diphtheria and whooping cough used in the adolescent/adult-formulations. The “a” in DTaP and Tdap stands for “acellular,” meaning that the whooping cough component contains only parts of the bacteria instead of the whole cell.

  • There is one generic pediatric Diphtheria and Tetanus Only (DT) vaccine used in the United States.
  • There are two Tetanus and Diphtheria (Td) vaccines used in the United States: Tenivac® and a generic.
  • There are two Tetanus, Diphtheria, and Pertussis (Tdap) vaccines used in the United States: Adacel® and Boostrix®.
  • There are six pediatric Diphtheria, Tetanus, and Pertussis (DTaP) vaccines used in the United States: Daptacel®, Infanrix®, Kinrix®, Pediarix®, Pentacel®, and Quadracel®.

The Centers for Disease Control and Prevention (CDC) recommends diphtheria, tetanus, and whooping cough (pertussis) vaccination for everyone.

Talk to your or your child’s healthcare professional about what is best for your specific situation.

Number and Timing of Doses

The number and timing of doses depends on the type of vaccine used and the person being vaccinated.

DTaP or DT

DTaP is recommended for all infants and children younger than 7 years of age; however, if the pertussis component is contraindicated, use DT to complete the primary series in this age group.

  • The recommended DTaP series is 5 doses, administered at 2, 4, and 6 months, 15 through 18 months, and 4 through 6 years.
  • The fourth dose of DTaP should be administered no earlier than 6 months after the third dose. However, the fourth dose does not need to be repeated if it is administered at least four months after the third dose.
  • The fourth dose of DTaP should not be administered before 12 months of age. It can be given at 12 through 15 months of age if the child is unlikely to return at 15 through 18 months of age; this is an off-label recommendation from the Advisory Committee on Immunization Practices.
  • The fifth dose of DTaP is not necessary if the fourth dose was given on or after the patient’s fourth birthday.

Tdap and Td

One dose of Tdap is recommended for all adolescents.

  • The preferred age for Tdap administration in adolescents is 11 to 12 years.
  • If adolescents (13 through 18 years) missed getting Tdap at 11 to 12 years of age, administer at the next patient encounter or sooner if adolescent will have close contact with infants.
  • Tdap can be administered regardless of interval since the last tetanus toxoid- and diphtheria toxoid-containing vaccine.

One dose of Tdap is recommended for pregnant women during each pregnancy.

  • The preferred timing for Tdap administration in pregnancy is 27 through 36 weeks gestation.
  • Tdap can be safely administered earlier in pregnancy if it is indicated for wound care or during a community pertussis outbreak. If Tdap is administered earlier in pregnancy, it should not be repeated between 27 and 36 weeks gestation; only one dose is recommended during each pregnancy.
  • Tdap can be administered regardless of interval since the last tetanus toxoid- and diphtheria toxoid- containing vaccine.
  • Tdap should not be offered as part of routine preconception care.
  • Tdap is recommended only in the immediate postpartum period before discharge from the hospital or birthing center for new mothers who have never received Tdap before or whose vaccination status is unknown.

One dose of Tdap is recommended for healthcare personnel who have not previously received Tdap and who have direct patient contact.

  • Tdap can be administered regardless of interval since the last tetanus toxoid- and diphtheria toxoid-containing vaccine.

Adults who did not receive Tdap as an adolescent should receive a single dose of Tdap.

  • Adults should be vaccinated as soon as feasible.
  • This Tdap booster dose can replace one of the 10-year Td booster doses.
  • Tdap can be administered regardless of interval since the last tetanus toxoid- and diphtheria toxoid-containing vaccine.

After receipt of Tdap, patients should continue to receive Td for routine booster immunization every 10 years.

How Well Do These Vaccines Work?

Vaccines that help protect against diphtheria, tetanus, and whooping cough (DT, DTaP, Td, and Tdap) differ in how well they work against each disease.

The diphtheria and tetanus toxoid components of these vaccines are estimated to work well for people who receive the primary series (which is three doses for people 7 years old or older and four doses for children younger than 7):

  • Nearly everyone (95 out of 100) is protected against diphtheria for approximately 10 years.
  • Nearly everyone is protected against tetanus for approximately 10 years.

In studies showing how well the whooping cough component of DTaP works:

  • Nearly all children (98 out of 100) who get all five doses of DTaP on schedule are fully protected against whooping cough within the year following the last dose.
  • About 7 out of every 10 of children who get all five doses of DTaP on schedule are fully protected against whooping cough five years after getting the last dose of DTaP.

In studies showing how well the whooping cough component of Tdap works:

  • About 7 out of every 10 people are fully protected against whooping cough in the first year after getting it.
  • About 3 or 4 out of every 10 people are fully protected against whooping cough four years after getting it.

What Are the Possible Side Effects of Diphtheria, Tetanus, and Whooping Cough Vaccines?

Most people who get a vaccine that helps protect against diphtheria, tetanus, and whooping cough (DT, DTaP, Td, and Tdap) do not have any serious problems with it. With any medicine, including vaccines, there is a chance of side effects. These are usually mild and go away on their own within a few days, but serious reactions are also possible.

Mild Problems

DT (Diphtheria and Tetanus) Vaccine

Mild problems following DT vaccination can include:

  • Reactions where the shot was given
    • Redness
    • Swelling
    • Soreness or tenderness
  • Fever
  • Loss of appetite
  • Vomiting

DTaP (Diphtheria, Tetanus, and Whooping Cough) Vaccine

Mild problems following DTaP vaccination can include:

  • Reactions where the shot was given
    • Redness
    • Swelling
    • Soreness or tenderness
  • Fever
  • Fussiness (irritability)
  • Feeling tired
  • Loss of appetite
  • Vomiting

Reactions where the shot was given and fever occur more often after the 4th and 5th doses of the DTaP series than after earlier doses. Sometimes the entire arm or leg that the shot was given in swells after the 4th or 5th dose. If this happens, the swelling lasts between 1 and 7 days.

Td (Tetanus and Diphtheria) Vaccine

Mild problems following Td vaccination can include:

  • Reactions where the shot was given
    • Pain
    • Redness
    • Swelling
  • Fever
  • Headache
  • Feeling tired

Tdap (Tetanus, Diphtheria, and Whooping Cough) Vaccine

Mild problems following Tdap vaccination can include:

  • Reactions where the shot was given
    • Pain
    • Redness
    • Swelling
  • Fever
  • Headache
  • Feeling tired
  • Nausea, vomiting, diarrhea, or stomach ache
  • Chills
  • Body aches or sore joints
  • Rash, swollen glands

Problems that Could Happen after Getting Any Injected Vaccine

  • People sometimes faint after a medical procedure, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting, and injuries caused by a fall. Tell the healthcare professional if you or your child is feeling dizzy, has vision changes, or has ringing in the ears.
  • Some people get severe pain in the shoulder and have difficulty moving the arm where a shot was given. This happens very rarely.
  • Any medicine can cause a severe allergic reaction. Such reactions from a vaccine are very rare, estimated at about 1 in a million doses, and would happen within a few minutes to a few hours after the vaccination.
  • As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death.

Diphtheria, Tetanus, and Pertussis Vaccine Recommendations

CDC recommends diphtheria, tetanus, and acellular pertussis vaccination (DTaP for those younger than 7 years of age, and Tdap or Td for those 7 years or older) across the lifespan.

  • Infants and children should receive 5 doses of DTaP, usually administered at 2, 4, and 6 months, 15 through 18 months, and 4 through 6 years of age. DT can be used for infants and children who should not receive acellular pertussis-containing vaccines.
  • Adolescents should receive a single dose of Tdap, preferably at 11 to 12 years of age.
  • Pregnant women should receive a single dose of Tdap during every pregnancy, preferably at 27 through 36 weeks gestation. Tdap is recommended only in the immediate postpartum period before discharge from the hospital or birthing center for new mothers who have never received Tdap before or whose vaccination status is unknown.
  • Adults should receive a single dose of Td every 10 years. For adults who did not receive Tdap as an adolescent, a dose of Tdap can replace one of the 10-year Td booster doses. (Note: When feasible, Boostrix® should be used for adults 65 years and older; however, either vaccine product administered to a person 65 years or older may be used. Providers should not miss an opportunity to vaccinate persons aged 65 years and older with Tdap. Therefore, providers may administer the Tdap vaccine they have available.)

Babies and Children

Babies and young children need three doses of the diphtheria, tetanus, and whooping cough (DTaP) vaccine to build up high levels of protection, and then two booster shots to maintain that protection through early childhood. Doses are recommended at the following ages:

  • 2 months
  • 4 months
  • 6 months
  • 15 through 18 months
  • 4 through 6 years

For children who should not get vaccines that contain protection against whooping cough (for example due to having a very bad reaction to DTaP), DT can be given instead of DTaP.

Preteens and Teens

Preteens should get one dose of the tetanus, diphtheria, and whooping cough (Tdap) vaccine to boost their immunity between the ages of 11 and 12 years. Teens who didn’t get Tdap as a preteen should get one dose the next time they visit their healthcare professional.

Pregnant Women

If you are pregnant, you should get a Tdap vaccine during the 3rd trimester of every pregnancy to help protect your baby from whooping cough in the first few months of life.

Adults

Adults should get one dose of the tetanus and diphtheria (Td) vaccine every 10 years. For adults who did not get Tdap as a preteen or teen, they should get one dose of Tdap in place of a Td dose to boost protection against whooping cough. However, adults who need protection against whooping cough can get Tdap at any time, regardless of when they last got Td.

Risks of a tetanus and diphtheria (Td) vaccine reaction

With any medicine, including vaccines, there is a chance of side effects. These are usually mild and go away on their own. Serious reactions are also possible but are rare.

Most people who get Td vaccine do not have any problems with it.

Mild Problems following Td vaccine:
(Did not interfere with activities)

  • Pain where the shot was given (about 8 people in 10)
  • Redness or swelling where the shot was given (about 1 person in 4)
  • Mild fever (rare)
  • Headache (about 1 person in 4)
  • Tiredness (about 1 person in 4)

Moderate Problems following Td vaccine:
(Interfered with activities, but did not require medical attention)

  • Fever over 102°F (38.9 °C) (rare)

Severe Problems following Td vaccine
(Unable to perform usual activities; required medical attention)

  • Swelling, severe pain, bleeding and/or redness in the arm where the shot was given (rare).

Problems that could happen after any vaccine:

  • People sometimes faint after a medical procedure, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting, and injuries caused by a fall. Tell your doctor if you feel dizzy, or have vision changes or ringing in the ears.
  • Some people get severe pain in the shoulder and have difficulty moving the arm where a shot was given. This happens very rarely.
  • Any medication can cause a severe allergic reaction. Such reactions from a vaccine are very rare, estimated at fewer than 1 in a million doses, and would happen within a few minutes to a few hours after the vaccination.

As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death.

Who Should NOT Get Tetanus, Diphtheria and Pertussis Vaccines?

Because of age or health conditions, some people should not get certain vaccines or should wait before getting them. Read the guidelines below and ask your or your child’s healthcare professional for more information.

Diphtheria and Tetanus Only (DT) Vaccines

Tell the person who is giving your child Diphtheria and Tetanus Only Vaccines if:

Your child has had a life-threatening allergic reaction or has a severe allergy.

  • Any child who had a life-threatening allergic reaction after a dose of DT should not get another dose.
  • Any child with a severe allergy to any component of DT should not get this vaccine. Your child’s healthcare professional can tell you about the vaccine’s ingredients.

Your child has been diagnosed with specific illnesses or conditions.

  • Talk with your child’s healthcare professional if your child:
    • Has seizures or another nervous system problem.
    • Had severe pain or swelling after any vaccine containing tetanus or diphtheria.
    • Ever had a condition called Guillian-Barré Syndrome (GBS).

Your child is not feeling well.

  • If your child has a mild illness, such as a cold, they can probably get the vaccine. If your child is moderately or severely ill, they should probably wait until they recover. Your child’s healthcare professional can advise you.

Your child is 7 years or older.

  • DT should not be given to anyone 7 years or older. Talk to your child’s healthcare professional about how your child can catch-up on their immunization schedule.

Diphtheria, Tetanus, and Pertussis (DTaP) Vaccines

Tell the person who is giving your child Diphtheria, Tetanus, and Pertussis (DTaP) vaccine if:

Your child has had a life-threatening allergic reaction.

  • Any child who had a life-threatening allergic reaction after a dose of DTaP should not get another dose.

Your child has been diagnosed with specific illnesses or conditions.

  • Any child who suffered a brain or nervous system disease within 7 days after a dose of DTaP not attributable to another cause should not get another dose.
  • Talk with the healthcare professional if you or your child:
    • Had severe pain or swelling after any vaccine containing tetanus or diphtheria.
    • Ever had a condition called Guillian-Barré Syndrome (GBS).
  • Some of the following children should not get another dose of DTaP vaccine, but may get a vaccine (called DT) that does not include protection against whooping cough. Talk with your child’s healthcare professional if your child:
    • Had a seizure or collapsed after a dose of DTaP.
    • Cried non-stop for three hours or more after a dose of DTaP.
    • Had a fever over 105°F (40.55 °C) after a dose of DTaP.

Your child is not feeling well.

  • If your child has a mild illness, such as a cold, they can probably get the vaccine. If your child is moderately or severely ill, they should probably wait until they recover. Your child’s healthcare professional can advise you.

Your child is 7 years or older.

  • DTaP should not be given to anyone 7 years or older. Talk to your child’s healthcare professional about how your child can catch-up on their immunization schedule.

(Tetanus and Diphtheria) Td Vaccines

Tell the person who is giving you or your child (Tetanus and Diphtheria) Td Vaccine if:

You or your child have had a life-threatening allergic reaction or have a severe allergy.

  • Anyone who has had a life-threatening allergic reaction to a dose of this vaccine or to any tetanus- or diphtheria toxoid-containing vaccine should not get this vaccine.
  • Anyone with a severe allergy to any component of Td should not get this vaccine. Your or your child’s healthcare professional can tell you about the vaccine’s ingredients.

You or your child have had a previous reaction to similar vaccines or have been diagnosed with specific illnesses or conditions.

  • Talk with the healthcare professional if you or your child:
    • Had severe pain or swelling after any vaccine containing tetanus or diphtheria.
    • Ever had a condition called Guillian-Barré Syndrome (GBS).

You or your child are not feeling well.

  • People who have a mild illness, such as a cold, can probably get the vaccine. People who are moderately or severely ill should probably wait until they recover. Your or your child’s healthcare professional can advise you.

Your child is younger than 7 years old.

  • Td should not be given to anyone younger than 7 years old.

Tetanus, Diphtheria, and Pertussis (Tdap) Vaccines

Tell the person who is giving you or your child Tetanus, Diphtheria, and Pertussis (Tdap) vaccine if:

You or your child have had a life-threatening allergic reaction or have a severe allergy.

  • Anyone who has had a life-threatening allergic reaction to a dose of this vaccine or to any diphtheria toxoid-, tetanus toxoid-, or whooping cough-containing vaccine should not get this vaccine.
  • Anyone with a severe allergy to any component of Tdap should not get this vaccine. Your or your child’s healthcare professional can tell you about the vaccine’s ingredients.

You or your child have had a previous reaction to similar vaccines.

  • Anyone who had coma or long repeated seizures within seven days after a childhood dose of DTP or DTaP, or a previous dose of Tdap, should not get Tdap, unless a cause other than the vaccine was found. They can still get Td.
  • Talk with your or your child’s healthcare professional if you:
    • Have seizures or another nervous system problem.
    • Had severe pain or swelling after any vaccine containing tetanus, diphtheria, or whooping cough.
    • Ever had a condition called Guillian-Barré Syndrome (GBS).

You or your child are not feeling well.

  • People who have a mild illness, such as a cold, can probably get the vaccine. People who are moderately or severely ill should probably wait until they recover. Your or your child’s healthcare professional can advise you.

Your child is younger than 7 years old.

  • Tdap should not be given to anyone younger than 7 years old.

Tetanus shot how often

Adults should get one dose of the tetanus and diphtheria (Td) vaccine every 10 years. For adults who did not get Tdap as a preteen or teen, they should get one dose of Tdap in place of a Td dose to boost protection against whooping cough. However, adults who need protection against whooping cough can get Tdap at any time, regardless of when they last got Td.

Tetanus prevention

Vaccination and good wound care are important to help prevent tetanus infection. Doctors can also use a medicine to help prevent tetanus in cases where someone is seriously hurt and doesn’t have protection from tetanus vaccines.

Vaccination

Being up to date with your tetanus vaccine is the best tool to prevent tetanus. Protection from vaccines, as well as a prior infection, do not last a lifetime. This means that if you had tetanus or were vaccinated before, you still need to get vaccinated regularly to keep a high level of protection against this serious disease. Tetanus vaccines are recommended for people of all ages, with booster shots throughout life.

  • Adults should get one dose of the tetanus and diphtheria (Td) vaccine every 10 years. For adults who did not get Tdap as a preteen or teen, they should get one dose of Tdap in place of a Td dose to boost protection against whooping cough. However, adults who need protection against whooping cough can get Tdap at any time, regardless of when they last got Td.
  • It’s recommended that adolescents get a dose of Tdap, preferably between the ages of 11 and 12, and a Td booster every 10 years thereafter. If you’ve never received a dose of Tdap, substitute it for your next Td booster dose and then continue with Td boosters.
  • If you’re traveling internationally, particularly to a developing country where tetanus might be common, make sure your immunity is current.

Good Wound Care

Immediate and good wound care can also help prevent infection.

  • Don’t delay first aid of even minor, non-infected wounds like blisters, scrapes, or any break in the skin.
  • Wash hands often with soap and water or use an alcohol-based hand rub if washing is not possible.
  • Consult your doctor if you have concerns and need further advice.

Tetanus signs and symptoms

Tetanus is often called “lockjaw” because one of the most common signs of this infection is tightening of the jaw muscles. Tetanus infection can lead to serious health problems, including being unable to open the mouth and having trouble swallowing and breathing.

The symptoms of tetanus usually develop 4 to 21 days after infection. On average, they start after around 10 days.

Lockjaw symptoms and signs of tetanus:

  • Jaw cramping
  • Stiffness in your jaw muscles (lockjaw), which can make opening your mouth difficult
  • Sudden, involuntary muscle tightening (muscle spasms) — often in the stomach
  • Painful muscle stiffness all over the body, which can make breathing and swallowing difficult
  • Trouble swallowing
  • Jerking or staring (seizures)
  • Headache
  • High fever 38 °C (100.4 °F) or above and sweating
  • Changes in blood pressure and a fast heart rate

Left untreated, the symptoms can get worse over the following hours and days.

Tetanus diagnosis

Doctors diagnose tetanus based on a physical exam, medical and immunization history, and the signs and symptoms of muscle spasms, stiffness and pain. Laboratory tests generally aren’t helpful for diagnosing tetanus.

Tetanus treatment

Tetanus is a medical emergency requiring:

  • Care in the hospital
  • Immediate treatment with medicine called human tetanus immune globulin (TIG)
  • Aggressive wound care
  • Drugs to control muscle spasms
  • Antibiotics
  • Tetanus vaccination

Wound care

Cleaning the wound is essential to preventing growth of tetanus spores. This involves removing dirt, foreign objects and dead tissue from the wound.

Medications

  • Antitoxin. Your doctor may give you a tetanus antitoxin, such as tetanus immune globulin. However, the antitoxin can neutralize only toxin that hasn’t yet bonded to nerve tissue.
  • Antibiotics. Your doctor may also give you antibiotics, either orally or by injection, to fight tetanus bacteria.
  • Vaccine. All people with tetanus should receive the tetanus vaccine as soon as they’re diagnosed with the condition.
  • Sedatives. Doctors generally use powerful sedatives to control muscle spasms.
  • Other drugs. Other medications, such as magnesium sulfate and certain beta blockers, might be used to regulate involuntary muscle activity, such as your heartbeat and breathing. Morphine might be used for this purpose as well as sedation.

Supportive therapies

Severe tetanus infection often requires a long stay in an intensive care setting. Since sedatives can inhibit breathing, you might temporarily need a ventilator.

Most people who develop symptoms of tetanus eventually recover, although it can take several weeks or months.

Lifestyle and home remedies

Puncture wounds or other deep cuts, animal bites, or particularly dirty wounds put you at increased risk of tetanus infection. Get medical attention if the wound is deep and dirty, and particularly if you’re unsure of when you were last vaccinated. Leave unclean wounds open to avoid trapping bacteria in the wound with a bandage.

Your doctor may need to clean the wound, prescribe an antibiotic and give you a booster shot of the tetanus toxoid vaccine. If you’ve previously been immunized, your body should quickly make the needed antibodies to protect you against tetanus.

If you have a minor wound, these steps will help prevent tetanus:

  • Control bleeding. Apply direct pressure to control bleeding.
  • Keep the wound clean. After the bleeding stops, rinse the wound thoroughly with clean running water. Clean the area around the wound with soap and a washcloth. If something is embedded in a wound, see your doctor.
  • Use an antibiotic. After you clean the wound, apply a thin layer of an antibiotic cream or ointment, such as the multi-ingredient antibiotics Neosporin and Polysporin. These antibiotics won’t make the wound heal faster, but they can discourage bacterial growth and infection.Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment.
  • Cover the wound. Exposure to the air might speed healing, but bandages can keep the wound clean and keep harmful bacteria out. Blisters that are draining are vulnerable. Keep them covered until a scab forms.
  • Change the dressing. Apply a new dressing at least once a day or whenever the dressing becomes wet or dirty to help prevent infection. If you’re allergic to the adhesive used in most bandages, switch to adhesive-free dressings or sterile gauze and paper tape.

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