Tetanus is a life-threatening bacterial infection that causes severe muscle spasms and sometimes death. Tetanus is not contagious and people of all ages can be affected. Tetanus can be prevented by vaccination. Treatment includes being given antitoxin, usually in a hospital.
What is tetanus?
Tetanus is a bacterial infection caused by Clostridium tetani. The bacteria make a toxin in your body that causes the disease.
Tetanus causes severe muscle spasms, especially in the neck and jaw (called lockjaw). Around 1 in 10 people who get the disease will die from it. Babies and older people have the highest risk of dying from tetanus.
Tetanus can lead to:
- suffocation or being unable to breathe
- pneumonia
- very high blood pressure
- very low blood pressure
- heart attack.
Tetanus Symptoms
Tetanus symptoms include:
- muscle spasms, especially in the face and neck
- painful fits that can last for minutes
- not being able to open your mouth (lockjaw)
- swallowing problems
- breathing problems
- heart problems
- fever.
Symptoms usually start between 3 and 21 days after catching tetanus.
Who is at risk to get Tetanus
It can affect people of any age. Tetanus is rare in Australia because most people are immunized. People at high risk of disease include:
- people who have not been immunized against tetanus
- people who have not had a booster immunization in the past 10 years.
Most deaths from the infection occur in people aged over 70 years.
How Does Tetanus spread
Spores of the bacteria that cause tetanus are found in soil, dust and animal waste. When the spores enter your body through a cut or sore, they grow into bacteria that produce a very strong toxin.
The bacteria that cause the infection are found in soil everywhere. It can enter your bloodstream through:
- cuts and wounds in your skin
- any wound that is not a clean
- animal or human bites.
It does not spread from person to person, so you cannot catch tetanus from someone else.
Prevention of Tetanus
It can be prevented with vaccination, however, immunity fades over time so you need booster doses to make sure you stay protected.
You can help avoid getting infected by keeping:
- your tetanus immunization up to date
- cuts and wounds clean
- covering wounds when doing outdoor activities, such as sport, gardening, maintenance around the house.
Find out more about getting vaccinated against tetanus.
Diagnosis for Tetanus
Your doctor can diagnose the infection by:
- examining recent cuts or wounds that could have been in contact with soil
- checking for other symptoms such as neck or jaw stiffness, trouble swallowing and irritable behavior
- asking when you had your last tetanus booster.
If you have the infection your doctor may be required to notify your state or territory health department.
Treatment for Tetanus
This is a life-threatening disease that is treated in the hospital over a period of days. Treatment includes:
- wound care
- antibiotics
- tetanus antitoxin
- medicines to stop seizures
- life support, in severe cases.
Tetanus vaccine
It is preventable. The vaccine is given as part of routine childhood immunization under the National Immunisation Program. It’s given free of charge at 6 weeks to 2 months, 4 months and again at 6 months old. Booster vaccinations are recommended at 18 months and 4 years. Older children are usually given an additional booster vaccination at 11 to 13 years. You may also need a booster if you are going traveling or if you are injured. After the complete course of tetanus vaccinations, another booster is usually recommended for people over 50.
If you’re unsure whether your vaccination is up to date, see your doctor. It’s never too late.
Vaccination is your best protection against tetanus. This table explains how the vaccine is given, who should get it, and whether it is on the National Immunisation Program Schedule. Some diseases can be prevented with different vaccines, so talk to your doctor about which one is appropriate for you.
What age is it recommended?
Children at 2 months, 4 months, 6 months, 18 months, 4 years, and between 10 and 15 years.
Pregnant women in the third trimester.
50 years old if you haven’t had a vaccine in the last 10 years.
65 years if you haven’t had a vaccine in the last 10 years.
If you are traveling overseas and haven’t had a vaccine in the last 10 years.
If you have an open wound and haven’t had a vaccine in the last 5 years.
How many doses are required? 6 doses, then boosters every 10 years.
How is it administered? Injection
Is it free?
Free for children.
Free for people under 20 years old, refugees and other humanitarian entrants of any age.
For everyone else, there is a cost for this vaccine.
Find out more on the Department of Health website and the National Immunisation Program Schedule, and ask your doctor if you are eligible for additional free vaccines based on your situation or location.
Common side effects The vaccine is very safe. Side effects may include redness, swelling or hardness where the needle went in.
Health outcome for Tetanus
Due to the availability of a very effective vaccine and widespread immunization, tetanus is now a rare disease. About 2% of people who develop tetanus in Australia will die as a result of the disease. The death rate is much higher in places overseas where access to medical care is limited.
Help and assistance for Tetanus
For further assistance, please contact your local doctor, community health center or nearest public health unit. You can be immunized at your local doctor or medical center. Check if your local council, community child health or community health center holds free immunization clinics.
Identification of tetanus
Clinical features
It is an acute, potentially fatal disease caused by tetanus bacilli multiplying at the site of an injury. These produce an exotoxin that reaches the central nervous system and causes muscle stimulation.
The initial feature is increased muscle rigidity. This may be restricted to, or most pronounced in, muscles near the injury (localized tetanus). Depending on the severity, muscle rigidity usually affects most parts of the body and is associated with hyperreflexia. As a result, features such as the neck, back, and limb stiffness; stiff jaw or ‘lockjaw’ (trismus); and a sardonic smile (risus sardonicus) may occur.
With progression, superimposed painful muscle spasms can appear anywhere or involve most body muscles simultaneously. Opisthotonos can result. This is severe hyperextension and spasticity of the muscles of the head, neck and spinal column, causing arching. Painful spasms may become very frequent and, together with background rigidity, cause life-threatening interference with respiration.
Laryngeal spasm is a very serious complication that may occur at any stage and can cause sudden asphyxia. Exhaustion and inability to swallow are also associated with severe disease.
Case-fatality rates vary from 10 to 90 percent and are highest in infants and the elderly.
Diagnosis
Clinical features of severe classical tetanus are virtually diagnostic.
Laboratory confirmation of the infection is often difficult.
C. tetani antibodies are sometimes detectable in serum samples but may result from waning past immunization. Cultures from the site of infection should be attempted, although the organism is often not recovered.
The incubation period of Clostridium tetani
The incubation period is usually 3–21 days, although it may range from 1 day to several months, depending on the nature of exposure. Most cases occur within14 days.
Cases with shorter incubation periods tend to have more severe disease and thereby a greater risk of death.
Public health significance and occurrence of tetanus
It occurs worldwide but is now rare in developed countries because of high immunization rates. Infection is most likely in older people who have never been immunized, or who have waning and inadequate immunity.
It is still common in developing countries with lower immunization rates and where contact with animal excreta is more common. Tetanus, particularly neonatal tetanus, is a significant cause of death in these settings.
In 1989 the World Health Assembly committed to the elimination of neonatal tetanus. The World Health Organization estimates that, in 2008 (the latest year for which estimates are available), 59,000 newborns died from neonatal tetanus, a 92 percent reduction from the situation in the late 1980s. In the same year, 46 countries still had not eliminated maternal and neonatal tetanus (MNT) in all districts. Although progress continues to be made, by December 2010, 39 countries had not reached MNT elimination status.
Intravenous drug use is an independent risk factor for tetanus in the absence of acute injuries and may be linked to localized case clusters.
Reservoir for Clostridium tetani
C. tetani are widely distributed in cultivated soil, and in the gut of humans and animals. Spores can usually be found wherever there is contamination with soil.