Tetanus, also known as lockjaw, may seem like a disease of the past. Even though cases of tetanus are now extremely uncommon, the disease has not disappeared. The bacteria that cause tetanus are still present in the soil and the environment. When contracted, tetanus is severe and can cause dangerous complications and even result in death. Fortunately, tetanus is highly preventable when you take precautions and seek the right medical attention.

What Is Tetanus?

Tetanus is an infection that develops after coming into contact with bacteria called Clostridium. Most people are exposed to the bacteria through a puncture wound, such as by stepping on a rusty nail. The Clostridium tetani bacteria generates spores without exposure to the air. These spores multiply in environments that are dark and airless such as in soil. The spores produce toxins that bind to the central nervous system when people are infected with the bacteria.

Most people in the United States receive the vaccination against tetanus in childhood. However, immunity wears off, and a vaccine booster must be given approximately every 10 years. Many adults may believe they are still immune to tetanus based on their childhood vaccines when they are in fact no longer protected.

Stages and Types of Tetanus

If you become exposed to the bacteria that causes tetanus, you won’t immediately develop symptoms. It usually takes seven to ten days to begin showing the signs of tetanus after the initial infection.

Tetanus appears in four different types.

  • Generalized tetanus: The most common type is generalized tetanus. Approximately 50 to 75 percent of cases of generalized tetanus develop lockjaw, which is the inability to open the jaw fully due to muscle spasms. As the disease progresses without treatment, affected patients experience muscle rigidity and intense reflex spasms. These spasms can become severe enough to cause bone fractures, tendon ruptures, and respiratory failure.
  • Localized tetanus: This type of the disease affects only the muscles around the affected site. The mortality rate from localized tetanus tends to be very low, especially compared to generalized tetanus, because the bacteria doesn’t spread to other sections of the central nervous system.
  • Cephalic tetanus: This is an uncommon form of the disease. The cause is usually head trauma or a particularly severe ear infection. It may become generalized or remain localized to the head.
  • Neonatal tetanus: This type occurs when infants are born to infected mothers. The disease is thought to be transmitted through the healing umbilical cord site. It is rare in industrialized nations but more common in the developing world. It is a severe cause of neonatal mortality.

Symptoms and Causes

A puncture wound is the most common cause of tetanus, but rusty nails aren’t the only way to get such an injury. Other ways to get a puncture wound include tattoos and piercings, primarily when performed improperly or by an unlicensed technician. Intravenous drug use can also lead to a tetanus infection.

Other causes of tetanus transmission include injuries that cause dead tissue, burns, dental infections, animal and insect bites, and chronic infections or sores. Cases of neonatal tetanus may occur when the umbilical cord is cut with a non-sterile instrument.

Symptoms of tetanus include the following:

  • Fever
  • Sudden high blood pressure
  • Sweating
  • Drooling
  • Muscle spasms, including facial spasms
  • Shortness of breath
  • Difficulty swallowing
  • Muscle stiffness
  • Irritability
  • Stiff neck

When untreated, tetanus can also cause seizures and may even lead to death.

Prevention and Risks

The best way to prevent tetanus is to get vaccinated. The vaccine for tetanus was invented in 1924, a time when people were much more likely to contract the bacteria. The tetanus vaccine has been in widespread use since 1940. Today, the vaccine is nearly always given in conjunction with diphtheria vaccine as the Td vaccine, or with diphtheria and pertussis, as the Tdap vaccine.

Tetanus can also be prevented with proper hygiene and care of wounds that break the skin. Any injury that breaks the skin should be thoroughly disinfected and covered with a bandage.

Diagnosis and Tests

There are no tests doctors can use to diagnose tetanus. Doctors usually diagnose tetanus based on the results of a physical exam, immunization status, and the presence of symptoms such as stiff muscles, difficulty breathing or trouble swallowing.

Treatment, Procedures, and Medication

Prevention is more efficient than management for tetanus because the disease has no cure. The first steps for treating tetanus include wound care that thoroughly removes all the dirt, foreign objects and dead tissue from the point where the skin is damaged. Medical staff will also administer another round of the tetanus vaccine.

The other treatments for tetanus include a combination of anti-toxin, antibiotics, pain relief, sedatives and muscle relaxers. If you seek medical treatment early enough, doctors can give you tetanus immune globulin, an anti-toxin that neutralizes toxins before they bind to tissues.

Doctors may also give you antibiotics, as well powerful sedatives to control muscle spasms. You may also receive other medicines, like beta blockers or magnesium sulfate, to regulate your breathing and muscle activity. You may also receive morphine for pain relief.


If you suspect you may have come into contact with tetanus bacteria, you should immediately go to the hospital. Emergency room doctors are trained in managing tetanus infections. You want to get urgent medical attention to prevent potentially fatal complications.

Do your part to protect yourself and your family by getting a tetanus vaccination or vaccine booster. But if you do catch the disease, tetanus is treatable when caught early enough.