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Tetanus (Lockjaw)

What Is Tetanus?

Tetanus is a serious bacterial infection that affects the nervous system and causes muscles throughout the body to tighten. Tetanus is also called lockjaw, because the infection primarily causes muscle contractions in the jaw and neck, but it can eventually spread to other parts of the body. Tetanus infection can be life-threatening without treatment. Approximately 10 to 20 percent of tetanus infections are fatal, according to the Centers for Disease Control and Prevention (CDC).

Tetanus is a medical emergency that requires immediate treatment in a hospital. Fortunately, tetanus is preventable through the use of a vaccine. However, this vaccine does not last forever. Tetanus booster shots are needed every 10 years to ensure immunity. Because of the easy availability of the vaccine, tetanus is rare in the United States. However, it is more common in other countries that do not yet have strong immunization programs.

What Causes Tetanus?

Bacteria called Clostridium tetani cause tetanus. Spores of the bacteria can be found in dust, dirt, and animal droppings. Spores are small reproductive bodies produced by certain organisms. They are often very resistant to harsh environmental conditions, like high heat.

A person can become infected when these spores enter the bloodstream through a cut or deep wound. The spores release the bacteria, which then spread throughout the body and produce a toxin called tetanospasmin. This toxin is a poison that blocks the nerve signals from your spinal cord to your muscles. This can lead to severe muscle spasms.

Tetanus infection has been associated with:

  • burns
  • puncture wounds from piercings, tattoos, or injection drug use
  • animal bites
  • wounds contaminated with dirt, feces, or saliva
  • dental infections
  • insect bites
  • chronic sores and infections

Tetanus is not contagious from person to person. The infection occurs worldwide, but is more common in hot, damp climates with rich soil, and in densely populated areas.

What Are the Symptoms of Tetanus?

Tetanus affects the nerves that control your muscles, which can lead to difficulty swallowing. You may also experience spasms and stiffness in various muscles, especially those in your jaw, abdomen, chest, back, and neck.

Other common tetanus symptoms are:

  • fast heart rate
  • fever
  • sweating
  • high blood pressure

The incubation period — the time between exposure to the bacteria and the illness — is between three and 21 days, but symptoms typically appear within 14 days of initial infection. Infections that occur faster after exposure are typically more severe and have a worse outcome (prognosis).

How Is Tetanus Diagnosed?

Your doctor will perform a physical examination to check for symptoms of tetanus, such as muscle stiffness and painful spasms.

Unlike many other diseases, tetanus is not generally diagnosed through laboratory tests. However, your doctor may still perform lab tests to help rule out diseases with similar symptoms, such as meningitis (a bacterial infection that affects the brain and spinal cord) or rabies, a viral infection that causes brain swelling.

Your doctor will also base a tetanus diagnosis on your immunization history. You’re at a higher risk against tetanus if you haven’t been immunized or if you’re overdue for a booster shot.

How Is Tetanus Treated?

Treatment will depend on the severity of your symptoms.

Tetanus is typically treated with a variety of therapies and medications, such as:

  • cleaning the wound to get rid of the source of the bacteria. In some cases, a surgical procedure called debridement is used to remove dead or infected tissue.
  • antibiotics like penicillin to kill the bacteria in your system
  • tetanus immune globulin (TIG) to neutralize the toxins that the bacteria have created in your body
  • muscle relaxers to control muscle spasms
  • a tetanus vaccine given along with the treatment

If you have difficulty swallowing and breathing, you may need a breathing tube or ventilator (a machine that moves air in and out of the lungs).

What Are the Complications of Tetanus?

Severe muscle spasms as a result of tetanus can also cause serious health complications, such as:

  • breathing problems due to spasms of the vocal cords (laryngospasm) and spasms of the muscles that control breathing
  • pneumonia (an infection of the lungs)
  • brain damage due to lack of oxygen
  • abnormal heart rhythm
  • bone fractures and fractures of the spine due to muscle spasms and convulsions
  • secondary infections due to prolonged hospital stays

How Can I Prevent Tetanus?

Vaccination can prevent tetanus infections, but only if you receive your booster shots on schedule. In the United States, the tetanus vaccine is given to children as part of the diphtheria-tetanus-pertussis shot (also called the DTap shot). This is a three-in-one vaccine that protects against diphtheria, pertussis, and tetanus. However, this doesn’t provide lifelong protection. Children need to also get a booster shot called Tdap at 11 or 12 years of age. This vaccine protects against tetanus, diphtheria, and whooping cough. Adults then need a booster vaccine called the Td vaccine (for tetanus and diphtheria) every 10 years after that. Check with your doctor if you aren’t sure if you’re up-to-date on your shots.

Proper treatment and cleaning of wounds can also help prevent the infection. If you are injured outside and think your injury has made contact with soil, call your healthcare provider and ask about your risk of getting infected with tetanus.

What Is the Outlook for Tetanus Patients?

Without treatment, tetanus can be fatal. Death is more common in young children and the elderly. According to the CDC, in recent years roughly 11 percent of reported cases of tetanus have been fatal. This was higher in people over the age of 60 years (18 percent) and people who were unvaccinated (22 percent).

Prompt and proper treatment will improve your outlook. Go to your doctor or emergency room right away if you believe you may have tetanus. Even if you get tetanus, you can still get it again someday if you’re not protected by the vaccine. The vaccine is extremely effective, according to the CDC. Reports of tetanus occurring in fully immunized people who have received a vaccine or booster within the last 10 years are very rare. 

Content licensed from:

Written by: Gretchen Holm
Published on: Jul 17, 2012
Medically reviewed on: Jul 17, 2017: Deborah Weatherspoon, Ph.D., MSN, RN, CRNA

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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