Tetanus

This factsheet is for people who have tetanus, or who would like information about it.

Tetanus is a disease caused by a bacterial infection. It affects your brain and nervous system, causing spasms and convulsions that can be life-threatening.
 
About tetanus
Symptoms of tetanus
Complications of tetanus
Causes of tetanus
Diagnosis of tetanus
Treatment of tetanus
Prevention of tetanus
 

About tetanus

Tetanus is a condition caused by infection of a type of bacterium called Clostridium tetani, which usually enters your body through a wound. The bacteria produce a toxin that affects your nervous system. This toxin causes your muscles to repeatedly contract and go into spasm.

In 2010, there were almost 9,700 reported cases of tetanus worldwide.

Symptoms of tetanus

Tetanus infection may result in several different patterns of illness.

Generalised tetanus

This is the most common type of tetanus and can be life-threatening. You may be infected with the tetanus bacteria for between three and 21 days before having symptoms. The symptoms (once they appear) may include:
 

• jaw muscle spasms or stiffness (lockjaw)
• muscle stiffness or pain, which usually starts in your neck, shoulders and back
• spasms or convulsions of your body (that can last for up to two weeks), which may be painful and can affect your breathing or digestion
• fever
• sweating
• difficulty swallowing and breathing
• headache

 
With intensive medical support, eight to nine out of 10 people survive.

 
Localised tetanus

If you have localised tetanus, bacteria only affect the muscles near the wound where they entered your body. This causes your muscles to go hard and you may have painful spasms. Localised tetanus is rare. It can be treated and isn't usually life-threatening.

Cephalic tetanus

This is another rare form of tetanus. It's most common in children and affects people who have had a head injury or an ear infection. Cephalic tetanus affects the nerves that run from your brain to other parts of your body and may cause paralysis of parts of your face. Cephalic tetanus may develop into generalised tetanus and can be life-threatening.
 

Neonatal tetanus

This affects newborn babies in less developed countries, particularly in Asia and Africa, and is often fatal. The symptoms are similar to generalised tetanus and occur within two weeks of birth. Babies with neonatal tetanus may:

• not feed well and not put on weight
• appear stiff or rigid
• have spasms

 
Complications of tetanus

 
Without treatment, tetanus is usually fatal, but people can survive with intensive medical therapy. The spasms or convulsions may be violent and you can stop breathing or have a heart attack. Other complications of tetanus include:

• pneumonia and other infections
• fractures – broken bones caused by spasms or convulsions
• abnormal heart rhythm
• coma

Causes of tetanus

Tetanus is caused by a toxin produced by a bacterium called C. tetani, which is found in soil and animal faeces. It can cause a tetanus infection if it enters your body through a wound or a cut. You're most likely to develop an infection if you have a wound that was caused by something dirty, such as a knife or nail, or an animal bite. Babies can get neonatal tetanus via a healing umbilical stump that hasn't been cleaned properly or that has been cut with an instrument that isn't sterile.

Most people who get tetanus haven't been immunised, or haven't had their tetanus booster. If you haven't been immunised or you haven't had your booster, you can get tetanus if:

• you have a wound and it becomes infected – this may be minor such as a scratch or cut, or you may have had a piercing
• you inject drugs or medicines using a needle that isn't sterile and has tetanus bacteria on it

Tetanus can't be passed from person to person.

Diagnosis of tetanus

If you have had a wound as described above, you should seek urgent medical attention. If you have a recent wound and muscle stiffness or spasms, starting near the wound and progressing elsewhere, this could indicate the initial symptoms of tetanus and you will need immediate medical attention.

The diagnosis of tetanus is usually based on the characteristic symptoms and signs. It may be confirmed by taking a blood test that looks for traces of the toxin in your blood.

Please note that availability and use of specific tests may vary from country to country.

Treatment of tetanus

 
Your doctor will clean your wound thoroughly, and any dead tissue will be removed to help prevent further infection. You will be given an injection, which will work against the toxins produced by the bacteria that cause tetanus. You will also be given intravenous antibiotics to treat the infection and medicines called muscle relaxants, such as diazepam or lorazepam, if you're having muscle spasms.

You will usually need to stay in a critical care unit in hospital and will be linked to a heart monitor and may need to be put on a ventilator to give you help with breathing. If you're having trouble swallowing, you may need to be fed through a tube that will be put through your nose and into your stomach, or you may be given liquid nutrition through a drip.

Availability and use of different treatments may vary from country to country. Ask your doctor for advice on your treatment options.
 

Prevention of tetanus

 
Tetanus can be prevented through immunisation with a vaccine. It can also be prevented in newborn babies by immunising women of childbearing age, either during or outside of pregnancy. The World Health Organization recommends that if you want to be protected throughout life, you should have the vaccine in infancy, followed by a booster at school-entry age (between four and seven), then in adolescence (12 to 15), and also in early adulthood.

If you have a wound with any dirt in it, seek medical advice. If you have a cut or weeping wound, such as a burn, you may need a booster dose of tetanus vaccine as a precaution. You may also be given a dose of tetanus immunoglobulin which is a protein (antibody) to help your body fight any tetanus infection you might develop. Ask your doctor for more advice.

Produced by Krysta Munford, Bupa Health Information Team, August 2012.