What is tetanus?
Tetanus or lockjaw is a very serious and deadly disease caused by spores of bacteria found in the environment. A tetanus infection can lead to serious health problems such as being unable to open the mouth, trouble breathing, and muscle spasms.
Tetanus does not spread from person to person. The spores of tetanus bacteria live in soil, dust, and manure. The spores can get into the body through broken skin, usually through injuries from contaminated objects. Tetanus bacteria can also infect the body through breaks in the skin caused by a surgical procedure, dental infections, burns, bone fracture, or intravenous drug use.
Between 2009–2018, a total of 297 tetanus cases were reported, averaging 29 cases per year. Of those cases, there were 19 deaths, all in adults aged 55 years or older. In 2018, 23 tetanus cases were reported, with no deaths.
What are the symptoms of tetanus?
Tetanus is often called lockjaw because the most common symptom of tetanus is spasms (tightening) of the jaw muscles. Other symptoms of tetanus include:
- Muscle spasms (often in the stomach)
- Muscle stiffness all over the body
- Trouble swallowing
- Jerking or staring (seizures)
- Fever and sweating
- Changes in blood pressure and heart rate
If a person has symptoms of tetanus, they can appear anywhere from 3 to 21 days after exposure. The further the injury site is from the central nervous system (brain and spinal cord), the longer it will take to see symptoms. The longer it takes to see symptoms after an injury, the lower the chance of death. In contrast, the sooner you see symptoms after an injury, the higher the chance of death.
Is tetanus contagious?
No, tetanus does not spread from person to person. Tetanus is the only vaccine-preventable disease that is infectious but does not spread from one person to another person.
What makes tetanus a serious illness?
Even with medical treatment, tetanus leads to death in about 1 to 2 in 10 cases, especially in those 60 years of age and older and in people who are unvaccinated. Other serious complications of tetanus include spasms of the vocal cords, broken bones, pneumonia (lung infection), and pulmonary embolism (blood clot in the lung). Doctors can diagnose tetanus by looking for certain signs and symptoms. There are no hospital lab tests that can confirm tetanus.
Who is at risk for tetanus?
Anyone can get tetanus, but rates of disease are highest among people who have never received a tetanus vaccine and adults who don't stay up to date on their 10-year booster shots.
You may also be at higher risk for tetanus if you:
- Have diabetes
- Have a history of immunosuppression (weak immune system)
- Are an injecting drug user
- Are doing humanitarian aid work, such as constructing or demolishing buildings, in countries outside the US.
If you are not vaccinated against tetanus or it has been too long since your last tetanus booster, you are at risk for tetanus if you get a puncture or dirty wound or burn.
What is the best way to prevent tetanus?
Your best protection against tetanus is vaccination before exposure. The Centers for Disease Control and Prevention (CDC) recommends tetanus vaccines for people of all ages, with booster shots throughout life. If you had tetanus disease or got the tetanus vaccine before, you still need to get this vaccine regularly to keep a high level of protection against this serious disease.
There are several types of vaccines that protect against tetanus, as well as other diseases like diphtheria and pertussis (whooping cough). DTaP vaccine is a recommended vaccine for babies and young children. Tdap and Td vaccines are recommended vaccines for adolescents and adults.
Birth to age seven
Kids are immunized in the first 18 months of life with a four-shot series of the combination vaccine, DTaP. It includes diphtheria, tetanus, and pertussis. Kids who get all four doses before their fourth birthday should get a fifth dose before starting kindergarten or elementary school. If a child gets the fourth dose on or after their fourth birthday, the fifth dose isn’t necessary. People over age seven do not get DTaP vaccine. DT vaccine is for kids under age seven who can't tolerate the pertussis (whooping cough) component.
Age 10 and up
Adolescents aged 11 or 12 years should get one dose of Tdap vaccine. Kids in 7th grade who are at least 11 years old must show proof of Tdap vaccination. After a person receives Tdap vaccine, they need to get Tdap or Td vaccine as a booster shot every 10 years .
Any age after being injured
If you have a severe and dirty wound or burn, see a healthcare provider right away. They may need to give you tetanus vaccine to prevent you from contracting tetanus, even if it has been less than 10 years since your last dose.
What should I do if I get sick with tetanus?
If you or someone you know gets sick with tetanus, go to the emergency room for treatment as soon as possible. Then call your healthcare provider or local health department.
A healthcare provider will clean your wound. You may also get tetanus immune globulin (TIG) or Immune Globulin Intravenous (IGIV), which provides short-term protection. You may also get antibiotics and medications to control muscle spasms. Once your condition has become stable, you will get a tetanus-containing vaccine (Td or Tdap).
Vaccination is important because having tetanus disease does not result in tetanus immunity for life. You are still at-risk for getting tetanus again. The risk of reinfection is one of the reasons why the CDC recommends adults get a booster shot for tetanus every 10 years.
Vaccine Information Statements
- DTaP (Diphtheria, Tetanus, Pertussis) (CDC)
- Multiple Vaccines (CDC)
- There is no separate Vaccine Information Statement for combination vaccines. For patients getting Pediarix, give the Vaccine Information Statements for DTaP, Hepatitis B, and IPV.
- Tdap (Tetanus, Diphtheria, Pertussis) (CDC)
- Td (Tetanus, Diphtheria) (CDC)
- Tetanus is a notifiable condition
- Traveler's health: tetanus (CDC)
- About tetanus (CDC)
- Facts about tetanus (lockjaw) (National Foundation for Infectious Diseases)
- Tetanus Questions and Answers (PDF) (Immunization Action Coalition)
- Ask the Experts (IAC)