Tetanus

Also called lockjaw

Tetanus is a serious disease caused by bacteria that is usually found in soil and manure. It affects your nervous system and causes severe muscle contractions, mainly of your jaw and neck muscles.

Tetanus can interfere with your ability to breathe and can be life threatening. You should immediately go to your nearest A & E or call 111 for an ambulance if you develop severe muscle stiffness or spasms.
If you're concerned about a wound, see your doctor or nearest A & E, particularly if: 
  • the wound is deep
  • the wound contains dirt, poo (faeces) or a foreign object
  • you haven't been fully vaccinated against tetanus
  • you're not sure whether you've been fully vaccinated against tetanus. 

What causes tetanus?

Tetanus is caused by bacteria called Clostridium tetani. These bacteria are commonly found in soil and the manure of animals such as horses and cows, and can enter the body through a wound. Once in the body, the bacteria can quickly multiply and release a toxin that affects the nerves, causing symptoms such as muscle stiffness and spasms. 

Deep wounds containing dirt or foreign objects are most likely to lead to tetanus, but the condition can occur after a minor injury that you didn't notice at the time.

The bacteria can get into the body through:

  • open fractures where the skin is broken and the bone is exposed
  • bite wounds
  • wounds that have foreign objects, such as wood splinters 
  • wounds that have been contaminated with dust, soil or manure, especially if not immediately disinfected
  • crush injuries
  • burns
  • body piercings and tattoos 
  • eye injuries.

Tetanus cannot be spread from person to person.

Who is most at risk?

Anyone who has not received a primary course of 3 tetanus-containing vaccines is at risk of getting tetanus.

People over 50 years of age (particularly women) are most likely to get tetanus. This is because the national childhood immunisation programme with tetanus vaccine only started in 1960. Before 1960, tetanus immunisation was only routinely delivered to armed forces personnel.

What are the symptoms of tetanus?

The symptoms of tetanus usually start about three to 21 days after being infected. The initial symptoms include muscle weakness, stiffness or cramps and difficulty chewing or swallowing food (lockjaw). As the disease worsens, muscles become stiff and rigid, with painful contraction spasms. Other symptoms include a high temperature (fever) of 38°C or above, sweating and a rapid heartbeat.

Left untreated, the symptoms can continue to get worse over the following hours and days. In some cases, life-threatening problems such as suffocation or a cardiac arrest (where the heart stops beating) can occur.

How is tetanus treated?

If your doctor suspects you could develop tetanus but you haven't had any symptoms yet, they will clean any wounds you have and give you an injection of tetanus immunoglobulin. They may also give you a dose of the tetanus vaccine if you haven't been fully vaccinated in the past.

Tetanus immunoglobulin is a medication that contains antibodies that kill the tetanus bacteria. It offers immediate but short-term protection from tetanus.

If you develop symptoms of tetanus, you'll need to be admitted to a hospital. This is a medical emergency because tetanus can affect your breathing.

How can I prevent tetanus?

Immunisation

The best protection against tetanus is having a complete course of 3 doses of tetanus-containing vaccine and administration of booster doses. This does not stop the bacteria growing in a contaminated wound, but it provides protection against the harmful toxin released by the bacteria. In New Zealand, tetanus is combined with other vaccines and is part of the national immunisation programme.

  • Babies are immunised at 6 weeks, 3 months and 5 months old. They’re not protected until they’ve had all 3 doses.
  • Booster doses are given to children when they’re four and 11 years old.
  • To ensure protection continues, a tetanus booster is offered at 45 and 65 years of age. Boosters may also be needed after some cuts, grazes and wounds. The vaccine is free but you’ll need to pay a small administration fee. Ask your doctor or nurse for more information.

Read more about immunisation and vaccines.

Wound care

Keep cuts, scratches and grazes covered while working outside. Make sure that any injury is immediately and thoroughly cleaned. Read more about cuts and grazes.

Learn more

Tetanus Ministry of Health, New Zealand
Tetanus Immunisation Advisory Centre, New Zealand

References

  1. Tetanus Immunisation Advisory Centre, New Zealand
  2. Rural infection series BPAC, May 2014
  3. About tetanus CDC, US