Tetanus - Are You at Risk?

Do you believe tetanus, often called lockjaw, is caused by stepping on a rusty nail? If you do, you're partly right. Rust doesn't cause tetanus, but stepping on a nail might if you're not immunized. In fact, any damage to the skin, even burns and blisters, allows tetanus-causing bacteria to enter the body.

Tetanus is not as common as it once was. Still, tetanus patients have only about a 50-50 chance of recovering. Most tetanus deaths occur among infants and the elderly.

Everyone who has not had a tetanus shot is at risk to this disease. However, persons in certain occupations such as farming, firefighting, and construction, and campers and gardeners, are at higher risk.

Protect with Tetanus-diphtheria (Td) Shots

Today, illness and death due to tetanus are preventable. For adults, a Td shot every 10 years ensures complete protection against two diseases, tetanus and diphtheria.

Persons who have never received a Td shot, or can't remember receiving one, should start with the three-shot primary series.

Td Schedule for Persons 7 Years Old and Older
In 1 to 2 months
In 6 to 12 months
Every 10 years

Tetanus - Caused by a Bacterium

Tetanus is caused by a bacterium, Clostridium tetani, found worldwide in soil, dust, and the feces of animals and man. The likelihood of tetanus is greatest following deep, dirty puncture wounds where there is little bleeding and an absence of oxygen. But tetanus has occurred following other injuries such as burns, scratches, and slivers. A powerful toxin (poison) produced in the wound travels to the brain. There it interferes with breathing control and other important body functions.

Tetanus does not spread from person to person like measles, mumps, rubella or polio.

Painful and Deadly

Although tetanus toxin affects several areas of the body, it acts primarily on the jaw muscles. Stiffness in the jaw, neck and limbs are early signs of this disease. Later the jaws become firmly closed, hence the common name for tetanus, lockjaw.

As a tetanus patient becomes sicker, the back may arch and abdominal muscles may become rigid. Painful seizures may be triggered simply by turning on a light or by a slight noise. Swallowing may become difficult. Suffocation occurs when muscles involved with breathing are affected by the toxin.

Even those who recover from tetanus do not build up lasting immunity to this disease. Another attack could occur unless a tetanus booster shot is received every 10 years.


Although diphtheria is rare today, it still occurs. One in ten who gets diphtheria will die from it.

This disease of the nose, throat, and windpipe can be easily mistaken for a sore throat, and is highly contagious. Diphtheria is spread by inhaling bacteria expelled by sick people or handling their contaminated articles. Death from diphtheria may be due to suffocation or heart failure caused by bacterial toxin.

Treating the Tetanus Patient

Treatment after an injury depends on the type of injury and the number of tetanus shots the injured person has had in the past. If the injured person received a Td booster within the last 10 years, further treatment may not be necessary.

If, however, the injured person was not protected or does not know if vaccine was received, Td and/or TIG (tetanus immune globulin) may be given. TIG fights the toxin while Td vaccine helps the body build immunity.

A hospitalized tetanus patient requires antibiotics to prevent infection and drugs such as diazepam (Valium) to relax the muscles. Intravenous feeding and a opening in the windpipe are often necessary. Hospitalization may last a month or more.

Keep an Up-to-Date Record

If you do not have an immunization record, ask your doctor or public health agency for one when you get your Td booster. Be sure to enter the month, day, and year you received the vaccine. If you are injured or ill, an up-to-date record will help your doctor determine which shots, if any you may need.


Last Updated: Thursday, April 10, 1997 07:57 pm
Allen Johnson - ND Dept. of Health - ajohnson@state.nd.us