Tetanus Dr Trisha Macnair A person with a contaminated wound may develop tetanus.

In this article

What is tetanus? Symptoms

Causes and risk factors Treatment and recovery

Tetanus is a serious bacterial infection that usually results from a contaminated wound and may be fatal if not treated. It is now uncommon in the UK due to vaccination.

The incubation period varies from a few days to a few weeks. Then there's general tiredness or weakness followed by spasm of the jaw muscles (called lockjaw, called trismus). Spasm of the muscles of the face can make the person appear to have a fixed grin. Spasms may occur spontaneously or be triggered by stimulation, such as noise or light.

Other symptoms include:

• problems with swallowing or breathing
• arching of the back and neck
• inability to pass urine
• sweating
• abnormal heart rate and blood pressure

The person usually remains mentally alert. Babies may go off feeding, have a poor sucking technique and become irritable. In severe cases, especially in the very young and old, tetanus is often fatal.

Tetanus is caused by a bacterium called Clostridium tetani, which is found in soil and animal manure. Spores of the bacteria are picked up when a wound is contaminated by, for example, garden soil. The wound may go unnoticed and the infection may not seem severe, but the bacteria release a poison called a neurotoxin that attacks the nervous system and causes problems such as muscle spasm.

Anyone who has a contaminated wound may develop tetanus. Farmers and those working with soil are at increased risk. In developing countries, the custom of dressing a newborn baby's umbilical cord stump with animal dung often leads to neonatal tetanus.

If you suspect tetanus, get urgent medical help.

The diagnosis is usually clear from the symptoms and history. The bacteria may be detected in the wound, but as tetanus is a medical emergency treatment is usually started based on symptoms alone.

Treatment should be in hospital. Depending on the severity of the case, sedation, muscle-relaxant drugs and even artificial ventilation to help breathing may be needed. The wound may need to be cleaned to remove the source of the toxin and antibiotics given. With treatment, most people recover completely.

Tetanus is a preventable condition. Immunisation is offered as part of the standard vaccination schedule in the UK. Boosters are given before school entry and then every ten years.

If your child has a deep wound, get medical advice even if they've been vaccinated for tetanus, sometimes an extra dose of tetanus vaccine is needed. Don't wait for symptoms to appear.

This article was last medically reviewed by Dr Orlena Kerek in March 2009