What is Tetanus?

Tetanus, also known as lockjaw, is a serious bacterial infection that is characterised by painful muscle spasms. In some cases these spasms can be severe enough to tear the muscles and cause bone fractures. Tetanus is caused by the bacteria Clostridium tetani, which can be found in dirt and soil. This bacteria infects the body through open wounds, such as cuts or puncture wounds caused by a contaminated object. Tetanus is not contagious, so you cannot catch tetanus from somebody who is infected.

Tetanus requires emergency hospital treatment to manage the symptoms, and it can take months to fully recover from an infection. Without treatment, tetanus is fatal in up to 76% of cases. Even with treatment, around 10% of confirmed cases of tetanus are fatal. However, tetanus is easily preventable with a course of the tetanus vaccine.

What are the symptoms?

Symptoms include:

  • muscle stiffness
  • muscle spasms
  • a high temperature (fever)
  • a rapid heartbeat
  • elevated blood pressure
  • headache

You can find out more information on our page dedicated to the symptoms of tetanus

Who is at risk of tetanus?

People who aren’t immunised – if you’ve never been vaccinated against tetanus, or if you haven’t had a booster dose in the last ten years, then you may be at risk of contracting tetanus.

Newborn babies of mothers who have not been immunised – babies can be born with temporary immunity to certain diseases, such as tetanus, if their mother was immune during pregnancy. This is known as maternal passive immunity, which is when antibodies that protect against certain diseases are passed on to the baby through the placenta, or through breastfeeding. If you are pregnant and you have not been vaccinated against tetanus, then your newborn will be at a higher risk of catching it until they have been vaccinated themselves.

Elderly people – because the immune system can weaken with age, elderly people are at the most risk of catching tetanus, and that infection being fatal. This is even more common in elderly people who have not been vaccinated, or have only been partially vaccinated against tetanus.

Injecting drug users – equipment used to inject drugs, or batches of the drugs themselves, can be contaminated with the bacteria that cause tetanus. Tetanus-causing bacteria can then get into the body when the needle pierces the skin, or can be introduced directly into the bloodstream if the drugs themselves are contaminated.

Diabetics – people with diabetes can be more vulnerable to infections, as their immune systems can be weakened by high blood sugar levels. In addition to being more prone to infection, cases of tetanus in diabetics may also be more likely to be fatal than in those without any pre-existing health conditions.

Immunosuppressed people – if you have a weakened or suppressed immune system, which can be caused by a pre-existing condition such as HIV or certain medications, then you’re at a higher risk of contracting infections like tetanus and developing complications.

Is tetanus dangerous?

Tetanus is a very dangerous infection, and even with appropriate treatment an infection is fatal 10% of the time.

It is estimated that tetanus causes up to 293,000 deaths around the world every year. Tetanus is especially dangerous during childbirth: it is also estimated that tetanus is responsible for up to 7% of all deaths of newborn babies, and 5% of women who die due to complications during pregnancy or childbirth.

How do you get tetanus?

The bacteria that causes tetanus, Clostridium tetani, is commonly found in dirt, soil, manure, and dust. This bacteria gets into the body through open wounds, most commonly causing an infection if you’ve suffered a puncture wound – for example stepping on a nail. This is because the bacteria that causes tetanus grows best in environments where there’s not much oxygen, so it thrives in deep and narrow wounds where there is less exposure to oxygen. A wound does not need to be visibly dirty to pose a risk of tetanus, though dirty wounds are more likely to become infected.

Tetanus-prone wounds and activities include:

  • cuts and scrapes
  • puncture wounds
  • animal bites 
  • burns
  • compound fractures (when a broken bone pierces the skin)
  • tattoos and piercings, especially if done with unsterilised equipment
  • injecting drugs

Because tetanus lives primarily in soil and dirt, cuts or puncture wounds sustained while gardening have a high risk of causing tetanus. If you get injured while gardening, even if it’s just a small nick, get in contact with your GP as soon as possible.

One common myth is that rust causes tetanus. Rust itself does not cause tetanus, though a nail (or any other metallic object) that has been exposed to the elements long enough to accumulate rust is more likely to have also been exposed to the bacteria that causes tetanus. Because of its rough and uneven surface, a layer of rust also provides lots of tiny spaces for microorganisms to live in, which increases the likelihood that a rusted object could be contaminated with infectious material. While there is an increased risk of tetanus from rusty objects, puncture wounds from any source (rusted or not) have the potential to cause tetanus.

Tetanus is not a contagious disease, so you cannot catch tetanus from somebody who is, or has been, infected.

How can I protect myself against tetanus?

Get vaccinated – tetanus can be easily prevented with a single dose of the combined tetanus, diphtheria, and polio vaccine. You still need this vaccine even if you have had tetanus before, as recovering from this infection does not make you immune to future infections. The vaccine offers protection against tetanus for up to 10 years, so you’ll need a booster jab if you’re at risk and haven’t been vaccinated against tetanus in the last 10 years. You can get the combined tetanus, diphtheria, and polio vaccine in any Superdrug Health Clinic in the UK.

Clean and disinfect your wound – dirty wounds are more prone to infection, as tetanus-causing bacteria and other microorganisms that live in dirt can contaminate them. If you have an injury that causes the skin to break, the best thing to do is wash it out as soon as possible with clean water to get rid of any infectious material that could have gotten into the wound. If it is a deep puncture wound, then do not use soap or apply any antiseptic. After cleaning out the wound, wrap a sterile bandage around the wound to prevent further contamination and seek urgent medical attention. If you have not received a tetanus jab in the last 10 years, you should tell the medical team, so they can give you a booster.