Lockjaw

Tetanus is a serious but rare infection caused by bacteria. It usually occurs when a flesh wound becomes contaminated.

Without treatment, complications of tetanus are likely to develop, which can be fatal. However, vaccination and improvements in treatment mean deaths from tetanus are now rare in the UK. In England and Wales in 2011, there were only three recorded cases of tetanus.

What causes tetanus

Tetanus is caused by a type of bacteria called Clostridium tetani. The bacteria can live in many different substances including:

soil
house dust
animal and human waste, such as manure

The tetanus bacteria usually enter the body through a wound in the skin or a serious burn. Once inside, they multiply and release a powerful type of poison, known as a neurotoxin.

The neurotoxin disrupts the normal workings of the nerves, causing symptoms such as stiffness and muscle spasms.

Read more about the causes of tetanus and who is at risk.

Other symptoms of tetanus include:

muscle stiffness and spasms in the jaw muscles – often referred to as lockjaw
difficulty swallowing (dysphagia)

Diagnosing tetanus

A confident diagnosis can usually be made if someone has recently had a wound or similar injury and has painful muscle spasms and muscle stiffness.

A spatula test can help confirm tetanus if there is any doubt about the diagnosis. It involves inserting a spatula into the back of your throat. The spatula will cause a gag reflex and you will try to push the spatula out of your mouth. If you have the infection, the spatula will cause your throat muscles to spasm and you to bite down onto the spatula.

Treating tetanus

If you have a deep wound that could become contaminated by tetanus bacteria and you have been vaccinated, you will be given a medication called tetanus immunoglobulin (TIG) as a precaution.

If you have not been vaccinated and develop tetanus, you will need to be admitted to hospital for treatment. Treatment usually involves a combination of medications, such as antibiotics, muscle relaxants and antitoxins, to combat the effects of the infection.

A ventilator (a machine to assist with breathing) can be used to help prevent suffocation.

Most people survive the infection, although it can take up to four months to make a full recovery.

Tetanus vaccination

A vaccination to protect against tetanus is given as part of the NHS childhood vaccination programme.

The full course of the tetanus vaccination consists of five doses. The first three doses are given in the 5-in-1 vaccine for babies at two, three and four months of age.

This is followed by a booster of tetanus vaccine in the 4-in-1 pre-school booster jab which is given around four years of age.

And a final booster against tetanus is given to children betweeen 13 and 18 years of age as part of the 3-in-1 teenager booster.

After the full course of five injections, you should have lifelong immunity against tetanus. However, if you or your child has a deep wound, it's best to get medical advice.

If you are not sure whether you've had the full course, for example because you were born in another country, contact your GP for advice.

Tetanus vaccination for travel

Tetanus is found throughout the world. Any location where medical attention may not be available if you hurt yourself is considered a high-risk area.

A tetanus vaccination is usually recommended for anyone who:

has not been vaccinated before
has not been fully vaccinated (in the UK you should receive five doses of the tetanus vaccine)
is travelling to a country with limited medical facilities, and whose last dose of the tetanus vaccine was more than 10 years ago