Tetanus, or lockjaw, is a bacterial infection that is characterized by painful muscle spasms, serious complications, and can lead to eventual death.

Tetanus is not transmitted from person-to-person. A person usually becomes infected with tetanus when dirt enters a wound or cut.

Tetanus germs are likely to grow in deep puncture wounds caused by dirty nails, knives, tools, wood splinters, and animal bites. The disease is caused by a potent neurotoxin that is produced by the bacteria in the absence of oxygen.

People of all ages can get tetanus but it can be prevented by the administration of tetanus toxoid, which induces specific antitoxins. To prevent maternal and neonatal tetanus, tetanus toxoid needs to be given to the mother before or during pregnancy, and clean delivery and cord care needs to be ensured.

The disease is particularly common and serious in newborn babies. This is called neonatal tetanus and most infants die who get the disease. Neonatal tetanus is particularly common in rural areas where most deliveries are at home without adequate sterile procedures.

People who recover from tetanus do not have natural immunity and can be infected again and therefore need to be immunized.

How you get tetanus

Tetanus bacteria can survive for a long time outside the body, and are commonly found in soil and the manure of animals such as horses and cows.

If the bacteria enter the body through a wound, they can quickly multiply and release a toxin that affects the nerves, causing symptoms such as muscle stiffness and spasms.

The bacteria can get into your body through:

  • cuts and scrapes
  • tears or splits in the skin
  • burns
  • animal bites
  • body piercings, tattoos and injections
  • eye injuries
  • injecting contaminated drugs

Tetanus can’t be spread from person to person.

Symptoms of tetanus

The symptoms of tetanus usually develop 4 to 21 days after infection. On average, they start after around 10 days.

The main symptoms include:

  • stiffness in your jaw muscles (lockjaw), which can make opening your mouth difficult
  • painful muscle spasms, which can make breathing and swallowing difficult
  • a high temperature (fever) of 38C (100.4F) or above
  • sweating
  • a rapid heartbeat

Left untreated, the symptoms can get worse over the following hours and days.

How tetanus is treated

Tetanus immunoglobulin is a medication containing antibodies that kill the tetanus bacteria. It provides immediate, but short-term, protection from tetanus. Doctors may also give you a dose of the tetanus vaccine if you haven’t been fully vaccinated in the past.

Tetanus vaccination

A tetanus vaccination is given as part of the AHO childhood vaccination programme.

The full course of the vaccination requires five injections, usually given on the following schedule:

  • The first three doses are given as part of the 6-in-1 vaccine at 8, 12 and 16 weeks for all babies born on or after August 1 2017.
  • A booster dose is given as part of the 4-in-1 pre-school booster at age three years and four months.
  • A final booster is given as part of the 3-in-1 teenager booster at age 14.

This course of five injections should provide long-lasting protection against tetanus.