Tetanus
Tetanus is caused by a toxin produced by bacteria called Clostridium tetani. These bacteria are widespread in the environment within soil, dust and manure. Unvaccinated people are at risk of developing tetanus if a wound or cut is contaminated by the bacteria.
Signs and symptoms
Tetanus is an acute disease characterised by painful muscular contractions and spasms. Involvement of the muscles of the jaw and neck has led to tetanus also being known as 'lock jaw'. Older children and adults may present with abdominal rigidity due to involvement of the muscles of the trunk.
Transmission
Tetanus is not directly transmitted from person to person. It is contracted through a cut or wound which becomes contaminated by the bacteria. It can enter the body through even a minor injury, but deep puncture wounds or cuts are more likely to become infected. The time from exposure to the bacteria and the development of symptoms is usually about 10 days, but it can be longer.
Treatment
The treatment for tetanus involves giving tetanus antitoxin to combat the toxins produced by the infecting bacteria. As people with tetanus have severe muscle spasms and difficulty with breathing, treatment is generally undertaken in a hospital intensive care facility.
As recovery from tetanus may not result in immunity, an important part of the treatment is to ensure that the person starts a vaccination course to prevent them from contracting tetanus again.
Prevention
Any wound should be cleaned thoroughly with soap and water.
Vaccination is the best way to protect against tetanus (see Immunisation). If a person suffers a tetanus-prone wound and is not fully vaccinated or has not had a tetanus booster dose in the previous five years, seek medical attention immediately.
Immunisation
The National Immunisation Program Schedule provides funded tetanus-containing vaccinations for the following groups:
- all children at 2, 4 and 6 months of age with booster doses 18 months and 4 years of age (each dose is one injection combined with other childhood vaccines)
- adolescents are offered another booster dose of tetanus-containing vaccine through the School Immunisation Program in Year 7.
The tetanus vaccine is available for adolescent/adults as a combined vaccine, either as diphtheria-tetanus-pertussis (whooping cough) or diphtheria-tetanus vaccine.
Immunisation to protect against tetanus is also recommended, but not funded, for:
- all adults aged 50 years and over who have not received a booster dose in the previous 10 years
- adults with a tetanus-prone wound who have not received a booster dose of tetanus-containing vaccine in the previous five years
- persons who have not received a primary course of tetanus vaccination
- travellers to countries where health services are difficult to access.
To be fully effective, it is important that all recommended doses of the vaccine are received at the recommended times. Booster doses are essential for maintaining immunity to diphtheria, tetanus and pertussis.
Like all medications, vaccines may have side effects. Most side effects are minor, last a short time and do not lead to any long-term problems. Possible side effects of the tetanus vaccine may include fever, redness and soreness where the injection was given, nausea, headache, tiredness and aching muscles. More serious side effects are extremely rare and can include severe allergic reactions. Contact your immunisation provider if you or your child has a reaction following vaccination which you consider serious or unexpected.
Health outcome
Due to the availability of a very effective tetanus vaccine and widespread immunisation, tetanus is now a rare disease. About 2% of people who develop tetanus in Australia will die as a result of the disease. The death rate is much higher in places overseas where access to medical care is limited.
Help and assistance
For further assistance, please contact your local doctor, community health centre or nearest public health unit. You can be immunised at your local doctor or medical centre. Check if your local council, community child health or community health centre hold free immunisation clinics.
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Other Resources
- 13 HEALTH (call 13432584)
- Immunisation Australia (call 1800 671 811)
References
Heymann, D., ed. 2015. Control of Communicable Diseases Manual, 20th edition. Washington, DC: American Public Health Association.
The current online Australian Immunisation Handbook May 2023.