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Tetanus (lockjaw) disease is caused by Clostridium tetani (C. tetani), an anerobic, gram-positive, bacteria that can develop into a spore. Tetanus spores can be found in soil, manure, and in the digestive tracts of animals and humans. Tetanus has also been reportedly found in contaminated heroin and on skin surfaces.
The tetanus bacteria, C. tetani, produces two exotoxins, tetanolysin, and tetanospasmin. At this time, the exact function of tetanolysin is unknown. However, tetanospasmin exotoxin is the neurotoxin responsible for the clinical symptoms of tetanus.
Tetanus bacteria do not survive in the presence of oxygen; however, the bacteria are quite resistant to most chemicals and heat. Puncture wounds, like animal bites that do not bleed very much and are protected by tissue and skin from direct exposure to oxygen can be the perfect environment to cause an infection.
Once infected, the tetanus spores multiply and produce toxins that spread throughout the body. The incubation period for tetanus infection, from exposure to the appearance of the first symptoms, ranges from three days to three weeks. Initial symptoms include muscular stiffness of the jaw and neck, headache, seizures, heart rate and blood pressure changes, fever, and chills. Complications include fractures, vocal cord spasms, impaired breathing, pulmonary embolism, pneumonia, infections acquired in the hospital during treatment, and death.
There are four recognized forms of tetanus disease. The most common form of tetanus is generalized tetanus, which is responsible for approximately 80 percent of cases. Initial symptoms involve jaw muscle spasms, frequently referred to as “lockjaw.” Muscle spasms involving the extremities, neck, and trunk may also occur. Complications of generalized tetanus can include severe muscle spasms and neurological abnormalities, resulting in prolonged hospital stays and even death.
Localized tetanus is less common and more mild form of the disease that involves muscle spasms near a wound. This form of the disease is often associated with persons previously vaccinated against tetanus and can potentially progress into generalized tetanus.
Cephalic tetanus is a rare but serious form of the disease associated with ear infections or head wounds. Cephalic tetanus typically presents as a cranial nerve palsy and may progress to localized or even generalized tetanus.
Neonatal tetanus, while nearly non-existent in the United States, continues to be a threat to infants born in developing countries. Neonatal tetanus results primarily when childbirth occurs in unsanitary conditions and the umbilical cord becomes contaminated. Symptoms typically develop within one week, with infants noted to be irritable, difficult to feed, and may have rigidity with spasms.
Since the early 1900s, reported tetanus deaths dramatically declined prior to the introduction of vaccines in the late 1940s. Factors contributing to the decline include improvements in wound care, use of tetanus immune globulin (TIG), and decreases in exposure due to population movement from rural to urban environments.
IMPORTANT NOTE: NVIC encourages you to become fully informed about Tetanus and the Tetanus vaccine by reading all sections in the Table of Contents , which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.