Description:

Tetanus

Tetanus is a serious but rare condition caused by bacteria getting into a wound.

In 2019 there were only 4 cases of tetanus reported in England. The number is low because an effective tetanus vaccine is given as part of the NHS childhood vaccination programme .

Most people who get tetanus have either not been vaccinated against it or did not complete the entire vaccination schedule.

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

Tetanus cannot be spread from person to person.

Symptoms of tetanus

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

The main symptoms of tetanus include:

stiffness in your jaw muscles (lockjaw), which can make it difficult to open your mouth
painful muscle spasms, which can make it difficult to breathe and swallow
a high temperature
sweating
a rapid heartbeat

If it's not treated, the symptoms can get worse over the following hours and days.

When to get medical advice

Contact a GP or visit your nearest minor injuries unit if you're concerned about a wound, particularly if:

it's a deep wound
there's dirt or something inside the wound
you have not been fully vaccinated for tetanus, or you're not sure if you have

A doctor will assess the wound and decide whether you need treatment and whether you need to go to hospital.

Go to your nearest A&E immediately, or call 999 for an ambulance, if you get severe muscle stiffness or spasms.

How tetanus is treated

If a doctor thinks there's a chance you could develop tetanus from a wound, but you do not yet have any symptoms, they'll make sure your wound is thoroughly cleaned. They may also give you an injection of tetanus immunoglobulin.

If you have not been fully immunised for tetanus, or you're not sure whether you have, you may be given a dose of the tetanus vaccine. You may also be given antibiotics.

Tetanus immunoglobulin is a medicine containing antibodies that prevent the tetanus toxin working, stopping its effects on the nerves. It provides immediate, but short-term, protection from tetanus.

If you develop symptoms of tetanus, you'll usually need to be admitted to a hospital intensive care unit (ICU) , where you may be given several different treatments. These could include tetanus immunoglobulin, antibiotics, and medicine to help muscle stiffness and spasms.

Most people who develop symptoms of tetanus do recover, but it can take several weeks or months.

Tetanus vaccination

The tetanus vaccine is given as part of the NHS childhood vaccination programme .

The full course of vaccination includes 5 injections, usually given on the following schedule:

the first 3 doses are given as part of the 6-in-1 vaccine at age 8, 12 and 16 weeks
a booster dose is given as part of the 4-in-1 pre-school booster at age 3 years and 4 months
a final dose is given as part of the 3-in-1 teenage booster at age 14

This course of 5 injections should provide long-lasting protection against tetanus. However, if you or your child has a deep or dirty wound, it's best to get medical advice.

If you're not sure whether you've had the full vaccination course, contact your GP surgery for advice. It's possible to fully vaccinate older children and adults who were not vaccinated when they were younger.

Tetanus travel jab

Tetanus is found throughout the world, so you should make sure you're fully vaccinated before travelling abroad.

Contact your GP surgery for advice if you're planning to travel abroad and have not been fully vaccinated against tetanus, or you're going to an area with limited medical facilities and your last vaccine dose was more than 10 years ago.

You'll be offered the 3-in-1 teenage booster . This injection, which also protects against diphtheria and polio , is usually free on the NHS.

If you've never had the tetanus vaccine before, you may be advised to have as many doses as possible before you travel. There should be a 1-month gap between each dose. If there's not enough time to have all the doses you need, you can complete the course when you return.