Tetanus

It's very rare in the UK but more widespread in some developing countries. It's caused by bacteria called Clostridium tetani and usually enters the body via a cut, sore or open wound – or, in the case of newborns in developing countries, through the cord stump. 

It can be so serious that unless it's treated promptly, it can kill. This is because the bacteria, once inside your bloodstream, produce a poison that interferes with nerve signals from the spinal cord to the muscles. This in turn can cause muscle spasms as well as rigidity in the jaw (lockjaw) and other parts of the body.

Tetanus isn't contagious between people, and since the introduction of the childhood immunisation programme in 1961 in the UK, cases are rarely diagnosed. People most at risk are the over 65s who haven't been vaccinated.

A full course of anti-tetanus vaccination consists of five doses, given as injections, the final two of which are boosters. It's generally considered that the last dose give you lifelong immunity, although you might be offered further boosters if you're travelling to countries where there's more risk of tetanus infection or if there's any doubt that you've had all five doses.

What are the symptoms of Tetanus?

The main symptoms of tetanus are muscle spasms and rigid muscles, usually starting with the jaw, which is a condition known as lockjaw and prevents the patient from opening their mouth; then spreading to the neck and throat. This can make swallowing almost impossible. There may be facial spasms, too. The muscle stiffness can affect breathing as it spreads to the chest, and can become more widespread. In severe cases, especially in children, the spine becomes markedly arched.

Other symptoms include a fever (temperature of 38°C or above); sweating, fast heartbeat and high blood pressure.

If left untreated, the complications that can prove fatal include septicaemia (blood poisoning), heart attack, kidney failure and suffocation.

What are the treatments and remedies of Tetanus?

If you suspect a tetanus infection after contact with soil, manure or dust in an open wound, sore or cut, seek medical help straightaway, as a doctor will need to decide on the appropriate treatment. 

You may, for instance, be given an intravenous injection of a substance called tetanus immunoglobulin (TIG), which contains antibodies that fight tetanus if the doctor judges your wound to be 'tetanus prone', meaning likely to have become infected with tetanus. 

TIG only offers short-term protection and your body won't produce its own antibodies to fight the infection longer term, so you should also have an anti-tetanus vaccine to protect you.

If you're pregnant and at risk of tetanus infection, you should have a TIG injection and the vaccine without delay. There aren't any known complications for expectant mum or baby.

Sometimes antibiotics are given to prevent tetanus bacteria from multiplying, and prevent muscle rigidity from spreading. There are other medications that can be given to relax the muscles, too and, in rare cases, surgery may have to be performed to clean and repair the open wound.

A person suffering from muscle spasms will be prescribed a high-calorie diet until the condition subsides. This is because of all the extra energy being used by the body. Assistance with breathing might also be needed.

This guide 

The information in this Bounty A-Z of Family Health is not a substitute for an examination, diagnosis or treatment by a doctor, midwife, health visitor or any other qualified health professional. If in doubt, always speak to a doctor.

Bounty will not be held responsible or liable for any injury, loss, damage, or illness, however this occurs or appears, after using the information given on this website and in particular the A-Z of Family Health.

Further help

For health advice and information 24 hours a day, 365 days a year, the NHS offers call and web services. You can also visit NHS websites for services, health information and health news at nhs.uk 

• England – call 111 from any landline or mobile phone free of charge, or visit nhs.uk 
• Scotland – call 111 from any landline or mobile phone free of charge, or visit nhs24.com 
• Wales – call 0845 4647 , or visit nhsdirect.wales.nhs.uk 
• Northern Ireland – visit hscni.net