Tetanus

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

Most people who get tetanus weren’t vaccinated against it or didn’t 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 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.

When to get medical advice

Visit your nearest minor injuries unit or phone 111 if you’re concerned about a wound, particularly if:

it’s a deep wound
there’s dirt or something inside the wound
you haven’t been fully vaccinated, or you’re not sure if you have

A healthcare professional will assess the wound, and decide whether you need treatment and whether you need to go to hospital.

Go immediately to your nearest accident and emergency (A&E) department or call 999 for an ambulance if you develop severe muscle stiffness or spasms.

How tetanus is treated

If a healthcare professional thinks you could develop tetanus but you haven’t had any symptoms yet, they’ll clean your wounds and give you an injection of tetanus immunoglobulin.

Tetanus immunoglobulin is a medication containing antibodies that kill the tetanus bacteria. 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 a number of different treatments. These could include tetanus immunoglobulin, antibiotics, and medication to relieve muscle stiffness and spasms.

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

Tetanus immunisation

The tetanus vaccine’s given as part of the NHS childhood immunisation programme.

The full course of the immunisation requires 5 doses, 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 between 13 and 18 years of age.

This course of 5 doses 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 immunisation course, contact your GP surgery for advice. It’s possible to fully immunise older children and adults who weren’t immunised when they were younger.

Tetanus travel jab

Tetanus is found throughout the world, so you should ideally make sure you’re fully immunised before travelling abroad.

If you’ve never had a tetanus immunisation before, you may be advised to have as many of the three initial doses of the vaccine as possible before you leave (there should be one-month gaps between each dose) and complete the full course when you return.

If you’ve been partly or fully immunised, a tetanus shot is usually still recommended as a precaution if you’re travelling to an area with limited medical facilities and your last dose of the vaccine was more than 10 years ago.

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

Find out how you can get a travel immunisation