What is tetanus? What causes it?

When you were a kid, have you heard your parents telling you always to wear your slippers or shoes whenever going out of your house, and avoid stepping on the ground bare-feet? Aside from your feet may be thorn by sharp and pointed objects on the ground, maybe, your mother knew about the dangers and health risks that tetanus could cause you.

We always think that we can get tetanus from rusty objects like nails, wires, metallic pipes, iron, etc. Possibly yes, but not all the time. Tetanus is not infectious but is an infection caused by Clostridium tetani bacteria. These bacteria are found throughout our environment, but mostly dwelling in places such as soil, dust, and feces. (click here for more details)

Tetanus bacteria can be killed easily, but it can produce spores. According to Dr. William Schaffner, an infectious-disease specialist at Vanderbilt University, it’s not just the rust from a nail that causes tetanus but the exposure of the rusty nail to a dirty environment where the bacteria live. But not all the time, a dirty environment can be “visibly dirty,” since there are cases of tetanus from a kitchen knife cut.

tetani bacteria lie inactive in spore form and can live for long periods and can survive extreme conditions as long as oxygen is present. But when the spores enter the body through a deep wound, their oxygen supply is cut off. Once they have entered the human body, they multiply quickly and produce dangerous toxins carried through the blood.

It can be fatal when the bacteria infect a person, and the toxins scatter within the different parts of his body and go up to the brain.

Tetanus has three types: Localized tetanus, Cephalic tetanus, and Generalized tetanus. The generalized tetanus is the most common among the three. The entire body experiences uncontrolled spasms that typically start in the ear and the neck resulting in a locking of the jaws. That is why tetanus is commonly called “lockjaw.” Meanwhile, there is also neonatal tetanus that usually occurs due to umbilical stump infections. (click here for more details)


Once the bacteria have entered the body, it takes 7-10 days to see its manifestation. However, there are variations from four days to about three weeks, and in some cases, may take months. There is a long incubation period if the injury site is far from the central nervous system, which is the primary target of the bacteria. (click here for more details)

The common symptoms are muscle spasms and stiffness, which usually start with the jaw, eventually spreading through the entire face, down to the neck, and causing difficulties with swallowing. Difficulty in breathing may also be experienced, and in some cases, abdominal and limb muscles are also affected.

In severe cases that are more common among children, the spine will arch backward as the back muscles become affected.

Other common manifestations of the infection are:

  • Blood on the stool
  • High fever
  • diarrhea
  • headache (migraines)
  • sensitivity to touch
  • sore throat
  • extreme sweating
  • irregular (rapid) heartbeat
  • High blood pressure

When not treated immediately, complications may occur, such as a fracture of the spine and long bones due to severe contractions of the muscles, aspiration pneumonia, seizures, high blood pressure, and death.

How is tetanus treated?

When you have cut or wound, immediately clean it thoroughly to prevent the infection, but a tetanus-prone wound or cut needed an urgent professional medical treatment. Mild cases of tetanus are treated using prescribed penicillin or metronidazole. These antibiotics prevent the multiplication of the bacteria and stop the neurotoxin production that causes muscle spasms and stiffness.

Patients with allergy to antibiotics may be given tetracycline as an alternative. Anticonvulsants like diazepam (Valium), will relax the muscles, prevent spasms, reduce anxiety, and work as sedatives. Neuromuscular blocking such as pancuronium and vecuronium are useful in controlling muscle spasms. They can block the signals from nerves to muscle fibers.

For emergency cases, tetanus immunoglobulin (TIG) is given to a patient immediately, despite previous vaccinations received. It contains antibodies that kill Clostridium tetani once injected into a vein provides immediate short-term protection against tetanus. TIG has a temporary effect than vaccinations. But it can be safely administered to pregnant and breastfeeding mothers.