Tetanus is caused by the bacterium Clostridium tetani. This germ makes a toxin, or poisonous substance, that attacks the part of the spinal cord that controls the muscles. In this country, about 1 in 10 people with tetanus die from it.

Tetanus is now rare in this country because children are vaccinated against it. The vaccine is combined with vaccines that protect against diphtheria and pertussis (whooping cough). Most cases of tetanus are found in people over 60 who haven’t had a booster shot. Their immunity has gradually worn off. That trend may be changing, though, because tetanus is increasing among IV drug users. Two tetanus vaccines are available for adults. Tdap protects against tetanus, diphtheria, and pertussis. The Td vaccine prevents tetanus and diphtheria.

Adults should get a diphtheria-tetanus (Td) booster once every 10 years throughout their life. This is true even if you don't have a wound. Getting a Td booster every 10 years applies if you have a minor, clean wound. But if you have a wound that is more likely to get tetanus, you'll need the tetanus shot if it has been more than 5 years since your last vaccine. These include wounds that have dirt, feces, soil, or saliva in them. It also includes puncture, deep, or severe wounds. And it includes serious burns and frostbite. You can't get tetanus from the vaccine.

You can't get tetanus from someone else. The germ that causes tetanus is found in soil, dust, animal saliva, and manure. It enters the body through a cut, usually a deep puncture wound.

Symptoms of tetanus infection may include spasms and stiffness of the jaw (lockjaw) and neck muscles. This makes it hard to swallow. A tetanus infection may also cause severe spasms and stiffness of the belly (abdominal muscles) and chest muscles. This makes it hard to breathe. Other symptoms of a tetanus infection include fever, sweating, and fast heart rate.

The only way to protect yourself is to get a tetanus booster every 10 years. You may need an earlier booster if you have a high-risk cut or injury and haven't been boosted within the last 5 years.

Tetanus germs can enter the skin through something as small as a pinprick, but they prefer deeper wounds. Clean any wound you get with soap and water. Then use an antiseptic. If the wound is deep or dirty, have your healthcare provider check it out. If you haven't had a tetanus booster in the last 5 years, you may need to get another booster. Be sure to give your vaccine record to your healthcare provider.

Symptoms usually show up 3 days to 3 weeks after the germs enter the body. Tetanus has no definite cure. But it can be treated with surgery to clean an infected wound. It's also treated with anti-tetanus and anti-spasm medicines, and antibiotics. You may need to be on a breathing machine (ventilator) until you can breathe well on your own. Tetanus is treated in the ICU (intensive care unit). Even with modern medical care, tetanus can be fatal. From 1 to 2 in 10 people with tetanus may die from it. Complications can include breathing problems, broken bones, blood clots, and pneumonia. For people who survive, recovery can take several months. Nerve damage may take even longer to heal, or it may be long-term (permanent).