Tetanus is a serious bacterial disease that causes muscle spasms and breathing problems. Tetanus is uncommon in Australia because of the widespread use of the tetanus vaccine. Some types of wounds are more likely to encourage the growth of tetanus bacteria, such as compound fractures, animal bites, burns or any wounds contaminated with soil, horse manure or pieces of foreign objects. Immunisation is available and serious side effects or allergic reactions are rare.
Tetanus is a serious bacterial disease that causes muscle spasms and breathing problems. The bacterium that causes tetanus is called Clostridium tetani. The bacteria produce toxins that affect the nervous system. Around one in 10 people infected with bacteria that causes tetanus will die.
Tetanus is uncommon in Australia because of the widespread use of the tetanus vaccine. Anyone who hasn’t been immunised is at risk.
Symptoms of tetanus
The signs and symptoms of tetanus may include:
- muscle spasms that begin in the jaw and neck
- inability to open the mouth (lockjaw)
- swallowing problems
- breathing difficulties
- painful convulsions (fits)
- abnormal heart rhythms.
Complications of tetanus
The extremely serious and potentially lethal complications of tetanus can include:
- respiratory failure
- hypertension (high blood pressure)
- hypotension (low blood pressure)
- heart attack.
Causes of tetanus
Tetanus bacteria live in soil, dust and manure, particularly horse manure. Infection occurs when the bacteria enter the body through a break in the skin. Symptoms occur between three days and three weeks after infection. Most cases occur within 14 days. Generally, if symptoms appear very quickly, the infection is severe. Tetanus is not transmitted from person to person.
Anyone who has not been immunised against tetanus is at risk, in particular:
- people who work with soil, or horses, or in dusty environments
- intravenous drug users
- Australians travelling overseas to parts of Asia, South America or Africa
- people who have high-risk wounds that are more likely to be infected with tetanus bacteria.
Some wounds are more likely to encourage the growth of tetanus bacteria. Examples of these wounds are:
- compound fractures (the broken bone pierces the skin)
- animal bites
- any type of penetrating wound, such as from a rusty nail or rose thorns
- wounds contaminated with soil, horse manure or foreign objects such as wood fragments.
Diagnosis of tetanus
The diagnosis is usually made by physical examination and taking the medical history, including information about immunisation. It is difficult to confirm a diagnosis through laboratory tests.
Treatment for tetanus
Tetanus is a life-threatening disease and sometimes, death will occur even with prompt medical attention.
Treatment for tetanus may include:
- antitoxin (called tetanus immunoglobulin) – to neutralise any tetanus toxin that is circulating and not yet attached to nerve tissue
- anti-convulsive medications
- life support – for example, the person may be placed on an artificial respirator if they have severe breathing problems
- vaccination – having tetanus does not make you immune, so you should be immunised.
Seek medical advice for dirty wounds or wounds where the skin has been penetrated. The doctor may advise a tetanus booster shot depending on how long it is since your last tetanus dose. If you have not had any previous immunisations against tetanus, a full course of three doses should be given. If the doctor thinks the type of wound you have might encourage the growth of tetanus bacteria, you might also receive tetanus immunoglobulin.
Immunisation against tetanus
In Victoria, the tetanus vaccine is available in a number of combined immunisations that also contain vaccines against other serious and potentially fatal diseases. The type of combined vaccine used will depend on your age.
Protection against tetanus is available under the National Immunisation Program Schedule. In Victoria, immunisation against diphtheria is free of charge for:
- children at two, four and six months of age – in the form of a diphtheria, tetanus, whooping cough, hepatitis B, polio and Haemophilus influenzae type b (Hib) vaccine (six-in-one vaccine)
- children at four years of age – in the form of a diphtheria, tetanus, whooping cough and polio vaccine (four-in-one vaccine)
- students in year 10 of secondary school – a booster dose of diphtheria, tetanus and whooping cough vaccine (three-in-one vaccine)
- adults 50 to 59 years – a booster dose of diphtheria and tetanus vaccine (two-in-one vaccine)
- children up to and including nine years – catch-up immunisations are available for children who have not been fully vaccinated.
- Aboriginal and Torres Strait Islander people, refugees and asylum seekers ten years and over – catch-up immunisations are available for people who have not been fully vaccinated.
Immunity against tetanus decreases with time and further booster shots may be needed. A course of tetanus-containing vaccine is recommended for anyone who has never been vaccinated. Immunisation may not be free of charge.
Three doses are given at monthly intervals and two further booster doses are given 10 years apart. The first vaccine can be given as a combination with diphtheria, tetanus and whooping cough. Following doses should be given as diphtheria and tetanus.
A diphtheria and tetanus booster is recommended from 50 years up to and including 59 years of age (inclusive) and is provided free-of-charge in Victoria. See your doctor or consult with your local government immunisation service provider for more information.
Pregnancy and tetanus immunisation
Combination vaccines containing diphtheria, tetanus and whooping cough vaccines are not recommended for pregnant women although they can be given in some circumstances. Women who are breastfeeding can receive these vaccines. Speak with your doctor for more information.
Where to get help
- Your doctor
- In an emergency, always call triple zero (000)
- Emergency department of your nearest hospital
- Your local government immunisation service
- Maternal and Child Health Line (24 hours) Tel. 132 229
- NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
- Immunisation Program, Department of Health, Victorian Government Tel. 1300 882 008
- National Immunisation Information Line Tel. 1800 671 811
- Your local pharmacist
Things to remember
- Tetanus is a serious bacterial disease that causes muscle spasms and breathing problems.
- Tetanus is uncommon in Australia because of the widespread use of the tetanus vaccine.
- If you get a tetanus-prone wound and you haven’t been immunised in the last 10 years (five years for pregnant women), you should visit your doctor as soon as possible
- The best prevention against tetanus is immunisation.
You might also be interested in:
- Immune system.
- Immunisation - childhood.
- Immunisation - DTP, polio, hep B, and Hib.
- Immunisation - facts and misconceptions.
- Immunisation in secondary schools.
- Immunisation status certificates.
- Immunisations - catch-ups.
- Infections - bacterial and viral.
- Whooping cough.
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Last reviewed: October 2013
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