What causes Tetanus

Tetanus is caused by clostridium tetani, a bacterium which is naturally found in soil and animal manure. Spores of the bacteria gain access to the body when a wound is contaminated, by garden soil for example. Whilst the wound may go unnoticed as the infection may not seem very severe - the bacteria will continue to release a poison called a neurotoxin that attacks the nervous system and causes problems such as muscle spasm.

Who's affected by Tetanus?

Anyone who has a contaminated wound may develop tetanus. Some people such as farmers or those working with soil are at increased risk. In developing countries, the custom of dressing a new-born baby's umbilical cord stump with animal dung often leads to neonatal tetanus.

What are the symptoms of Tetanus?

The tetanus incubation period varies from a few days to a few weeks. This is followed by general tiredness or weakness followed by spasm of the jaw muscles, which is called lockjaw. Spasm of the muscles of the face can make the person appear to have a fixed grin. Spasms may occur spontaneously but may be triggered by stimulation such as noise or light. Other symptoms include:

• problems with swallowing or breathing
• arching of the back and neck
• inability to pass urine
• sweating
• abnormal heart rate and blood pressure

The person usually remains mentally alert. Babies may go off their feed, have poor sucking and become irritable. In severe cases, especially in the very young and elderly, tetanus is often fatal.

How's Tetanus diagnosed and treated?

The diagnosis is usually clear from the symptoms and history. The bacteria may be detected in the wound - but as tetanus is a medical emergency, treatment is usually started based on symptoms alone.

If you suspect tetanus you should get urgent medical help. Treatment should be in hospital. Depending on the severity of the case, sedation, muscle-relaxant drugs and even artificial ventilation to help breathing may be needed. The wound may need to be cleaned to remove the source of the toxin. With treatment most people recover completely.

Further help

Tetanus is a preventable condition. Immunisation is offered as part of the UK vaccination schedule. Boosters are given before school and each ten years subsequently. If your child has a deep wound, you should get medical advice even if they have been vaccinated for tetanus. Don't wait for symptoms.

See the parents guide giving answers to common immunisation questions.