| Tetanus | |
|---|---|
| Other names | Lockjaw |
 | |
| Muscle spasms (specifically opisthotonos) in a person with tetanus. Painting by Sir Charles Bell, 1809. | |
| Specialty | Infectious disease |
| Symptoms | Muscle spasms, fever, headache[1] |
| Usual onset | 3–21 days following exposure[1] |
| Duration | Months[1] |
| Causes | Clostridium tetani[2] |
| Risk factors | Break in the skin[3] |
| Diagnostic method | Based on symptoms[1] |
| Prevention | Tetanus vaccine[1] |
| Treatment | Tetanus immune globulin, muscle relaxants, mechanical ventilation[1][4] |
| Prognosis | 10% risk of death[1] |
| Frequency | 209,000 (2015)[5] |
| Deaths | 56,700 (2015)[6] |
Tetanus, also known as lockjaw, is a bacterial infection characterized by muscle spasms.[1] In the most common type, the spasms begin in the jaw and then progress to the rest of the body.[1] Each spasm usually lasts a few minutes.[1] Spasms occur frequently for three to four weeks.[1] Some spasms may be severe enough to fracture bones.[7] Other symptoms of tetanus may include fever, sweating, headache, trouble swallowing, high blood pressure, and a fast heart rate.[1][7] Onset of symptoms is typically three to twenty-one days following infection.[1] Recovery may take months.[1] About ten percent of cases prove fatal.[1]
Tetanus is caused by an infection with the bacterium Clostridium tetani.[2] The organism is commonly found in soil, saliva, dust, and manure.[3] Illness generally occurs through a break in the skin such as a cut or puncture wound by a contaminated object.[3] Toxins secreted by C. tetani interfere with normal muscle contractions.[4] Diagnosis is based on the presenting signs and symptoms.[1] The disease does not spread between people.[1]
Tetanus can be prevented by immunization with the tetanus vaccine.[1] In those who have a significant wound and have had fewer than three doses of the vaccine, both vaccination and tetanus immune globulin are recommended.[1] The wound should be cleaned and any dead tissue should be removed.[1] In those who are infected, tetanus immune globulin or, if unavailable, intravenous immunoglobulin (IVIG) is used.[1] Muscle relaxants may be used to control spasms.[4] Mechanical ventilation may be required if a person's breathing is affected.[4]
Tetanus occurs in all parts of the world but is most frequent in hot and wet climates where the soil has a high organic content.[1] In 2015 there were about 209,000 infections and about 59,000 deaths globally.[5][6] This is down from 356,000 deaths in 1990.[8] In the US there are about 30 cases per year, almost all of which have not been vaccinated.[9] An early description of the disease was made by Hippocrates in the 5th century BC.[1] The cause of the disease was determined in 1884 by Antonio Carle and Giorgio Rattone at the University of Turin, and a vaccine was developed in 1924.[1]