Tetanus: Risks, Symptoms, and Treatments

Written by:  J.Sace • Edited by: Paul Arnold
Updated Dec 13, 2009

Knowledge of tetanus is indispensable in life preservation. Learn the risks, symptoms, and treatments of this fatal illness.

Clostridium tetani Picture 

The tetanus vaccine becomes very important in hospitals during the New Year’s Eve celebration because patients injured by fireworks are demanding it for protection against tetanus. Well, this is very true in the Philippines where thousands of people are sent to hospitals each year because of fireworks related accidents during the New Year’s celebration. There is still ignorance about this disease among people, especially in developing countries, which is why many are dying without being vaccinated or even seen by a doctor.

Tetanus is an infection caused by Clostridium tetani, an endospore-forming, obligately anerobic, gram-positive, rod-shaped bacterium. It usually thrives in soil contaminated with animal feces.

Tetanus Symptoms

Lock-jaw in a patient suffering tetanus. 

Tetanus symptoms observed in a patient are caused by the neurotoxin tetanosporin, which is released upon the death, or lysis, of the growing C. tetani. The toxin enters the central nervous system through peripheral nerves or the blood. Unlike other bacteria, C. tetani themselves do not spread from the infection site, and there is no observable inflammation. This implies that you could not actually know whether you are infected or not!

How does tetanosporin damage a patient’s body physiologically? Let’s review some basic physiology. In the normal operation of a muscle, a nerve impulse initiates muscle contraction. At the same time, a signal will also be sent to the opposing muscles telling them to relax so as not to oppose the contraction. Tetanosporin will block the relaxation mechanism so that both opposing set of muscles contract – giving the characteristic muscle spasms. One good example of the effect of a muscle spasm is lockjaw – a condition where the mouth is prevented from opening. Normal mouth opening requires that one muscle jaw contracts while the other relaxes. Another serious symptom of tetanus is opisthonos: spasms of the back muscles which cause the heels and the head to bend backward – over bending results in the fracture of the spinal cord, eventually causing paralysis.


Since C. tetani are anaerobes, they multiply best in an environment that lacks oxygen, like in the end of a deep wound. An individual stabbed with a rusty knife has a high risk of acquiring the tetanus bacteria. Drug users are also at risk if they used contaminated drugs and needles. Tissue injuries which are not so deep are often neglected, though medical researchers say that they still pose a risk so long that C. tetani is present in the object that made the wound.

Treatments for Tetanus: Who Needs Tetanus Shot?

Since the 1940s, tetanus vaccines have been available, but vaccination (tetanus shot) was not always as ordinary as it today. Today, the tetanus vaccine is part of the standard DTP childhood vaccine. The vaccine for tetanus is a toxoid, an inactivated toxin that initiates the formation of antibodies that neutralize the bacterial toxin. Maintaining a good immunity against the disease requires vaccination every ten years; however, many people think that a single tetanus shot during a life time is enough, which is why many people fail to undergo revaccination and become infected.

It is the doctor’s decision whether it is necessary to give tetanus shot to an individual who has a severe wound to provide him protection against tetanus. Typically, there is not enough time to administer the vaccine to create antibodies and stop the progression of the infection, even if tetanus shot is provided as a booster to an immunized patient. Nevertheless, temporary immunity can be given by tetanus immune globulin (TIG), prepared from the antibody-containing serum of immunized individuals.

The physician’s decision for treatment greatly depends on the degree of the deep injuries and the patient's history of immunization . Small injuries with minor tissue damage may not be considered a risk for tetanus. Individuals with large injuries who have received three or more tetanus shot within the past ten years may not take the vaccination because they are still protected. The people with extensive wound but no histories of vaccination or with low-immunity are administered with tetanus shot to provide temporary protection. Moreover, the first toxoid series would be administered to give more lasting immunity to the patient.


Nester, Eugene. 2000. Microbiology: A Human Perspective. Boston: McGraw-Hill Higher Education

Clostridium tetani Image

Tetanus patient

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