Tetanus is a dangerous disease of the nervous system caused by a neurotoxin produced by Clostridium tetani bacteria. Infection occurs when bacterial spores get into a wound (even a minor one) – especially if the wound has contact with soil, dust, animal faeces or is "dirty" (puncture, crush, lacerated wound, burn, surgical wound, etc.). The source of the pathogen is the environment (spores are common in the environment), and tetanus is not transmitted from person to person. The incubation period is usually 3–21 days (often approx. 14 days); a shorter incubation period may be associated with a more severe course. Most at risk are: non-immunized people or those without booster doses, older people, people with "tetanus-prone" wounds, and in countries with weaker care – also newborns (e.g., umbilical stump infection).
The onset is often non-specific (e.g., headache, fever, sweating, malaise, anxiety, sleep problems), and then symptoms typical for tetanus appear:
The course can be milder (mainly lockjaw and less severe convulsions) or severe, requiring intensive care. Even with modern treatment, tetanus can end in death (risk increases, among others, in elderly people).
When to urgently see a doctor / go to ER? Always when lockjaw, painful muscle spasms, difficulty breathing or swallowing, cyanosis, loss of consciousness appear after an injury – these are potentially life-threatening symptoms.
Tetanus is a cosmopolitan disease (it can occur anywhere), but the greatest burden of cases concerns regions with lower vaccination coverage and poorer access to perinatal care – especially Sub-Saharan Africa and parts of Asia (including South and Southeast Asia). This information is most important for travelers to developing countries, people working physically in the field (contact with soil), volunteers/mission trips, and people planning a longer stay outside large medical centers.
Type of vaccine: the vaccine contains tetanus toxoid (anatoxin) and very often appears as a combined preparation:
For whom recommended: practically for everyone (especially people without current doses), and in adults, booster doses are key.
Schedule for adults:
Doses "after injury": for tetanus-prone wounds, a doctor may recommend a booster earlier than after 10 years, and in some people also tetanus immunoglobulin (TIG) for immediate protection.
When does protection appear? The antibody response after a booster dose increases quickly – usually within approx. 2 weeks.
Tetanus is a severe, potentially fatal neurological disease that can develop even after a minor injury if immunity has waned. The surest protection is vaccination and booster doses – particularly important in adults and before trips to countries with weaker medical care. If you are planning a trip, it is best to check the date of the last dose and possibly get vaccinated at least 2–4 weeks before departure, and with a risky wound – report to a doctor immediately (post-exposure prophylaxis is time-sensitive).