What Is Tetanus, and How Can You Prevent It?

Tetanus is a rare but life-threatening disease. It’s caused by a germ called Clostridium tetani (say: klos-TRID-ee-um teh-TAN-eye), or C tetani for short. The good news is that tetanus is almost entirely preventable with a vaccine.

What Is Tetanus?

Tetanus is a serious infection that affects your nervous system. It happens when C tetani bacteria get into your body and make a toxin (a poison). That toxin travels to your brain and spinal cord, where it blocks the signals your nerves use to control your muscles. This causes painful, uncontrollable muscle spasms that can become severe enough to be deadly.

How Do You Get Tetanus?

C tetani bacteria live in soil, dust, and manure. You can get tetanus when these bacteria get into your body through a break in your skin, such as a puncture wound, a cut, or a burn. Once inside a wound, the bacteria grow and start producing their toxin.

Who Is Most at Risk?

You’re at higher risk for tetanus if you haven’t been fully vaccinated against it, or if you’re overdue for a booster shot. Risk goes up further if you also have a skin injury, especially a puncture wound, a crush injury, or a burn. Chronic wounds are riskier for people with diabetes or a weakened immune system. Other risk factors include being older than 80, using intravenous (IV) drugs, and, for newborns, having the umbilical cord cared for in a nonsterile way.

Tetanus is uncommon in the United States. Between 2013 and 2023, the CDC reported 267 cases and 13 deaths nationwide. It’s a much bigger problem worldwide for newborns: the World Health Organization estimates that newborn tetanus caused about 24,000 deaths globally in 2021. Newborn tetanus has been rising in at least 18 countries since 2020 because the COVID-19 pandemic disrupted vaccination programs.

What Are the Symptoms?

Symptoms usually show up about 10 days after infection. The first sign is often jaw muscle spasms, sometimes called “lockjaw.” Painful muscle spasms can also spread to the face, neck, back, and abdomen, which can make it hard to swallow or breathe. Fever and sweating are common. Later on, blood pressure and heart rhythm can swing dramatically.

How Is Tetanus Diagnosed and Treated?

Doctors diagnose tetanus based on your symptoms and history — there’s no lab test that confirms it. Tetanus is a medical emergency. It requires close monitoring in an intensive care unit because of the risk of breathing failure and heart or blood pressure problems.

Treatment includes a single shot of human tetanus immunoglobulin, a medicine that neutralizes the toxin and stops symptoms from getting worse. Patients also get a full series of tetanus vaccinations, even if they were vaccinated before. Doctors clean the wound thoroughly and remove any damaged tissue around it. Antibiotics, usually metronidazole or penicillin, are also given. Muscle spasms may be eased by limiting loud noise, touch, and bright light, and medicine may be used to relax the muscles in severe cases. If breathing becomes difficult, a patient may need a ventilator for weeks while they recover.

How Can You Prevent Tetanus?

Vaccination is the best way to prevent tetanus. The CDC recommends a 5-shot vaccine series for children younger than 7, given as part of a combination vaccine that also protects against diphtheria and pertussis (whooping cough), known as DTaP. Adolescents and adults should get an updated tetanus booster every 10 years.

If you get a puncture wound or a wound with soil in it, seek medical care right away. Depending on your vaccination history and how serious the wound is, you may need a tetanus booster, tetanus immunoglobulin, or both.

Source: Zhou S, Malani P. “What Is Tetanus?” JAMA, published online April 30, 2026. doi:10.1001/jama.2026.2744