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Tetanus Symptoms and Treatment

Contributor Ellen Nagami, MD, MPH
1 minute read
A child getting vaccinated

If you’ve ever stepped on a rusty nail and then immediately needed a vaccine, you might be familiar with tetanus. But tetanus can have more causes than you might think.

“Tetanus is a sometimes fatal disease of the central nervous system, which is the brain and spinal cord,” explains Ellen Nagami, MD, MPH. Dr. Nagami is a Mass General Brigham infectious disease doctor who cares for patients at Brigham and Women’s Hospital.

“Tetanus is often thought of as occurring only because of stepping on a rusty nail or being bitten by a dog. But actually, tetanus bacteria can infect the body through any open wound, especially deep, penetrating ones,” says Dr. Nagami. In developing countries, some newborns develop tetanus when the umbilical stump becomes infected. The risk is even higher when the mother hasn’t been immunized.

Thanks to safe and effective vaccines, cases of tetanus in the U.S. are fortunately rare. Learn more about tetanus and the importance of vaccination to prevent this deadly disease. 

What causes tetanus? 

Tetanus bacteria occur in nature, often found in soil and manure. “They can also be found in the human intestine and other places,” Dr. Nagami notes, but they don’t spread from person to person. The bacteria only enter the body through an open wound, like a puncture wound or a burn. 

Once inside the body, the tetanus bacteria make a poison that causes painful and uncontrollable muscle spasms or contractions. Tetanus can also be called “lockjaw,” because of the effect is has on the body. 

Symptoms of tetanus infection

Symptoms for tetanus often don’t show up right away. “It may take 3 to 21 days to develop symptoms. On average, symptoms appear around day 8,” Dr. Nagami says. In infants, symptoms can develop from 3 days to 2 weeks.

The most common signs and symptoms of tetanus are:

  • Stiff abdominal and back muscles
  • Contraction of the facial muscles
  • Painful muscle spasms, especially near the wound area
  • Fever
  • Fast pulse
  • Trouble swallowing
  • Difficulty breathing

A tetanus infection is a medical emergency that requires hospital care. With severe symptoms, patients may not be able to breathe on their own. If you’re having trouble swallowing, difficulty breathing, or are concerned you may have tetanus, call 9-1-1 or go to an emergency room.

Tetanus treatments

Staying up-to-date on vaccines can prevent an infection in the first place. Your doctor may recommend getting an updated vaccine after an injury, just in case. If you or someone you know has a wound that could potentially lead to an infection, get urgent or emergency medical care right away. If there’s heavy bleeding, call 9-1-1. The emergency providers will make sure the wound is properly cleaned to prevent an infection and give you an updated vaccine if necessary.

Treatment for tetanus may include:

  • Thoroughly cleaning the wound
  • Medicines to control spasms
  • Antitoxin injections, which neutralize the toxins produced by the bacteria
  • Antibiotics to kill the tetanus bacteria
  • Other medicines to control pain and other symptoms, such as a fast heartbeat
  • Use of a ventilator breathing machine if you have trouble breathing on your own 
The best way to prevent tetanus is to get the vaccine.

Ellen Nagami, MD, MPH

Infectious Diseases Doctor

Mass General Brigham

What is the tetanus shot called?

“The best way to prevent tetanus is to get the vaccine,” says Dr. Nagami. The vaccines to prevent tetanus are safe and extremely effective, and the Centers for Disease Control and Prevention (CDC) recommends tetanus vaccination for everyone.

There are three different types of vaccines in the U.S. to prevent tetanus and other diseases. They are:

  1. DTap: Protects against diphtheria, tetanus, and pertussis (whooping cough)

  2. Tdap: Protects against tetanus, diphtheria, and pertussis

  3. Td: Prevents tetanus and diphtheria

The CDC recommends that children get 5 DTaP vaccines between the ages of 2 months and 6 years, and that pregnant people should get the vaccine during each pregnancy.

Adults receive the Tdap shot and should get a booster shot every 10 years. If you have an injury that leaves you at risk of tetanus, you can receive the booster shot before the 10-year mark. 




Children age 2 months to 6 years


5 total vaccines


TDap or Td booster

Every 10 years, or after 5 years if you have a severe wound or burn

Pregnant adults


Once per pregnancy

“The good news is tetanus has become very uncommon in the U.S. due to widespread vaccination,” confirms Dr. Nagami. The other diseases treated with the vaccines, diphtheria and pertussis, used to be major causes of serious illness and death for children in the United States. Vaccines have made those relatively rare, as well. 


Diphtheria is a serious bacterial infection that spreads from person to person through coughing or sneezing. The bacteria release a toxin that damages tissues in the body, and can cause:

  • Difficulty breathing
  • Skin sores
  • Damage to the heart, kidneys, and nerves
  • Death

Treatment includes antitoxins to prevent damage to the body and antibiotics to kill the bacteria. Without treatment, up to half of patients die from the disease. Thanks to vaccines, diphtheria infections are very rare in the U.S.


Pertussis is another serious bacterial infection that affects the airways. It’s spread from person to person through coughing or sneezing. The bacteria produce toxins that cause the airways to swell.

In adults, pertussis can present as the common cold. For unvaccinated adults, or younger children and babies who haven’t been fully vaccinated yet, pertussis can cause serious complications and even death.

Pertussis can cause:

  • Difficulty breathing
  • Violent coughing, including a high-pitched “whoop” sound. Patients have been known to vomit or even fracture ribs due to the severity of the cough.
  • Apnea (pauses in breathing) or cyanosis (turning blue or purple due to lack of oxygen)
  • Death

Doctors usually treat pertussis with antibiotics. According to the CDC, rates of pertussis infections have gone down 75% since the 1940s due to vaccines.  


Infectious Disease Doctor