Tetanus (Lockjaw)

In the 1920s and 1930s, in Canada, there were up to 50 deaths a year from tetanus. Because of immunization, death and serious illness decreased dramatically. Between 1980 and 2004, Canada saw an average of four cases of tetanus a year. The last death from tetanus reported was in 1997.

What is tetanus?

Tetanus is a bacterial disease. It affects the nervous system, travelling up nerves via the muscles. The first muscles affected are the jaw muscles, which become stiff and “locked,” which is why tetanus is sometimes referred to as “lockjaw.”

How does it spread?

Tetanus lives in the soil, dust and dirt everywhere, including our backyards and playgrounds. It enters the body through a break in the skin, which can be a small, everyday cut that would normally need no treatment. A popular misconception has it that tetanus lives in rust, hence the popular idea of catching tetanus from stepping on a rusty nail. Rusty nails are often found outside, and can be contaminated with the tetanus bacterium, but it’s not the rust itself that causes tetanus.

Signs and Symptoms

The first symptom of tetanus is stiffness that moves through the body, starting with the jaw, neck and stomach. It can affect breathing and swallowing, and is extremely painful. The symptoms can occur from days to months after exposure to the bacterium. If left untreated, tetanus infection can lead to seizures and death.

How can I protect myself and people around me?

The only real protection against tetanus is immunization. The tetanus vaccine is included in a combined vaccine called DTaP, for younger children, and Tdap and Td for older children and adults.

Tetanus immunization is not given on its own. Throughout the world it is given together with protection against other diseases together in one immunization.

In Yukon, tetanus is a part of the combination immunization DTaP-HB-IPV-Hib, which protects infants and children from: diphtheria, tetanus, pertusiss, Hepatitis B, polio and Haemophilus influenzae type B, all in one shot.

The routine Yukon immunization schedule recommends:

  • DTaP-HB-IPV-Hib  immunization at 2, 4 and 6 months of age

  • A dose (DTaP-IPV-Hib) at 18 months

    • After the dose at 18 months, children have completed the primary series against diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type B. After this they need a booster dose against tetanus when they start school and again in 10 years.
  • Booster dose (DTaP-IPV) at four to six years old

  • Booster dose (Tdap)  in Grade 9

  • As an adult you also need a tetanus-diphtheria booster shot every ten years to remain protected. These boosters keep the immunizations you received as a child working.

You need the primary series and booster doses to be protected. If you missed your booster dose, your body may not continue to protect itself from tetanus. Contact your local health centre for drop-in and appointment times to be immunized.

Most children and adults have no reactions to immunization. Some people have minor reactions to immunization. These reactions do not interfere with day-to-day activities and go away on their own in two to three days. The most common reaction is swelling and redness with or without tenderness around the injection site. A few people develop fever (one to 18 in 100 children immunized), headaches or muscle pain. If this is the case with you or your child, you many choose to give/take a fever medication such as acetaminophen if the fever is 38.5°C or higher.

Any fever medication such as acetaminophen, before the immunization is not recommended.  

More About Tetanus

If you’ve been exposed to tetanus, you can be treated with a post-exposure tetanus prophylaxis, which is a shot given after a tetanus-causing injury to prevent infection. The treatment will depend on the patient’s last booster shot, how many tetanus immunizations the patient has received, the kind of wound, and current health status.

You can only obtain a post-exposure tetanus prophylaxis if you know you’ve been exposed to tetanus. Very often the wound is minor and treated at home, with no thought given to the potential exposure to the tetanus bacterium. This is why it is important to be immunized against tetanus and to keep up the booster shots.

According to the Public Health Agency of Canada, children who survive tetanus have continuing problems with brain function, including speech and memory.