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What Is Tetanus? Where It Hides & Why You Should Care

worker about to step on a nail

If you think of terrible diseases, tetanus probably isn't among the first to come to mind. Unless you happen to step on a rusty nail, you likely don't think a lot about tetanus shots. But tetanus is actually a very painful and serious disease. We talked to infectious diseases doctor Steven Zeichner, MD, to learn exactly what tetanus is and how to avoid it.

What Is Tetanus?

The Clostridium tetani bacteria creates a toxin that causes tetanus. This bacteria lives in dirt and in your gastrointestinal tract. The bacteria exists as "spores" for a long time. That means it usually hangs out in your backyard or inside your stomach without causing problems.

The bacteria makes you sick when it gets into your body (outside your digestive tract) and makes toxins. It can get in through:

What Does Tetanus Do?

Tetanus infection is a medical emergency and needs long-term hospital care. There's no cure. Treatment includes aggressive wound care and drugs to fight the infection and ease symptoms and pain.

Tetanus makes a toxin that poisons your nervous system cells. This keeps your muscles from relaxing after they contract. Think of a charley horse or muscle cramp that won't stop.

The first sign is usually "lockjaw" or muscles spasms in the jaw. Other symptoms include:

You can get severe complications like broken bones from severe muscle spasms. Or you might need a ventilator to help you breathe.

In 2017, an unvaccinated 6-year-old was hospitalized for tetanus and suffered a painful 2 months of treatment, which cost almost a million dollars.

Could I Get Tetanus?

It's rare, especially in the U.S. There were only 17 reported cases in 2021. That's because tetanus shots are part of the normal vaccines most Americans get.

However, some countries don't provide tetanus booster shots. There were more than 73,000 cases worldwide in 2019.

When Do I Need a Tetanus Vaccine?

The Centers for Disease Control and Prevention recommends:

These vaccines also protect against whooping cough (pertussis) and diphtheria. Read the CDC's full guidelines for tetanus, whooping cough, and diphtheria vaccines.

You should ask your doctor about a vaccine if you get an open wound and you're not sure when your last shot was.

Zeichner explains that getting a second dose even within five years of a shot won't hurt you. Insurance usually covers this routine vaccine. And the cost of the vaccination definitely beats the hospital bill if you get sick.

Schedule a Checkup

Has it been a while since your last vaccine?

What's the Deal With Rust?

Zeichner isn't sure where the idea that rust transmits tetanus came from. He notes something rusty is probably also dirty enough to harbor the bacteria.

The bacteria lives in dirt but can move through the air, landing on something like a rusty nail.

Clean Your Wounds

It's good practice to clean your wounds and it helps prevent tetanus. Wash with mild soap and water to remove any bacteria. Even a wound caused by something clean, like kitchen knife, can put you at risk for tetanus.

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