Most people think tetanus is caused by stepping on a rusty nail or receiving a serious puncture wound. But in reality, tetanus bacteria is everywhere, especially in dirt, dust and manure, and it can enter the body through a tiny pinprick, scratch from an animal, splinters, bug bites and burns that break the skin.

A tetanus infection can be deadly. As many as 40 percent of people who get a tetanus infection die from it. The disease affects the nervous system and can result in spasms strong enough to break bones.

One condition that often happens with tetanus is a spasm and tightening of the mouth that causes the jaw to stiffen, also called lock jaw. Tetanus infection also can cause the muscles of the diaphragm to spasm and tighten, making it difficult to breathe. The disease can lead to dangerously high blood pressure, breathing failure and pneumonia that can result in coma or death.

More adults are taking the threat of tetanus lightly - because vaccination is almost 100 percent effective - however, it is important to have your tetanus booster.

Tetanus Shots

Most people received a series of tetanus vaccinations when they were children. It is administered in children usually in combination with vaccines against other illnesses such as pertussis (whooping cough) and diphtheria.

Tetanus shots generally are required for children before starting school. Five doses of vaccine are recommended before the age of 6. After the initial series of immunizations, a booster of tetanus and diphtheria vaccine (referred to as Td) should be given at 11-12 years of age and every 10 years after that.

When Should I Get a Tetanus Booster?

If it has been more than 10 years since you had a tetanus shot. For most adults, the protection from a tetanus shot falls off with time.

If you're 50 years and older. According to the CDC, a number of people in this age group didn't receive their first tetanus shots during childhood. If you are in this age group and haven't had these shots, you should start with a series of three Td shots.

If you are unsure or have no records of receiving the first series of tetanus shots or boosters as a child.

If you're traveling to a country with hot, damp climates and soil that contains a lot of organic matter.

If you're an agricultural worker, or if you work with dirt and manure.

If your job or activities cause a lot of cuts and scrapes on your skin.

If you're recovering from tetanus infection. Having a case of tetanus does not mean you cannot get it again.

Pregnant women who have not been immunized and haven't received a recent booster or may deliver in an unhygienic place. When you are immunized, antibodies that fight the disease are passed from you to your fetus. (Please consult your healthcare provider, especially if you are in the first trimester of pregnancy.)

If you are hurt and require emergency tetanus treatment.

Are There Side Effects?

You probably will be sore for a day or two near the spot of the vaccination. You also might experience some redness and swelling where the shot was given for 1-2 days.

You can treat these symptoms by taking a non-aspirin pain reliever, such as acetaminophen or ibuprofen.

It's very rare you would have a serious allergic reaction from the Td vaccine, but if you experience a deep, aching pain and loss of muscle in your upper arm(s) that starts 2 days to 4 weeks after you get the shot, contact your healthcare provider right away.

Resources

1. Federal Department of Agriculture. (1996, July-August). Adults need tetanus shots, too. Retrieved April June 18, 2004 from the World Wide Web: http://www.fda.gov/fdac/features/696_tet.html

2. CDC. (1994, June 10). Tetanus and diphtheria vaccine (Td): What you need to know before you or your child gets the vaccine. Retrieved June 18, 2004 from the World Wide Web: http://www.cdc.gov/nip/publications/VIS/vis-td.pdf

Tom Kerr is consulting editor at ADVANCE.