Wednesday, Nov 12, 2025 22:15 [IST]
Last Update: Tuesday, Nov 11, 2025 16:34 [IST]
What is Tetanus and how does it affects our immune system?
Tetanus is a serious, often fatal, bacterial disease that affects the nervous system, leading to painful muscle stiffness and spasms, commonly known as "lockjaw". It is not contagious and is preventable through vaccination. The disease is caused by a potent neurotoxin, tetanospasmin, produced by the bacteria “Clostridium tetani”. The bacteria's spores are commonly found in soil, dust, and animal feces and enter the body through breaks in the skin, such as puncture wounds, cuts, burns, or animal bites. Once inside the body, in low-oxygen (anaerobic) conditions, the spores become active bacteria and produce the toxin. The toxin then spreads via the bloodstream and lymphatic system to the central nervous system, including the spinal cord and brain. The core mechanism of attack is the toxin's interference with the nerves that control muscles. It blocks the release of inhibitory neurotransmitters, such as glycine and gamma-aminobutyric acid, in the central nervous system. This blockage leaves the excitatory nerve impulses unopposed, resulting in continuous, unopposed muscle contraction and painful spasms.
The first common symptom is stiffness and painful spasms in the jaw muscles, making it difficult to open the mouth or swallow. This is known as “lockjaw”. The stiffness and spasms spread to other parts of the body, including the neck, back, abdomen, and limbs. Severe back muscle spasms can cause the body to arch backward. The muscle rigidity and spasms can lead to severe complications, including spasms of the vocal cords, neck, and respiratory muscles can obstruct the airway and cause life-threatening breathing difficulties or respiratory failure. The toxin can affect the autonomic nervous system, leading to fluctuations in heart rate (rapid or slow), high or low blood pressure, fever, and extreme sweating. Aspiration pneumonia (lung infection from inhaling spit or vomit) is a common complication. Even with modern intensive care, tetanus can be fatal, with death often caused by airway obstruction or cardiac arrest.
Myth: Is Tetanus Toxoid is a Vaccine or needs to have a shot of single dose after the wound is developed?
Like other vaccines, “Tetanus Toxoid” is a vaccine and the vaccine doses have to be completed in regular schedule as advised by the medical professional. Unfortunately the myth is that after the wound is developed by a knife cut, old iron nail puncture in the feet, cut developed during regular household cleaning of utensils, bite from a dog or cat, we are advised to take an injection of “Tetanus Toxoid” (single shot) from a medical practioner (we used to go to a chemist and get injected) and we feel ourselves safe without consulting a doctor.
Real fact: Tetanus Toxoid is a Vaccine and it requires completion of vaccination course
In reality, if we are hurt or injured by the rusted iron nails in a construction site or by a knife during cutting vegetables, fruits or even a dog bite, we do take tetanus toxoid injection. Are we safe after the intake? Absolutely not. Because, the tetanus toxoid we have taken will start the vaccination process only unless we had previously completed the vaccination schedule in one month shot after the first one followed by booster dose in 6 months and in 5 years. So, the question is whether the tetanus toxoid injection that we have taken after the injury will not work? Answer is it will start working and try to build antibody against the bacteria but there is no guarantee that the present injury will be covered and we will be safe. In these cases, we have to take another tetanus toxoid known as “Immunoglobulin tetanus toxoid” which is very costly but will certainly built antibody against the bacterial infection of tetanus. Immunity power of tetanus vaccine becomes effective only after 3-4 weeks of vaccination course.
Tetanus in young patients is extremely rare since tetanus toxoid vaccination became mandatory in 1968. However, unexpected tetanus infection has been reported in young, immunized patients.
Tetanus is a severe, life-threatening condition. But with proper treatment, most people recover.
There's no cure for tetanus. Treatment focuses on managing symptoms and complications until the effects of the tetanus toxin resolve. Tetanus can be prevented through immunization with tetanus-toxoid-containing vaccines (TTCV). However, people who recover from tetanus do not have natural immunity and can be infected again.
The majority of reported tetanus cases are birth-associated among newborn babies and mothers who have not been sufficiently vaccinated with TTCV. In 2018, about 25 000 newborns died from neonatal tetanus, a 97% reduction since 1988, largely due to scaled-up immunization with TTCV.Tetanus is a medical emergency requiring care in the hospital immediate treatment with medicine called “Human Tetanus Immune Globulin” (HTIG). People who recover from tetanus do not have natural immunity and can be infected again, and therefore need to be immunized.
To be protected throughout life, WHO recommends that an individual receives 6 doses (3 primary plus 3 booster doses) of TTCV. The 3-dose primary series should begin as early as 6 weeks of age, with subsequent doses given with a minimum interval of 4 weeks between doses. The 3 booster doses should preferably be given during the second year of life (12–23 months), at 4–7 years of age, and at 9–15 years of age. Ideally, there should be at least 4 years between booster doses. The disease remains an important public health problem in many parts of the world, but especially in low-income countries or districts, where immunization coverage is low, and unclean birth practices are common. Neonatal tetanus occurs when nonsterile instruments are used to cut the umbilical cord or when contaminated material is used to cover the umbilical stump. Deliveries carried out by people with unclean hands or on a contaminated surface are also risk factors.
The latest guidelines (2023) recommend a primary childhood series of three doses, followed by booster doses at 18 months, 4–7 years, 9–15 years, and every 10 years thereafter. For adults, a booster is needed every 10 years, and an emergency booster may be required for a tetanus-prone wound if more than 5 years have passed since the last dose. Pregnant women should receive the vaccine between the 27th and 36th week of gestation to protect the newborn.
