We’ve all heard of tetanus, we know we should be vaccinated against it, but what actually is it? Tetanus is a bacterial infection, caused by the bacterium Clostridium tetani. And Clostridium tetani is pretty ubiquitous. It tends to live in soil and dirt pretty much everywhere. It can get into your body through a break in your skin – this might be a larger, obvious skin wound. But it can also be a tiny cut or even a prick in your skin, say from a thorn on your rosebush while you are gardening. Once inside your body, the bacterium can then produce a toxin (a toxic chemical) which can attack your nervous system and your muscles, leading to the symptoms of tetanus.
What symptoms does tetanus cause?
It can take up to 21 days for the symptoms of tetanus to develop after the bacterium first gets into the body. The classic first symptom is stiffness of the muscles of the jaw – you may have heard tetanus referred to as ‘lockjaw’ before – the person might find it difficult to open their mouth.
Then the stiffness symptoms can spread to involve the neck muscles and the muscles of the arms and legs. And the person can get spasms in these muscles as well. Spasms in the muscles around the neck can lead to swallowing difficulties, and if the muscles of breathing around the chest wall are involved, then this can lead to breathing difficulties.
A person with tetanus also tends to have a high fever. Tetanus can be fatal if it’s not treated.
How often do we see tetanus these days?
We don’t see tetanus very often because of the possibility of vaccinating against it but we do still see it sometimes. Each year in Switzerland, there are up to two cases of tetanus.
The people who tend to contract tetanus now are:
- People who have never been vaccinated.
- People who haven’t completed their vaccination schedule.
- Intravenous drug users who tend to have lots of dirty skin wounds.
What are the current guidelines in Switzerland regarding tetanus vaccination?
In Switzerland, 3 doses of tetanus vaccine are given during the standard immunisations for babies – usually at 2, 4 and 6 months. A 4th dose is given between 15 and 24 months, and a 5th dose between the ages of 4 and 7 years.
These first 5 doses of the tetanus vaccine are given in a combined vaccine with diphtheria and whooping cough.
A 6th dose of tetanus vaccine is recommended for adolescents somewhere between the ages of 11 and 15 years and then a seventh dose when you’re 25 years old.
Then, the recommendations are that adults between the ages of 25 and 64 should have a tetanus booster every 20 years, and then after the age of 65, every 10 years.
Sometimes more frequent vaccination with tetanus is suggested, for example for people who are travelling to various countries, or for people with immune system deficiencies.
Check your records to see if you have had all of the suggested doses of tetanus vaccine. Speak to your doctor if you think that anything is incomplete or if you have any questions.
You can find the full Swiss vaccination schedule here.
What happens if I injure my skin? Do I need another tetanus vaccination?
For superficial, clean, skin wounds that are low risk for tetanus:
If you are aged 25 to 64:
- If you haven’t had a tetanus vaccination in the last 20 years, or if you’ve had less than 3 doses of tetanus vaccine in the past, or if your vaccination status is unknown, another tetanus vaccination is recommended.
If you are under 25 years old:
- If you haven’t had a tetanus vaccination in the last 10 years, or if you’ve had less than 3 doses of tetanus vaccine in the past, or if your vaccination status is unknown, another tetanus vaccination is recommended.
If you are over 65 years old:
- If you haven’t had a tetanus vaccination in the last 10 years, or if you’ve had less than 3 doses of tetanus vaccine in the past, or if your vaccination status is unknown, another tetanus vaccination is recommended.
For dirty wounds, or more severe wounds, where the risk of tetanus is increased:
- If you are aged 25 to 64 and you haven’t been vaccinated against tetanus in the last 10 years, or if you’ve had less than 3 doses of tetanus vaccine in the past, or if your vaccination status is unknown, another tetanus vaccination is recommended.
- If you are under the age of 25 and you haven’t been vaccinated against tetanus in the last 5 years, or if you’ve had less than 3 doses of tetanus vaccine in the past, or if your vaccination status is unknown, another tetanus vaccination is recommended.
- If you are over the age of 65 and you haven’t been vaccinated against tetanus in the last 5 years, or if you have had less than 3 doses of tetanus vaccine in the past, or if your vaccination status is unknown, another tetanus vaccination is recommended.
If in doubt about whether a tetanus vaccination is needed when you injure your skin, you can always speak to a doctor on-call or someone in the Accident Emergency department for advice.
Written by Dr Michelle Wright
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. All reasonable care has been taken in compiling the information but there is no legal warranty made as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. HealthFirst and Dr Michelle Wright are not responsible or liable, directly or indirectly, for any form or damages whatsoever resulting from the use of information contained in or implied in this article.
