The tetanus bacteria usually enter the body through a wound or cut in the skin. Once inside, the bacteria multiply and release a neurotoxin (poison) called tetanospasmin, which causes the symptoms of tetanus to develop.
Tetanospasmin can spread through the bloodstream, blocking the nerve signals from the spinal cord to the muscles. This causes muscle spasms (involuntary contractions) and rigidity (stiffness) throughout the body, particularly in the neck, face and jaw (lockjaw).
Due to its potential seriousness, tetanus is a notifiable condition. This means that when the condition is diagnosed, the doctor making the diagnosis must inform the local authority under the Public Health (Infectious Diseases) Regulations (1988).
How common is tetanus?
In the UK since 1961, babies and young children have been routinely vaccinated against tetanus as part of the national childhood vaccination programme. Therefore, in the UK, tetanus infections are rare and most cases affect people over 65 who have not been vaccinated.
For example, from 1984 to 2004, there were 198 cases of tetanus in England and Wales, of which:
The highest number of tetanus cases during this period was in adults over 65 years of age. This is because people in this age category were not routinely vaccinated against tetanus as children. There were no reported cases in children under five years of age.
Since 1991, the number of tetanus cases has been consistently low, with an average of six cases occurring each year.
Neonatal tetanus
In the UK, there have been no cases of neonatal tetanus (tetanus in newborn babies) for over 30 years. However, in many developing countries, neonatal tetanus is still a public health problem. It is usually caused if the umbilical stump becomes infected when the umbilical cord is cut using unsterilised equipment.
One of the World Health Organization’s aims was to eliminate neonatal tetanus worldwide by 1995. However, the condition has not yet been totally eradicated, but the number of countries reporting cases is steadily decreasing.
Tetanus vaccination
All young children are offered the tetanus vaccine as part of the routine NHS childhood vaccination programme.
The tetanus vaccine encourages the body to create antibodies (infection-fighting cells) that provide a defence against tetanospasmin. This provides protection from the illness should you become infected with the tetanus bacteria.
The full course of the tetanus vaccine consists of five doses. The primary course consists of three injections, which provide protection against the infection for a number of years. The fourth and fifth doses are booster doses, which help maintain protection.
After the fifth dose, immunity remains for life and further boosters are not usually required, unless there is doubt about a person’s vaccination history or you are travelling to a remote area of the world where treatment for a tetanus infection may not be readily available.
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Page last updated: Wednesday 17 November 2010, 13:50
