May 11, 2020

How to Protect Yourself Against a Tetanus Infection

You can get it from more than just rusty nails

Woman working in garden

When the sun is shining, you can’t wait to get out and work in the garden. But before you get your hands dirty, ask yourself a question. When was your last tetanus shot?


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A tetanus infection starts when spores of the Clostridium tetani bacterium enter the body through broken skin. Most people link tetanus with an injury like stepping on a rusty nail.

But tetanus is everywhere: in soil, dust and animal waste. You can also get it from insect bites, animal bites, scratches or a tiny crack in the skin. Some cases come from scratches or small wounds that happen while gardening.

Because there’s no known cure for tetanus, it’s important to be aware of how it can happen, what it does to your body and make sure your tetanus booster is up to date.

Tetanus doesn’t always involve visible punctures

According to the CDC, it doesn’t take much for tetanus to enter the body. Something as innocent as a scrape can leave enough of a break in the skin for it to invade.

Infectious disease specialist Susan Rehm, MD notes that patients sometimes don’t even know they’ve hurt themselves in a way that can result in a case of tetanus. In one case, she says, a patient contracted the disease via a splinter in the pad of his thumb with no visible puncture wounds.

Fortunately, that patient survived but only after many months in intensive care. Not all patients are so lucky. According to the CDC, around 11% of tetanus infections prove to be fatal.


How tetanus attacks your body

Tetanus is hard to diagnose early on because so much of the damage happens internally. The spores of the tetanus bacteria enter the bloodstream through a break in the skin and then thrive and germinate inside the body. The germinating spores produce a toxin that disrupts the nervous system, first affecting the nerves nearest to the break in the skin.

From there, the infection spreads to the spinal cord and brain. Within five to ten days, tetanus shows its most frightening symptom: lockjaw.

The patient’s neck stiffens and there is difficulty swallowing. The abdomen grows rigid. As the toxins spread, general muscle spasms begin. Additional symptoms can include headaches, fever and seizures.

Once tetanus is underway, there is no stopping it. Tetanus can only be managed, not cured. But the good news is how easily preventable tetanus is.

The best prevention

Fortunately, a highly effective vaccine delivers full immunity from tetanus. The vaccine is given in early childhood through a series of shots and subsequent boosters. Many people don’t know that teens and adults need to receive booster shots every 10 years to maintain the needed level of protection.

Dr. Rehm advises everyone to receive at least one dose of Tdap, the tetanus and diphtheria vaccine that also protects against whooping cough (pertussis). Adults 19 years of age and older should receive Tdap or Td (tetanus and diphtheria vaccine without the pertussis component) every 10 years.


Another reason for adults to stay up to date with Tdap immunization is to protect infants they may come into contact with against whooping cough. Pregnant people are also advised to get Tdap with each pregnancy.

If you’re working in the garden, be sure to wear gloves to protect your hands from scrapes and to prevent possible infections via already present breaks in the skin.

Of course, it’s also important to practice good, safe wound care. Even if it’s a cut or scrape that seems like no big deal, be sure to wash the wound with soap and water and care for it properly, including bandaging, to prevent infection.

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