By: Yarlini Vipulanandan, MD, FAAP
Tetanus is a serious infection. It affects the body’s system that controls muscle movement. The bacteria that causes tetanus lives around us in the soil or dust.
Your child can be exposed to tetanus through any break in their skin, like a cut or a deep wound. The bacteria makes a toxin that causes painful muscle spasms.
Tetanus is often called "lockjaw" because it causes stiffness in the jaw and neck muscles, making it difficult to open the mouth or swallow.
Read on to learn more about tetanus in children, including symptoms, causes, treatment and why the DTaP vaccine is so important. Find out how tetanus spreads, when to call a doctor and how to protect your child.
How do kids get tetanus?
Tetanus is more common in warmer climates and during warmer months, when outdoor activities lead to more cuts and scrapes. These breaks in the skin can make it easier for germs to enter the body.
The germ that causes tetanus lives in soil and in animal and human intestines. If someone has a wound that gets dirty with soil or feces (poop), there is a chance they’ll get tetanus.
Once the germ is inside a wound, it grows and makes toxins. The deeper the cut, the higher the risk of getting sick.
Tetanus signs & symptoms in children
Symptoms of tetanus infection show up between 3 and 21 days after the germ gets inside a wound. Most people start feeling the symptoms 8 days after they get infected
When a wound gets very dirty, symptoms will show up faster and people can get sicker. Symptoms can also appear sooner when the injury is on the head or closer to the central nervous system, including the brain and spinal cord.
Newborns can get tetanus (called neonatal tetanus) if they are born in unclean conditions. It happens when someone cuts their umbilical cord with an object that has germs on it. This can allow tetanus bacteria to enter the body through the umbilical stump. Symptoms of neonatal tetanus usually show up within 7 days.
Children with a tetanus infection may have symptoms including:
"Lockjaw" (trismus) and problems opening the mouth or swallowing
Spasms of the back muscles, sometimes causing the body to arch backward
"Boat-shaped" abdomen (spasms of the abdominal muscles)
Spasms of the face muscles
Headache
High blood pressure
Racing heart and sweating
The muscle spasms can be anywhere from mild to severe. In severe cases, muscle spasms from tetanus can be strong enough to cause bone fractures and even interfere with breathing. Severe muscle spasms can last for one week and take multiple weeks to recover from.
People with tetanus may also develop lung infections if they inhale saliva or vomit (aspiration).
What parents can do to prevent tetanus in children
We can’t get rid of the tetanus germ. It lives in the environment all around us. But we can use the vaccine to avoid getting sick with tetanus.
The DTaP vaccine protects children from tetanus. It’s a combination vaccine that includes protection against diphtheria, tetanus and whooping cough.
The DTaP vaccine is one of the recommended childhood immunizations.
To be fully protected, children need five doses: at 2 months, 4 months, 6 months, 15-18 months and 4-6 years of age.
They also need a slightly different version of the vaccine, called Tdap, at age 11-12. It keeps them protected.
After that, everyone needs a Tdap booster every 10 years.
To protect your newborn, make sure that you are immunized against tetanus during pregnancy. This way you will pass that protection to your baby.
Watch this video to learn why children need the DTaP vaccine and why it has so many doses:
What to do if your child may have tetanus
If your child has a wound that was in contact with soil, call your pediatrician right away. This is especially important if they didn’t have all the recommended doses of the DTaP and Tdap vaccines, or if you are not sure they’re up to date.
Tetanus can be deadly, but most people recover with treatment. Depending on the wound, treatment for tetanus can include antibiotics, muscle relaxers or a medicine called antitoxin.
If your pediatrician suspects your child has tetanus, it’s very possible they are hospitalized and need breathing support.
Why the DTaP vaccine is important for all of us
Before the DTaP vaccine, parents had to worry all the time about scratches or scrapes their kids got while playing outside—especially if a dirty metal object caused the wound. Tetanus health problems can be serious or even fatal.
How common is tetanus in the U.S.?
Thanks to the DTaP vaccine, tetanus is very rare in the United States today. Only a small number of people get sick every year. Usually, those who have not been fully vaccinated or have not kept up with their Tdap boosters.
Most people with tetanus get better with treatment and survive, but the story would be different without the DTaP vaccine. Children with weakened immune systems or diabetes can get extremely sick. When they can’t get the vaccine, but most people around them do, they have a better chance of staying healthy.
Talk with your doctor
Tell your doctor if your child has known life-threatening allergies. Children with minor illnesses, with or without low-grade fever, can get vaccinated, but you should consult first with your doctor.
Possible effects after vaccination
Sometimes people have redness, swelling or feel soreness where they got the shot. A few children might get a fever. For any signs that concern you, call your doctor.
If someone has a serious reaction to a vaccine, there are two government agencies that monitor vaccine reactions and safety through the Vaccine Adverse Reporting System (VAERS)
More information
About Dr. Vipulanandan Yarlini Vipulanandan, MD, is a combined Pediatric Infectious Disease and Pediatric Hospital Medicine Fellow at the University of Alabama in Birmingham (UAB) and is pursuing research in both congenital infections and osteoarticular infections. She completed her pediatric residency training at University of Texas Southwestern Medical Center in Dallas. Dr. Vipulanandan is a post-residency training member of the American Academy of Pediatrics.
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