Tetanus in Children

What is tetanus in children?

Tetanus is a severe illness of the central nervous system caused by bacteria. It's also known as lockjaw. It can cause death. It's not contagious, but it can be prevented by a vaccine.

What causes tetanus in a child?

It's caused by the poison (toxin) of tetanus bacteria. Tetanus is not a contagious illness. The bacteria usually enter the body through a wound in the skin. Tetanus bacteria live in soil and animal manure. Tetanus occurs more often in warmer climates or during the warmer months.

It can also be found in the umbilical stump of infants in developing countries. This occurs in places where the tetanus vaccine is not often used, and people may not know how to care for the stump after the baby is born.

Which children are at risk for tetanus?

Tetanus is not common in the U.S. because children are vaccinated against it. A child is more at risk for tetanus if they have not had a tetanus vaccine and have a skin injury in an area of the country where tetanus may be active.

What are the symptoms of tetanus in a child?

After a child is exposed to tetanus bacteria, it may take from 3 to 21 days for symptoms to start. In babies, symptoms may take from 3 days to 2 weeks to start.

The most common symptoms of tetanus include:

• Stiffness of the jaw (lockjaw)

• Stiffness of the belly (abdominal) and back muscles

• Contraction (tightening) of the facial muscles

• Convulsions

• Fast pulse

• Fever

• Sweating

• Painful muscle spasms near the wound area. If these spasms affect the larynx or chest, the child may not be able to breathe.

• Trouble swallowing

The symptoms of tetanus can be like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

How is tetanus diagnosed in a child?

The healthcare provider will ask about your child's symptoms and health history. They may also ask about recent history of a bite or scratch or other skin wound. They will give your child a physical exam. The physical exam will include checking any skin wounds.

How is tetanus treated in a child?

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how soon after a possible exposure it is or if the condition has become symptomatic or severe. Treatment will be for tetanus, or to reduce the risk for tetanus after an injury. Treatment may include:

• Cleaning the skin wound

• Giving a series of tetanus antitoxin shots

• Prescribing antibiotic medicine

In severe cases, your child may need to be in the hospital. Treatment there may include:

• A breathing tube inserted into the front of the throat (tracheostomy) if your child has breathing problems

• Medicine to control spasms

Talk with your child's healthcare providers about the risks, benefits, and possible side effects of all medicines.

What are possible complications of tetanus in a child?

Complications of tetanus can include:

• Vocal cord spasms

• Broken bones from severe muscle spasms

• Breathing problems

• Lung infection (pneumonia)

• High blood pressure

• Abnormal heart rhythms

• Blood clot in the lung (pulmonary embolism)

How can I help prevent tetanus in my child?

The CDC recommends that children have 5 DTaP shots. A DTaP shot is a combination vaccine that protects against 3 diseases: diphtheria, tetanus, and pertussis.

• The first 3 shots are given at 2, 4, and 6 months of age.

• The fourth shot is given between 15 and 18 months of age.

• A fifth shot is given at 4 to 6 years of age.

• A booster shot of Tdap should be given to 11- or 12-year-olds at a regular checkup. The Tdap booster also protects against tetanus, diphtheria, and pertussis.

• Pregnant teens and women should get a Tdap booster between weeks 27 and 36 of every pregnancy to increase protection for their baby after birth. 

When should I call my child's healthcare provider?

Call the healthcare provider if your child has:

• Symptoms that don't get better, or get worse

• New symptoms

Key points about tetanus in children

• Tetanus is a severe illness of the central nervous system caused by bacteria. It can cause death.

• Tetanus is very uncommon in the U.S. because children are vaccinated against it.

• Tetanus can cause stiffness of the jaw (lockjaw), convulsions, and other symptoms.

• Treatment is done with a series of tetanus antitoxin shots.

• The CDC advises young children get 5 DTaP shots. A DTaP shot is a combination vaccine that protects against 3 diseases: diphtheria, tetanus, and pertussis. Older children should have the Tdap booster at ages 11 to 12.

Next steps

Tips to help you get the most from a visit to your child's healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child's condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child's provider after office hours. This is important if your child becomes ill and you have questions or need advice.