No test can confirm tetanus

Tetanus is an infection caused by Clostridium tetani, bacteria found in
the environment. It is **uncommon but very serious, and requires immediate
treatment in hospital**. In the United States, 1 in 10 cases is fatal.

The gap between the wound and the illness

**Symptoms typically appear between 3 and 21 days after exposure, averaging 8
days.** By the time the first sign arrives, the injury that caused it may be
three weeks old and forgotten — which is exactly the problem with diagnosing
it.

The first sign is most commonly spasms of the jaw muscles — "lockjaw".
Other symptoms:

• Trouble swallowing
• Sudden involuntary muscle spasms, often in the stomach
• Painful muscle stiffness all over the body
• Seizures — jerking or staring
• Headache
• Fever and sweating
• Changes in blood pressure and heart rate

**Tetanus requires immediate treatment. Contact a healthcare provider if you
have these symptoms.**

Diagnosis without a test

No laboratory or other test can confirm tetanus. Providers decide by
looking for the common signs and symptoms, and by asking about **recent cuts,
scrapes, punctures and trauma**.

That is the reason to remember a wound from three weeks ago, and to mention it
even when it seems unconnected.

Complications

Laryngospasm — uncontrolled tightening of the vocal cords · fractures, from
the force of the spasms · pulmonary embolism · aspiration pneumonia, a lung
infection from inhaling saliva or vomit · breathing difficulty.

Who is at higher risk

Anyone can get tetanus. Risk rises with:

The bacteria get in through broken skin, usually through injuries.

Prevention, in two parts

1. Vaccination is the best protection. The CDC recommends tetanus
vaccination for everyone, and being up to date is what prevents it.

2. Immediate, good wound care.

• Apply first aid even to minor, uninfected wounds
• Wash hands with soap and water, or use an alcohol-based rub
• Consult a provider if the wound is a puncture or deep (standing on a
  nail), contains dirt, soil, faeces or saliva (an animal bite), or
  contains dead tissue — from burns, fractures, crush injuries or
  frostbite

After some wounds, medicine is needed as well. **Human tetanus immune
globulin (TIG)** can prevent tetanus, and providers use it when someone is not
up to date on vaccination and has a serious or contaminated wound. Vaccination
also helps, depending on the person's history.

Source: Centers for Disease Control and Prevention.