Nearly all cases of tetanus occur in people who have never gotten the tetanus vaccine, or adults who don’t stay up to date with their 10-year boosters. The disease is not spread from person to person though, which makes it very different from other vaccine-preventable diseases. Instead, it's spread by bacterial spores that usually enter the body through a puncture. These make a powerful neurotoxin that causes muscle spasms and stiffness.  Complications  from tetanus are highest among people who have not been immunized or in older adults with inadequate immunization in industrialized countries.  You may also be at increased risk of tetanus after a natural disaster, especially if you live in a developing country. As soon as you get an injury or wound, clean and disinfect it. If you delay disinfecting the new wounds by more than 4 hours, you increase the chances of tetanus infection. This is even more important if the wound was caused by an object that punctured the skin, which can force bacteria and debris deep into the wound, making it an ideal environment for the growth of bacteria. Pay attention to whether the object that caused your wound is clean or dirty to decide whether you need a tetanus booster. A dirty, or contaminated, object has dirt/soil, saliva, or feces/manure on it, while a clean object does not. Remember that you can't necessarily know if an object has bacteria on it. The incubation period for tetanus varies from 3 to 21 days, with an average of 8 days. Tetanus severity is determined by a graded scale from I through IV. The longer it takes symptoms to appear, the more mild the disease is likely to be. Common symptoms of tetanus (in order of appearance) include:  Spasm of jaw muscles (commonly referred to as “lockjaw”) Stiffness of the neck Difficulty swallowing (dysphagia) Board-like rigidity of the abdominal muscles The diagnosis of tetanus relies solely on recognizing its symptoms. There are no blood tests that can diagnosis tetanus, so it's important to pay attention to any symptoms. You may also notice fever, sweating, elevated blood pressure, or rapid heart rate (tachycardia). Understand possible complications, including:  Laryngospasm, or spasm of the vocal cords, which can make breathing difficult Bone fractures Seizures/convulsions Abnormal heart rhythms Secondary infections, such as pneumonia, as a result of prolonged hospitalization Pulmonary embolism, or blood clots in the lungs Death (10% of reported cases are fatal)
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