Hesperian Health Guides

Tetanus (lockjaw)

In this chapter:

Tetanus is a deadly infection that gets into a wound or the umbilical cord, and then spreads throughout the body.

a person lying down with arched back and clenched fists.
Signs of tetanus most often appear 7 to 10 days after an injury. But signs can also start as soon as 3 days after being infected or not appear until 2 or 3 weeks later.
  • Tense and painful contractions of all the muscles.
  • During contractions, breathing may stop.
  • Extreme muscle spasms that come and go.
  • Lockjaw (cannot open the mouth easily).
  • Stiff neck and a stiff, board-hard belly.

Get medical help fast for these signs!


Tetanus is much easier to prevent than to treat. Prevent by vaccinating all children against tetanus and carefully cleaning wounds so they do not get infected. Children need 3 doses of the tetanus vaccine as infants and then 3 booster vaccines later. Pregnant women need a tetanus vaccination unless they have had one recently.

Wounds most likely to develop tetanus

a foot stepping on a nail that pokes up through a board.
a leg with an open fracture.
a needle piercing an earlobe.
  • Puncture wounds.
  • Gunshot wounds.
  • Broken bones, when the bone pokes through the skin (open fractures).
  • Severe burns or frostbite.
  • Unsafe abortions and injections or piercings with used needles can also lead to tetanus.

Serious, deep or dirty wounds need special cleaning, care, and antibiotics. Unless the person had a tetanus vaccine within the past 5 years, they need one now and also an injection of antitetanus immunoglobulin.

Newborn tetanus

Newborns can get infected with tetanus through the umbilical cord if the mother does not have up-to-date tetanus vaccinations. Cutting the cord with a sterile blade and keeping the cord clean protect babies from tetanus at birth.

This page was updated:05 Jan 2024