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Tetanus is an often fatal infectious disease caused by the toxigenic strains of the tetanus bacillus. Tetanus is now uncommon in industrialized countries. For low and middle income countries, the maternal and neonatal (birth-associated) form of the tetanus disease is still frequent and devastating.

Symptoms of tetanus

  • The bacterium penetrates the body through lesions (e.g., soiled wounds, open fractures, chronic ulcers…) or as a result of medical acts performed under insufficient aseptic precautions.
  • Following an incubation period of 3 to 21 days, tetanus most often presents as a generalized spastic disease. Contractions of the jaw muscle (or trismus) are a characteristic feature and are followed by spasms of the back muscles (opisthotonos) and sudden generalized convulsions.(1)
  • In the absence of treatment, the outcome is almost always fatal, particularly in the very young or the elderly.
  • Even after appropriate treatment, tetanus-related mortality remains high.

Epidemiology and vaccination against tetanus

  • Tetanus bacillus is ubiquitous and present in the soil in the form of highly resistant spores. Its reservoir can thus not be eliminated, but vaccination is a very effective weapon in the prevention of the disease.
  • While according to the WHO position paper in 2017, there is an absence of reliable global estimates of non-neonatal tetanus cases and deaths including maternal tetanus, it is estimated that in 2015, approximately 34,000 neonates died from neonatal tetanus.(1)
  • Tetanus vaccines are based on tetanus toxoid, and are usually combined with other valences (e.g., diphtheria, pertussis, polio, Hib…).


1 - WHO. Tetanus vaccines position paper. WER 2017, 92, 53–76. Accessed January 2018. http://apps.who.int/iris/bitstream/10665/254582/1/WER9206.pdf?ua=1