Symptoms

The average time from infection to appearance of signs and symptoms (incubation period) is 10 days. The incubation period can range from 3 to 21 days.

The most common type of tetanus is called generalized tetanus. Signs and symptoms begin gradually and then progressively worsen over two weeks. They usually start at the jaw and progress downward on the body.

Signs and symptoms of generalized tetanus include:

• Painful muscle spasms and stiff, immovable muscles (muscle rigidity) in your jaw
• Tension of muscles around your lips, sometimes producing a persistent grin
• Painful spasms and rigidity in your neck muscles
• Difficulty swallowing
• Rigid abdominal muscles

Progression of tetanus results in repeated painful, seizure-like spasms that last for several minutes (generalized spasms). Usually, the neck and back arch, the legs become rigid, the arms are drawn up to the body, and the fists are clenched. Muscle rigidity in the neck and abdomen may cause breathing difficulties.

These severe spasms may be triggered by minor events that stimulate the senses — a loud sound, a physical touch, a draft or light.

As the disease progresses, other signs and symptoms may include:

• High blood pressure
• Low blood pressure
• Rapid heart rate
• Fever
• Extreme sweating

Localized tetanus

This uncommon form of tetanus results in muscles spasms near the site of a wound. While it's usually a less severe form of disease, it can progress to generalized tetanus.

Cephalic tetanus

This rare form of tetanus results from a head wound. It results in weakened muscles in the face and spasms of the jaw muscles. It also can progress to generalized tetanus.

When to see a doctor

Tetanus is a life-threatening disease. If you have signs or symptoms of tetanus, seek emergency care.

If you have a simple, clean wound — and you've had a tetanus shot within 10 years — you can care for your wound at home.

Seek medical care in the following cases:

• You've not had a tetanus shot within 10 years.
• You are unsure of when you last had a tetanus shot.
• You have a puncture wound, a foreign object in your wound, an animal bite or a deep cut.
• Your wound is contaminated with dirt, soil, feces, rust or saliva — or you have any doubt about whether you've cleaned a wound sufficiently after such exposure. Contaminated wounds require a vaccination booster if it's been five or more years since your last tetanus shot.