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Tetanus in the Child Care Setting

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Tetanus, also called lockjaw, is very rare in the United States due to the very high immunization rates of persons living here. Tetanus is difficult to treat, but is completely preventable through vaccination. Children receive tetanus vaccine in combination with the pertussis and diphtheria vaccine. After childhood, adults need a booster injection every 10 years to make sure they are protected.

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Tetanus is caused by infection with the bacteria Clostridium tetani. These bacteria are common in the soil but are quickly killed by oxygen. Any wound or cut contaminated with the soil and not open to the air (such as a puncture wound or even a rose prick) will provide a suitable environment for the bacteria. Tetanus is usually acquired when a person who has not been immunized acquires such a wound by stepping on a dirty nail or being cut by a dirty tool. The bacteria infect the wound and produce a toxin that spreads through the blood. This toxin can cause severe muscle spasms, paralysis, and frequently death.

Anyone who has an open wound injury should determine the date of his or her last tetanus booster. A person who has not had a booster within the past 10 years, should receive a booster dose of vaccine and/or other medications to prevent tetanus disease. For some wounds, a person may need a booster if more than 5 years have elapsed since the last dose. Because tetanus is not spread person-to-person, tetanus in one child care attendee or provider will not spread to others.
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