Sanford Infectious Disease

Q&A: Tetanus concerns during the flood and cleanup

Dr. Kent Martin

What is tetanus? Tetanus is a disease caused by bacteria living in the soil and fecal matter. The germ makes a protein that causes severe muscle spasms often resulting in not being able to open the jaw when the spasms occur. This is the origin of the common name for tetanus—lockjaw.

How do you contract tetanus?

This type of bacteria is almost everywhere but is commonly found in sewage. Entry of the bacteria into the body occurs through a small cut, abrasion or wound, especially if the entry site is not carefully cleaned and disinfected.

What are the symptoms of tetanus?

Symptoms usually begin about five to 10 days after the injury. Muscles contract involuntarily and become rigid. Spasms usually begin in the jaw and throat making swallowing difficult, followed by the neck, shoulder, face and then the abdomen and limbs. Back muscles contract, making the back arch. Spasms of sphincter muscles can lead to constipation and difficulty urinating. People may have a rapid heart beat, profuse sweating and high fever. Slight disturbances—such as noise, a draft or the bed being jarred—can trigger painful muscle spasms throughout the body. Such spasms may interfere with breathing, sometimes so much that people turn blue. Rarely, muscle spasms may be limited to muscle groups near the wound. Such localized tetanus may persist for weeks. Even when the illness is severe, people remain fully conscious.

Given the flood event, should I get a tetanus shot?

While the chances of getting tetanus are small, the disease is often fatal. Preventing tetanus is far better than treating tetanus. If you haven’t had a tetanus shot in the last 10 years, receiving a vaccination booster would be a good idea—particularly if you’re going to spend time flood fighting or cleaning up once the water recedes. In battling the water and the ensuing cleanup, there is an increased risk of minor cuts and injuries. Some of the bacteria in water may cause tetanus.

I can’t remember when I received my last tetanus shot. Can I get a vaccination anyway?

Generally, it’s OK to get an extra tetanus booster within the 10-year window. If you have an injury that could result in contamination, a tetanus booster is given if more than five years have passed from your previous booster.

What else can I do to prevent tetanus or other infections during the flood?

Don’t wade into flood water without protection for your feet such as boots or even tennis shoes. Flip-flops or sandals are not adequate, as they don’t protect the top part of your feet from cuts or scrapes. If you do get cut, wash the site thoroughly and treat it with antibiotic cream. Adequately cover any wounds on your hands or other exposed areas before working around flood water, soil or sand.

Dr. Kent Martin is an infectious disease specialist at Sanford Health.