Tetanus enters the body through cuts in the skin. It can get in through even a tiny pinprick or scratch, but it prefers deep puncture wounds or cuts, like those made by nails or knives.
Children can also get tetanus following severe burns, ear infections, tooth infections, or animal bites. Rusty nails are often blamed for causing tetanus, but it is the tetanus bacteria, and not rust, that causes the disease. You can get tetanus from a shiny nail as easily as from a rusty one.
Tetanus bacteria can live anywhere, but they are usually found in soil, dust, and manure. Once they get into the body through a wound, it can take from 3 days to 3 weeks (usually about 8 days) for the first symptoms to appear. These are usually a headache, crankiness, and spasms of the jaw muscles.
Like diphtheria, tetanus can produce a toxin (poison) inside the body. As this toxin spreads, it causes muscle spasms in the neck, arms, legs, and stomach. It can cause painful muscle contractions strong enough to break a child's bones. Children with tetanus might have to spend several weeks in the hospital under intensive care. There are only about 50 cases of tetanus a year in the United States, but 3 out of every 10 people who get tetanus die from it.
As with the diphtheria vaccine, tetanus vaccine is really a toxoid, which protects against the toxin produced by tetanus bacteria. The vaccine can be obtained at any physician's office. It is recommended that adults receive a booster injection every five years at a minimum.