By Aletha Tippett MD
Tetanus is a multisystem disease caused by the bacterium Clostridium tetani. This bacterium is present in feces and soil. Tetanus has been mostly eradicated in the U.S. due to childhood immunization, however, there have been reported cases among immigrants, with higher risk behaviors such as body piercing and tattooing among young adults, and with failure to maintain adult booster immunization. Often, as adults, tetanus is not considered in overall health as evidenced by significant under-immunization with less than half of adults having current immunization. Other risk factors not well-recognized include diabetes, gangrene or chronic wounds, which increase the risk of tetanus to 50%. It is fatal in approximately 10-30% of cases. It may take anywhere from 3-21 days after exposure to the bacterium for the symptoms to become apparent. There is no test to diagnose tetanus, it is strictly a clinical diagnosis.