Tetanus
Reportable by Laboratories and ProvidersAbout this Reportable Disease
Infectious agent: Clostridium tetani
Description of illness: Tetanus is a serious, vaccine-preventable illness caused by a toxin produced by the spore-forming bacterium Clostridium tetani. Tetanus is a clinical diagnosis: there is no confirmatory laboratory test. About 30 cases are reported in the United States each year, typically in unvaccinated persons or older adults who have not stayed up to date on 10-year booster vaccinations. The bacteria are usually found in soil, dust, or manure and enter the body through breaks in the skin – usually cuts or punctures caused by contaminated objects: the incubation period ranges from 3-21 days (average 10 days). It does not spread from person-to-person.
Eighty percent of tetanus is generalized tetanus: 1-2 out of 10 patients die. The disease usually starts with trismus, or lockjaw, followed by stiffness of the neck, difficulty swallowing, and rigidity of the abdominal muscles. Other symptoms include elevated temperature, sweating, elevated blood pressure, and episodes of rapid heart rate. Severe, painful muscle spasms may occur for 3-4 weeks. Complications include broken bones, blood clots, pneumonia, and death.
Neonatal tetanus, a mostly fatal condition typically seen only in resource-limited countries, occurs in infants born to unimmunized mothers through infection of the unhealed umbilical cord, particularly when nonsterile umbilical cord-care practices are followed. Tetanus vaccination of women of reproductive age and clean delivery practices prevent neonatal tetanus.
Two more rare forms of tetanus include local or cephalic tetanus, either of which may progress to generalized tetanus. Local tetanus is most likely to occur in a partially immune person and causes muscles to contract only near the site of the injury. Contractions may persist for weeks before subsiding. Cephalic tetanus is the rarest, associated with breaks in the skin on the head or with otitis media. It has a brief 1-2 day incubation period and causes flaccid cranial nerve palsies and jaw spasms.
Interactive Disease Data
Laboratory Reporting for this Disease
Clostridium tetani
| TEST NAME | Clostridium tetani |
| DISEASE/DISORDER | Tetanus (lock jaw) |
| ALTERNATE NAME(S) | C.tetani, tetanus, lock jaw |
| METHODOLOGY | Culture |
| SPECIAL INSTRUCTIONS | CEDEP approval required prior to isolate submission. |
| ORDERING INFORMATION | TDH DLS Requisition: PH-4182 Clinical Submission Requisition |
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Laboratory Reporting
Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.
- Manually report results to TDH by faxing or mailing a completed PH-1600 form to your local health department, or faxing to the state health office at (615) 741-3857
- Automatically submit results to TDH via electronic laboratory reporting (ELR), which automates the process of sharing data with TDH using interoperability standards.
- See the ELR Onboarding Handbook for details on the onboarding process, checklist, frequently asked questions, business rules, message format, and vocabulary.
- To initiate the ELR onboarding process with TDH, register in the Trading Partner Registration (TPR) system TPR provides documentation for Promoting Interoperability (PI) attestation and milestone letters to document onboarding progress. Contact MU.Health@tn.gov for assistance.
- Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
- Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.
Information about this Reportable Disease for Healthcare Providers
Clinical Summary
- Tetanus is a serious infection caused by the toxin of Clostridium tetani, a soil-dwelling bacterium that enters the body through wounds.
- The toxin acts on the nervous system, causing painful muscle stiffness and spasms (often starting in the jaw, “lockjaw”) and possible progression to respiratory failure.
- Management requires intensive medical care, including wound cleaning, antitoxin, muscle relaxants, and support of breathing.
- The best prevention is active immunization (a tetanus vaccine series plus boosters) and prompt wound care.
Healthcare Provider Reporting
Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.
Providers must report cases of all diseases and conditions listed through one of these methods:
• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857
• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.
• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.
Information about this Reportable Disease for the Public
What It Is
Tetanus is a serious bacterial infection caused by Clostridium tetani, which produces a toxin that affects the nervous system and causes muscle stiffness and spasms.
Types
There are four main types—generalized (most common), localized, cephalic, and neonatal tetanus, depending on where and how the infection develops.
Signs and Symptoms
Symptoms include jaw cramping (lockjaw), muscle stiffness, painful spasms, trouble swallowing, fever, and difficulty breathing.
Treatment
Treatment involves wound cleaning, tetanus immune globulin (TIG), antibiotics, muscle relaxants, and supportive care such as assisted breathing if needed.
This Page Last Updated: March 25, 2026 at 8:53 PM