Tetanus is an acute, often fatal, disease caused by an exotoxin produced by the bacterium Clostridium tetani. Exotoxins are toxins released by a living bacterial cell into its surroundings. Symptoms of tetanus include generalized rigidity and convulsive spasms of skeletal muscles. The muscle stiffness usually begins in the jaw (lockjaw) and neck and then becomes more generalized throughout the body.
Although records from antiquity (fifth century BCE) contain clinical descriptions of tetanus, it was in 1884 when tetanus was first produced in animals by injecting them with pus from a fatal human tetanus case. During that same year, tetanus was produced in animals by injecting them with samples of soil.
In 1889, Kitasato Shibasaburo isolated the organism from a human, showed that it produced disease when injected into animals, and reported that the toxin could be neutralized by specific antibodies. In 1897, Edmond Nocard demonstrated the protective effect of passively transferred antitoxin, and passive immunization in humans was used for treatment and prevention during World War I. A method for inactivating tetanus toxin with formaldehyde was developed in the early 1920s. This led to the development of tetanus toxoid in 1924, which was first widely used during World War II.
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A package of ca. 1907 dried antitetanic serum at left compared to a vial of tetanus antitoxin ca. 1970–1980
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National Library of Medicine
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Today there are several combined vaccine products (Tdap, DTaP, TD, DT) available that combine tetanus toxoid with diphtheria toxoid and pertussis antigens. Depending on the age of the patient, certain vaccines are recommended over others (see the Centers for Disease Control and Prevention chart below).
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Poster from the Centers for Disease Control and Prevention about tetanus vaccines
