It is not transmitted from person to person. The tetanus germ is present throughout the environment and is commonly found in soil contaminated with manure. The incubation period is usually eight days but may range from three days to three weeks. Shorter incubation periods are associated with more heavily contaminated wounds. Recovery from tetanus may not result in immunity.
Second attacks can occur and immunization is indicated after recovery.
Wounds should be thoroughly cleaned, and dead or devitalized tissue removed. If the patient has not had a tetanus toxoid booster in the previous 10 years, a single booster injection should be administered on the day of injury. For severe wounds, a booster may be given if more than five years have elapsed since the last dose. Other complications include fractures of the spine or long bones, hypertension, abnormal heartbeats, coma, generalized infection, clotting in the blood vessels of the lung, pneumonia and death. An effective vaccine called tetanus toxoid has been available for many years.