Although tetanus victims can usually think clearly when conscious, coma may follow repeated spasms. Aspiration pneumonia is a common late complication and is found in 50 to 70 percent of autopsied cases. The mortality rate is about 25 percent in the United States and 50 percent worldwide. The bacteria that cause tetanus belong to the Clostridium family, also responsible for some other serious diseases, such as botulism and the type of gangrene suffered in war wounds. They also form spores, reproductive cells with thick walls that enable them to withstand unfavorable environmental conditions.
Spores are tough to kill and highly resistant to heat and the usual antiseptics that treat wounds.
Tetanus bacteria may enter the body through a puncture wound or scratch. This is why immunization is so important. Tetanus toxoid is virtually 100 percent effective in preventing tetanus. The Food and Drug Administration reviews the manufacturer's testing records for each lot of vaccine to ensure that the product is safe and effective for its intended use. FDA also sometimes tests random lots to ensure that the manufacturer's testing records are accurate.