Division of Public Health Services  Disease Handbook for Childcare Providers 
Bureau of Infectious Disease Control   REVISED –January 2018 
TETANUS 
 
Tetanus is a bacterium that lives in the soil and 
can enter the body through a cut or wound.  The 
bacteria produce a poisonous substance – 
exotoxin – that causes the clinical illness. 
 
Who gets this disease? 
Tetanus occurs almost exclusively in 
unimmunized or inadequately immunized 
persons. Previously having tetanus does not result 
in immunity to subsequent infections. Vaccination 
is required after initial recovery. 
 
How is it spread? 
Unlike other vaccine-preventable diseases, tetanus 
is not spre ad from person- to-person.  It occurs 
when the bacterium in soil or dust is introduced 
into the body through a wound. 
 
What are the symptoms? 
The poisonous exotoxin produced by the 
Clostridium tetani  bacteria causes muscles  to go 
into spasms  of the face/neck, abdomen, or area 
where the initial infection occurred.  Paralysis and 
death can result.  Sometimes tetanus is called 
“lockjaw”. 
 
How can Tetanus be prevented? 
The Advisory Committee on Immunization 
Practices (ACIP) recommends immunizing 
children against  tetanus – along with diphtheria 
and pertussis – beginning as early as six weeks of 
age. The diphtheria-tetanus-acellular pertussis 
(DTaP) vaccine is required  for both childcare 
and school attendance. The five dose series should 
be completed at 2 months, 4 months, 6 months, 
and 15-18 months, and 4-6 years of age 
Tdap/Tetanus diphtheria and acellular pertussis 
should be given once between the ages of 11- 18 
years.  Booster doses of tetanus -diphtheria toxoid 
(Td) vaccine every 10 years after finishing the 
childhood primary immunization series are 
necessary to maintain protection against tetanus.  
Tdap is available as a one time dose for adults 
who have not recently received a tetanus vaccine. 
Also, it is important to be sure that all cuts, 
scrapes and puncture  wounds are cleaned well 
with soap and water.  Consult your healthcare 
provider for need of tetanus vaccine after a 
wound. 
 
Who should be excluded? 
There is no need for the child or the childcare 
worker to be excluded as tetanus  is not spread 
from person-to-person. 
 
Reportable? 
Yes, tetanus is reportable by New Hampshire law 
to the Division of Public Health Services, Bureau 
of Infectious Disease Control at (603) 271-4496.