By Tom Latek
Kentucky Today
While tetanus infections are uncommon in the United States, a concerning increase in cases has been reported in recent years, according to public health officials in Kentucky.
In 2025, at least 37 tetanus cases were reported nationwide, the highest number in more than a decade. The overall risk to the public is considered low, however, these instances are indicative that tetanus has not been eradicated and still has the potential to cause serious illness.
Tetanus is caused by Clostridium tetani, a bacterium commonly found in soil, dust, and animal waste. Infection occurs when bacteria enter the body through breaks in the skin.
Although tetanus is often associated with stepping on a rusty nail, most infections result from more ordinary injuries, including cuts, puncture wounds, splinters, burns, crush injuries, or wounds contaminated with dirt or debris. Even small or unnoticed wounds can pose a risk if they are not properly cleaned. Tetanus does not spread from person to person.
“Once inside the body, the bacteria produce a powerful toxin that affects the nervous system, leading to painful muscle stiffness and spasms,” said Dr. Kris Bryant, associate medical director for the Louisville Metro Department of Public Health and Wellness and a pediatric infectious disease specialist with Norton Children’s. “Symptoms often begin with jaw stiffness (lockjaw) and neck pain, and can progress to difficulty swallowing, whole-body muscle rigidity, and severe spasms that interfere with breathing. Tetanus can be life-threatening without urgent medical care.”
The recent rise in tetanus cases is largely linked to gaps in vaccination. Most people receive vaccines against tetanus in childhood, but protection decreases over time. Adults are recommended to receive a booster shot every 10 years, yet many fall behind.
Treatment for tetanus typically requires hospitalization and focuses on stopping toxin activity, controlling muscle spasms, and supporting breathing and recovery. Care may include medications to neutralize the toxin, antibiotics to clear the infection, muscle relaxants, and intensive supportive care. There is no cure for tetanus once symptoms begin and recovery can take weeks or even months, making prevention especially critical.
“The good news is that tetanus is almost entirely preventable,” Bryant added. “Staying up to date on tetanus vaccinations and boosters, cleaning and covering breaks in skin, and seeking prompt medical care for deep or contaminated wounds can help ensure tetanus remains a rare disease around the country and in our community.”