Tetanus and Diphtheria

Tetanus and Diphtheria

Tetanus | Tetanus

Tetanus is caused by bacteria found in the soil and can cause life-threatening convulsions. Tetanus is transmitted via contaminated wounds or animal bites. The symptoms of tetanus are muscle stiffness and seizures. The tetanus bacterium is found in the soil all over the world, and it is therefore recommended to always have a valid tetanus vaccination, which means revaccination every 10 years.


Where are you at risk of being infected with tetanus?

Tetanus is not contagious from person to person. Instead, tetanus is transmitted by contact with soil or other dirt that contains the tetanus bacteria. 

Tetanus (tetanus) cannot be spread through intact skin, but can only be spread if you have an open wound or similar, from which the tetanus bacteria can enter the body. For example, you can become infected with tetanus via:

  • wounds contaminated with soil 

  • burns or wounds after an operation

  • abdomen if you have recently given birth

  • contamination or inflammation of the umbilical cord in newborns

  • unclean needles

Drug addicts who use dirty syringes, people with burns or surgical wounds and women who have just given birth are therefore at increased risk of becoming infected with tetanus.

In addition, the larger the wound and the more contaminated it is, the greater the risk of becoming infected with tetanus. However, the wound does not have to be large. The tetanus bacteria can also enter the body via very small tears and skin scrapings.

In which areas is Tetanus found?

There is a risk of tetanus in soil, dirt and the like all over the world.

Tetanus is most frequent in poor countries, where few are vaccinated and there are poor hygienic conditions.

Although tetanus is widespread throughout the world, the risk of infection in Denmark has decreased over the past several years, and the greatest decrease occurred when tetanus vaccination became part of the Danish childhood vaccination program in 1949. Today, only two cases of tetanus are seen in Denmark at most ( tetanus) per year.

What symptoms can be seen in Tetanus

The incubation period for tetanus is three to fourteen days. The larger and more contaminated a wound is, the shorter the incubation period and the faster the symptoms appear.

The first symptoms of tetanus are often centered around the area from which the bacteria entered the body, such as around the wound, and include:

  • pains

  • muscle twitching

  • cramps in the surrounding muscles

Later in the course, the spasms can spread to other muscles in the body, typically first to the face, jaw and neck, and symptoms of tetanus can subsequently be 'locked' jaw muscles, difficulty swallowing, muscle spasms and stiffness.

If the cramps do occur, they usually last one to two weeks. If you survive these cramps, it will take a few more weeks before you regain normal muscle function.

What treatment is available for tetanus?

The treatment of tetanus takes place in hospital, as the disease can be life-threatening due to the convulsions. Treatment should therefore be started as early as possible. 

During the treatment of tetanus, the wound from which the tetanus bacteria penetrated is first and foremost thoroughly cleaned with water, soap and alcohol. In some cases, the wound must be cleaned up by surgery.

The tetanus bacterium is treated with antibiotics and an anti-toxin (antitoxin) is given to neutralize the effect of the toxin produced by the tetanus bacterium. 

In case of severe convulsions, it is treated with anesthetics and muscle relaxants, which can control the convulsions. If the muscles for breathing are affected, the patient is often put on a ventilator to help them breathe.

How is tetanus prevented?

In general, good hygiene and wound hygiene with soap and water helps to keep the risk of infection for tetanus down.

However, the most effective prevention of tetanus is through preventive vaccination. Therefore, everyone is recommended to get the tetanus vaccine, which should be done every ten years after following the childhood vaccination program to maintain protection. It is therefore a good idea to always check whether you need a tetanus vaccination before you travel. 

How do you get vaccinated against tetanus?

The diphtheria and tetanus vaccine is part of the Danish childhood vaccination programme, and you are basic vaccinated against diphtheria and tetanus once you have completed this.


At the age of five, a revaccination is given against diphtheria, tetanus, whooping cough and polio. You are then protected against diphtheria and tetanus for the next 10 years. 

To continue to be protected, you must be revaccinated every ten years. The subsequent revaccination is called diTebooster® and protects against both diphtheria (whooping cough) and tetanus (tetanus). 



Diphtheria, also called whooping cough, is an acute infection typically in the upper parts of the respiratory tract (throat and throat), and is caused by the diphtheria bacterium Corynebacterium diphteriae. 

The diphtheria bacterium causes inflammation in the throat and respiratory tract, and produces a toxin which destroys the mucous membrane, so that a severe sore throat with thick deposits occurs. If the coatings break loose, they can be dangerous, as they can block the airways and thus make it difficult to breathe.

Where are you at risk of becoming infected with Diphtheria?

Diphtheria (whooping cough) is transmitted from person to person via droplet transmission, also called droplet infection. This means that diphtheria is transmitted by contact with droplets from the nose or other parts of the upper respiratory tract from an infected person.

This can be done, for example, through:

  • cough

  • sneeze

  • kiss

  • saliva (for example by drinking from the same bottle)

The period during which diphtheria is contagious is usually two weeks from the onset of diphtheria symptoms, but in rare cases it can last up to four weeks. 

In which areas is Diphtheria found?

Diphtheria (whooping cough) occurs in many places in the world, and Danish travelers who are not vaccinated may therefore be at risk of infection with diphtheria.

The greater the population density, the greater the infection risk for diphtheria due to the disease's transmission routes.

Typically, it is in poor and densely populated countries, where everyone has not been vaccinated against diphtheria, that there is primarily a risk of infection with diphtheria between people. 

More specifically, diphtheria is particularly prevalent in:

  • Asia

  • Middle East

  • Eastern Europe

  • South America

  • Africa

However, it is important to remember that outbreaks can occur all over the world, and the risk of diphtheria (whooping cough) in individual countries can therefore change. 

What symptoms can be seen in Diphtheria?

It usually takes two to five days from being infected until the symptoms of diphtheria appear. This period is called the incubation period. 

Symptoms of diphtheria (whooping cough) include sudden sore throat with difficulty swallowing and fever. The course of the disease can be mild and look like an ordinary sore throat, but can also be much more serious.

Severe diphtheria symptoms include white or grayish deposits on the mucous membranes of the respiratory tract, which may bleed when removed. The coatings can also block the airways if they tear loose.

Other diphtheria symptoms include swelling of the throat, which can cause breathing difficulties and become so severe that the airways are blocked and lead to suffocation. 

Late in the course of the disease, the toxin produced by the diphtheria bacteria can also affect the heart, nerves and kidneys, so that, among other things, cardiac arrest and paralysis can occur in the body.

What treatment is available for Diphtheria?

Diphtheria treatment takes place in hospital, and it is important to start the treatment as soon as possible, as it can otherwise be life-threatening. With early treatment, almost all patients are cured.

To treat diphtheria (whooping cough), antibiotics are given which effectively kill the diphtheria bacteria, Corynebacterium diphteriae. 

In addition, an anti-toxin (antitoxin) is also given, which neutralizes the poison (toxin) produced by the bacteria. 

How is diphtheria prevented?

The most important thing you can do to prevent diphtheria (whooping cough) is to get vaccinated.

First of all, you should be vaccinated against diphtheria by following the Danish childhood vaccination programme. After that, you must be vaccinated every ten years to still be fully protected. Vaccination against diphtheria is given together with vaccination against tetanus in a combined vaccine.

If you are going to travel, it is particularly important that you are fully protected against diphtheria (whooping cough).