The tetanus toxin, one of the most potent poisons known, acts on the motor nerves and causes muscle spasm at the site of infection and in other areas of the body. The most frequent symptom is stiffness of the jaw (lockjaw) and facial muscles. Difficulty in breathing and severe convulsions may ensue. The mortality rate is very high, especially in the very young and the aged; overall it is about 40%. Treatment with tetanus antitoxin should be started promptly in conjunction with human immune globulin. It is preferable, however, to prevent the disease by active immunization (including booster shots) with tetanus toxoid (see vaccination).
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