Have you had a tetanus shot recently?

Before you start digging in the dirt this summer, you might want to check.

Tetanus doesn’t just come from rusty nails or a cut from dirty metal. You can get it from many different sources, including the soil in your garden.

Tetanus is caused by a potent toxin produced by the bacterium Clostridium tetani, said Amy Carter, communicable disease and epidemiology registered nurse at the Weber-Morgan Health Department.

“The spores of Clostridium tetani are commonly found in nature, most often in soil, but can also be found in the intestines and feces of many animals,” Carter said. “Transmission primarily occurs through contaminated wounds, both major and minor.”

Tetanus may follow deep puncture wounds, burns, crush wounds, ear infections, dental infections, animal bites, pregnancy, miscarriage or elective surgery, Carter said. And yes, you can also get it from cutting yourself with a rusty nail.

According to an article published by the Cleveland Clinic, tetanus is difficult to diagnose.

“The spores of the tetanus bacteria enter the bloodstream through a break in the skin. They thrive and germinate inside the body,” the article states. “The germinating spores produce a toxin that disrupts the nervous system. It first affects the nerves nearest to the break in the skin. Then it spreads to the spinal cord and brain. Within five to 10 days, tetanus shows its most frightening symptom — lockjaw.”

About 80 percent of people infected with tetanus will develop a gradual onset of muscle stiffness first affecting the jaw (lockjaw) and neck, Carter said. Severe muscle spasms will follow and continue for weeks. Complete recovery can take several months.

“Complications from these spasms can include breathing difficulties, fractures of the spine or long bones, high blood pressure or abnormal heart rhythms,” Carter said. “In recent years, tetanus has been fatal in roughly 11 percent of cases.”

Immunization against tetanus plays a critical role in preventing infections, Carter said. Very rarely have cases occurred in those who have had the vaccination.

The vaccine, combined with diphtheria and pertussis begins at two months, followed by a booster at four, six, 12 to 18 months, four to six years old and 11 to 12 years old. Adults should then receive a booster every 10 years throughout life. Pregnant women should always receive a booster with every pregnancy to provide maternal pertussis antibodies to their newborn infants, Carter said.

Besides getting the vaccine, it’s important to thoroughly cleanse all wounds as soon as possible, Carter said. Any foreign material or dead tissue should be removed. If a person isn’t fully vaccinated, immune globulin can be given to try and remove any tetanus toxin not already bound to a nerve ending.

“If a person develops tetanus and is experiencing spasms, then supportive therapy and maintenance of an adequate airway are critical,” Carter said.