Tetanus is a serious, acute, non-contagious infection that is often fatal and usually requires hospitalization in an intensive care unit. It is caused by exotoxins produced by a Gram-positive anaerobic bacillus, a bacterium called Clostridium tetani, which is naturally present in soil. Infection can occur through any minor injury, cut, or wound. Generalized tetanus is a notifiable disease in France. Vaccination, along with the administration of immunoglobulins in the event of an injury, is the only possible prevention.

Due to the widespread use of tetanus vaccination, tetanus infections have become very rare in France and throughout industrialized countries, but have not completely disappeared. Thus, the disease primarily affects older adults who are unvaccinated or have incomplete vaccination.
However, it can affect anyone whose vaccinations are not up to date; thus, over the past 10 years, three cases have been reported in children aged 3 to 8 at the time of illness who had not been vaccinated, despite being born in France—a country where primary vaccination has been mandatory since 1940.

Tetanus: Key Figures and Results for 2021

• In France, between 1 and 10 cases of tetanus have been reported annually over the past 10 years. This represents an average annual incidence of 0.07 cases per million people during this period.

• The disease primarily affects the oldest age groups in the population: between 2012 and 2021, 71% of the 48 reported cases were aged 70 and older.

• The average annual incidence rate (per million inhabitants) of tetanus infection thus increases with age. It is 0.75 for those aged 80 and older and 0.14 for those aged 70–79. This rate is higher among women (0.09) than among men (0.05).

• The overall case-fatality rate was 29% over the 2012–2021 period, higher among those aged 70 and older (35%) compared to those under 70 (14%).