Tetanus

Summary

Tetanus (MONDO:0005526) is a disease and 236 clinical trials. Top therapeutic interventions include streptococcus pneumoniae polysaccharide conjugated to corynebacterium diphtheriae crm197, rotavirus, live attenuated, and tetanus toxoid. A subtype of primary bacterial infectious disease — broader associated-gene and molecular evidence is on the parent page (see Disease family below).

At a glance

• Prevalence: Unknown (Europe) [Orphanet-validated]
• Phenotypes (HPO): 30
• Clinical trials: 236

Clinical features

Epidemiology

Prevalence records

23 prevalence record(s), Orphanet, top 20 (validated / broadest geography first):

Type	Class	Value	Geography	Validation
Annual incidence	<1 / 1 000 000	0.024	Europe	Validated
Annual incidence	<1 / 1 000 000	0.014	France	Validated
Annual incidence	<1 / 1 000 000	0.044	Malta	Validated
Annual incidence	<1 / 1 000 000	0.01	Slovakia	Validated
Annual incidence	<1 / 1 000 000	0.014	Bulgaria	Validated
Annual incidence	<1 / 1 000 000	0.028	Croatia	Validated
Annual incidence	<1 / 1 000 000	0.004	Czech Republic	Validated
Annual incidence	<1 / 1 000 000	0.014	Denmark	Validated
Annual incidence	<1 / 1 000 000	0.032	Estonia	Validated
Annual incidence	<1 / 1 000 000	0.036	Greece	Validated
Annual incidence	<1 / 1 000 000	0.024	Hungary	Validated
Annual incidence	<1 / 1 000 000	0.016	Ireland	Validated
Annual incidence	<1 / 1 000 000	0.076	Italy	Validated
Annual incidence	<1 / 1 000 000	0.07	Lithuania	Validated
Annual incidence	<1 / 1 000 000	0.008	Netherlands	Validated
Annual incidence	<1 / 1 000 000	0.012	Norway	Validated
Annual incidence	<1 / 1 000 000	0.032	Poland	Validated
Annual incidence	<1 / 1 000 000	0.008	Portugal	Validated
Annual incidence	<1 / 1 000 000	0.032	Romania	Validated
Annual incidence	1-9 / 1 000 000	0.118	Slovenia	Validated

Signs & symptoms

Clinical features (HPO)

30 HPO clinical features (Orphanet curated; top 30 by frequency):

HPO ID	Term	Frequency
HP:0000211	Trismus	Very frequent (80-99%)
HP:0002015	Dysphagia	Very frequent (80-99%)
HP:0002179	Opisthotonus	Very frequent (80-99%)
HP:0003552	Muscle stiffness	Very frequent (80-99%)
HP:0040212	Risus sardonicus	Very frequent (80-99%)
HP:0001276	Hypertonia	Frequent (30-79%)
HP:0001649	Tachycardia	Frequent (30-79%)
HP:0001945	Fever	Frequent (30-79%)
HP:0002063	Rigidity	Frequent (30-79%)
HP:0005363	Humoral immunodeficiency	Frequent (30-79%)
HP:0011355	Localized skin lesion	Frequent (30-79%)
HP:0011964	Intermittent painful muscle spasms	Frequent (30-79%)
HP:0025258	Stiff neck	Frequent (30-79%)
HP:0000822	Hypertension	Occasional (5-29%)
HP:0001259	Coma	Occasional (5-29%)
HP:0001337	Tremor	Occasional (5-29%)
HP:0001662	Bradycardia	Occasional (5-29%)
HP:0002027	Abdominal pain	Occasional (5-29%)
HP:0002098	Respiratory distress	Occasional (5-29%)
HP:0002501	Spasticity of pharyngeal muscles	Occasional (5-29%)
HP:0002607	Bowel incontinence	Occasional (5-29%)
HP:0002789	Tachypnea	Occasional (5-29%)
HP:0003236	Elevated circulating creatine kinase concentration	Occasional (5-29%)
HP:0003345	Elevated urinary norepinephrine	Occasional (5-29%)
HP:0003639	Elevated urinary epinephrine	Occasional (5-29%)
HP:0005341	Autonomic bladder dysfunction	Occasional (5-29%)
HP:0006824	Cranial nerve paralysis	Occasional (5-29%)
HP:0012332	Abnormal autonomic nervous system physiology	Occasional (5-29%)
HP:0025145	Rigors	Occasional (5-29%)
HP:0025425	Laryngospasm	Occasional (5-29%)

Identifiers

Disease identifiers

Field	Value
Canonical name	tetanus
Mondo ID	MONDO:0005526
EFO	EFO:0005593
MeSH	D013742
Orphanet	3299
DOID	DOID:11338
ICD-11	1793762788
NCIT	C85185
SNOMED CT	276202003, 76902006
UMLS	C0039614
MedGen	21489
GARD	0005144
MedDRA	10043376
Is cancer (heuristic)	no

Also known as: Clostridium tetani caused infectious disease of the nervous system · Clostridium tetani infectious disease of the nervous system · lockjaw

Disease family

This is a subtype of primary bacterial infectious disease. Genetic, therapeutic, and trial evidence is largely curated at the broader-term level — see the parent page for the associated-gene cohort and molecular evidence.

Classification path: disease › human disease › disease by etiologic mechanism › disease of primarily extrinsic mechanism › infectious disease › bacterial infectious disease › primary bacterial infectious disease › tetanus

Related subtypes (36): Buruli ulcer disease, sennetsu fever, salmonellosis, pinta disease, chancroid, gonorrhea, anthrax infection, leprosy, botulism, diphtheria, bartonellosis, brucellosis, campylobacteriosis, glanders, granuloma inguinale, legionellosis, leptospirosis, listeriosis, Mycobacterium avium complex disease, ornithosis, rhinoscleroma, staphyloenterotoxemia, syphilis, cholera, ehrlichiosis, melioidosis, tuberculosis, tularemia, plague, Q fever, shigellosis, Lyme disease, relapsing fever, spirillary rat-bite fever, streptobacillary rat-bite fever, Borrelia miyamotoi disease

Subtypes (1): tetanus neonatorum

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

No tiered GWAS variants or ClinVar records for this disease.

Genes & proteins

No associated-gene cohort resolved for this disease. Atlas builds the molecular and therapeutic sections — associated genes, protein families, druggability, pathways, interactions, and drug associations — by aggregating over a disease’s associated genes (resolved via GWAS / GenCC / ClinVar / CIViC), and none resolved here. This is expected for antibody-mediated, autoimmune, or otherwise non-gene-defined conditions; the curated evidence for this disease is its clinical features, GWAS susceptibility, and clinical trials (above).

Function

No pathway enrichment — requires an associated-gene cohort.

Therapeutics

Drugs indicated for this disease

3 approved, 2 in late-stage (phase 3) trials. Disease-direct ChEMBL indications, not inferred from the associated-gene cohort below.

Drug	Development status
Diphtheria Toxoid	Approved (phase 4)
Hepatitis B Virus Hbsag Surface Protein Antigen	Approved (phase 4)
Tetanus Toxoid	Approved (phase 4)
Pertussis Vaccine	Phase 3 (in late-stage trials)
Siltartoxatug	Phase 3 (in late-stage trials)

Clinical trials & evidence

Clinical trials

Clinical trials: 236.

Phase distribution (across all retrieved trials)

Phase	Trials
PHASE3	106
PHASE4	47
Not specified	33
PHASE2	25
PHASE1	13
PHASE1/PHASE2	7
PHASE2/PHASE3	5

Top trials by phase / activity

NCT	Phase	Status	Title
NCT00168545	PHASE4	COMPLETED	Immunology of Non-specific Effects of Vaccine
NCT00254917	PHASE4	COMPLETED	Assessment of the Immunogenicity and Safety of PENTAXIM™ in Philippines
NCT00255021	PHASE4	COMPLETED	Immunogenicity and Safety of Sanofi Pasteur Pentaxim Combined Vaccine in Infants in Thailand
NCT00282295	PHASE4	COMPLETED	US-licensed Combined Vaccine Against Tetanus & Diphtheria, Given With US-licensed Vaccine Against Meningococcal Disease
NCT00304265	PHASE4	COMPLETED	Post-marketing Evaluation of Reactions Following Receipt of Recommended Adolescent Pertussis Vaccine
NCT00319553	PHASE4	COMPLETED	Post-licensure, Modified Double-blind, Multi-center Study Evaluating Safety and Immunogenicity of ADACEL® and BOOSTRIX®
NCT00325156	PHASE4	COMPLETED	Assess the Safety & Reactogenicity of DTPa-IPV/Hib Vaccine Administered at 3, 4, 5 & 18 Mths of Age, in Healthy Infants
NCT00347958	PHASE4	COMPLETED	Descriptive, Open-label, Multicenter Study of the Safety of Redosing With ADACEL® Vaccine
NCT00437671	PHASE4	TERMINATED	Tetanus Immunization in Subjects With No Immunization History or With Tetanus Antibody Levels Below Protective Levels
NCT00457249	PHASE4	COMPLETED	A Trial to Evaluate the Safety and Immunogenicity of ADACEL® Vaccine in Persons 65 Years of Age and Older
NCT00514059	PHASE4	COMPLETED	Immunogenicity and Safety Study of a Booster Dose (5th) of Diphteria-Tetanus-Pertussis-Polio Vaccine
NCT00544271	PHASE4	TERMINATED	Immunogenicity, Antibody Persistence and Safety of GSK Biologicals’ DTPa (INFANRIX) and dTpa (BOOSTRIX) Vaccines.
NCT00548171	PHASE4	COMPLETED	Immunogenicity & Reactogenicity of Boostrix 10 Years After Previous Booster Vaccination in Study NCT01267058
NCT00601835	PHASE4	COMPLETED	Canadian Manufactured Tetanus and Diphtheria Toxoids Adsorbed (Td) Vaccine Compared With U.S. Manufactured Td
NCT00610168	PHASE4	COMPLETED	Immunogenicity & Reactogenicity of Boostrix 10 Years After Previous Booster Vaccination.
NCT00611559	PHASE4	COMPLETED	Study of a New Formulation of DTPa-HBV-IPV/Hib Vaccine Administered as a Booster Dose to 18-23 Months Old Children
NCT00617812	PHASE4	COMPLETED	Safety and Immunogenicity Study of a Liquid Pentavalent Combination Vaccine
NCT00635128	PHASE4	COMPLETED	Safety and Immunogenicity of a Booster Dose of GSK Biological’s Boostrix-Polio Vaccine
NCT00674908	PHASE4	COMPLETED	Phase IV Interchangeability Study of a Liquid Pentavalent Combination Vaccine
NCT00712959	PHASE4	COMPLETED	Immune Responses in Adults to Revaccination With ADACEL® 10 Years After a Previous Dose
NCT00753649	PHASE4	COMPLETED	Immunogenicity and Safety of GSK Biologicals’ Infanrix Hexa in Infants
NCT00777257	PHASE4	COMPLETED	Study of Menactra® in US Adolescents When Administered Concomitantly With Tdap Vaccine
NCT00802867	PHASE4	COMPLETED	Study of DAPTACEL® Administered as a 5th Dose in 4 to 6-Year-Old Children Previously Immunized With PENTACEL™
NCT00870350	PHASE4	UNKNOWN	An Immunogenicity and Safety Study of Tetanus, Diphtheria and Acellular Pertussis Vaccine Booster
NCT00877357	PHASE4	UNKNOWN	Safety, Long Term Immunogenicity and Lot Consistency Study of Liquid Pentavalent Combination Vaccine
NCT01031303	PHASE4	COMPLETED	Immunogenicity and Safety of TETRAXIM™ Given as a Booster Dose at 4 to 6 Years of Age
NCT01137435	PHASE4	COMPLETED	Post Marketing Surveillance for ADACEL™ in South Korea
NCT01147900	PHASE4	COMPLETED	Evaluation of Boostrix™10 Years After Previous Booster Vaccination
NCT01294605	PHASE4	COMPLETED	Immunogenicity and Reactogenicity Study of BoostrixTM (dTpa) and Boostrix-IPV (dTpa-IPV)
NCT01311557	PHASE4	COMPLETED	Study of Adacel® Vaccine Administered to Persons 10 Years of Age
NCT01323959	PHASE4	COMPLETED	Immunogenicity and Safety of Booster Dose of BoostrixTM Polio Vaccine in Previously Boosted Adults
NCT01357720	PHASE4	COMPLETED	Study to Assess if Quinvaxem Can be Interchanged With Other Pentavalent Vaccines During Standard Childhood Vaccination
NCT01358825	PHASE4	COMPLETED	Study to Evaluate Antibody Persistence in Children Previously Vaccinated With Infanrix Hexa™ or Infanrix-IPV/Hib™
NCT01362322	PHASE4	COMPLETED	Immunogenicity and Safety of BoostrixTM Using a New Syringe in 10 to 15-year Old Adolescents
NCT01437423	PHASE4	COMPLETED	Regulatory Post-Marketing Surveillance Study for TETRAXIM™
NCT01439165	PHASE4	COMPLETED	Safety and Immunogenicity in Adults of Revaccination With Adacel® Vaccine 10 Years After a Previous Dose
NCT01457547	PHASE4	COMPLETED	Comparison of Immunogenicity and Reactogenicity of INFANRIX™ HEXA and HEXAVAC™ Vaccines as a Primary Vaccination Course
NCT01491087	PHASE4	COMPLETED	Safety of PENTAXIM® Given as a Three-Dose Primary Vaccination at 2, 3, and 4 Months of Age in Infants in China
NCT01546909	PHASE4	COMPLETED	Antibody Persistence to REVAXIS or DT Polio and Immune Response to TETRAVAC-ACELLULAIRE
NCT01629589	PHASE4	COMPLETED	Immunogenicity of Adacel® and BOOSTRIX® Vaccines in Adolescents

Drugs tested across these trials (top 30)

Molecule	Max phase	Trials referencing
STREPTOCOCCUS PNEUMONIAE POLYSACCHARIDE CONJUGATED TO CORYNEBACTERIUM DIPHTHERIAE CRM197	4	5
ROTAVIRUS, LIVE ATTENUATED	4	2
TETANUS TOXOID	4	2
HEPATITIS B VIRUS HBSAG SURFACE PROTEIN ANTIGEN	4	1
PENTETIC ACID	4	1
SODIUM CHLORIDE	4	1
TECHNETIUM TC 99M PENTETATE	4	1
HAEMOPHILUS INFLUENZAE TYPE B STRAIN 20752 CAPSULAR POLYSACCHARIDE TETANUS TOXOID CONJUGATE ANTIGEN	3	4
SILTARTOXATUG	3	3
PERTUSSIS VACCINE	3	1
TETANUS IMMUNE GLOBULIN	-1	1