How common are tetanus cases and deaths worldwide and in the United States in 2025?
Executive summary
Tetanus is now rare in high‑income countries but remains a preventable killer worldwide: global reported deaths fell to under ~35,000 by 2019 and confirmed global case counts have fallen by orders of magnitude since 1990 [1] [2]. In the United States, surveillance shows roughly 20–40 reported cases a year in recent decades and an average of about two deaths per year since 2000, with 2013–2022 totaling 267 cases and 13 deaths reported to CDC [3] [4].
1. A disease driven out of rich countries, not out of the planet
Tetanus incidence and mortality have crashed worldwide over the last three decades because of routine childhood DTP vaccination and maternal‑newborn vaccination efforts; Our World in Data and WHO‑derived charts show the majority of remaining cases and deaths concentrate in South Asia and sub‑Saharan Africa, while global deaths by 2019 fell to less than ~35,000 annually [2] [1]. WHO data collection systems (JRF/GHO) and global analyses repeatedly note that confirmed reported cases underestimate true burden in low‑resource settings because of limited testing and reporting [5] [6].
2. How common is tetanus in the United States in 2025?
U.S. national surveillance classifies tetanus as nationally notifiable and reports “sporadic” cases: since 2010, the CDC says there have been fewer than 40 reported cases each year; state and local pages and prior CDC summaries commonly cite ~30 cases per year as the U.S. average [3] [7] [8]. A CDC surveillance summary covering 2013–2022 recorded 267 cases and 13 deaths reported through NNDSS, and the CDC also notes mortality has declined >99% since the early 1900s and has averaged about two deaths per year since 2000 [4].
3. Who gets tetanus in the U.S. and why cases persist
U.S. cases occur mainly in people who are unvaccinated, under‑immunized, or elderly with waning immunity; risk groups cited in multiple clinical and public‑health sources include older adults, the unvaccinated, diabetics and injection‑drug users [9] [7]. Serologic surveys find most Americans retain protective antibody levels, but protection decreases with age and is lower among some subgroups, for example those born outside the U.S. and older adults — about 25% of adults ≥80 years lacked sero‑immunity in NHANES 2015–16 analysis [10].
4. How many people still die globally and why estimates vary
Published global estimates differ by source and method: the Global Burden of Disease and WHO‑derived datasets underpin Our World in Data’s conclusion that annual deaths dropped to below ~35,000 by 2019; older literature and GBD-derived papers cite tens of thousands of neonatal and other tetanus deaths in the 2010s [1] [11] [12]. Reporting gaps in low‑resource settings and the focus of deaths in neonatal and maternal tetanus make official confirmed‑case counts underestimates of true incidence [5] [6] [12].
5. Treatment, fatality and why vaccines matter
In places without intensive care, tetanus fatality can be extremely high — historically near 100% for neonatal tetanus — while access to mechanical ventilation and modern ICU care lowers case‑fatality in high‑income settings [13] [12]. That clinical reality explains why vaccination and maternal immunization are the dominant public‑health tools; CDC and WHO materials stress routine immunization and boosters every 10 years for adults to prevent the disease [3] [14] [15].
6. Limits of the available data and competing perspectives
Available public datasets rely on confirmed, reported cases; investigators warn confirmed counts understate burden where surveillance and reporting are weak [5] [6]. Our World in Data and GBD estimates emphasize declines in deaths and cases but use different sources and modelling approaches (WHO JRF, IHME/GBD), producing somewhat different totals and timelines — the consistent signal across sources is dramatic decline, concentrated remaining burden in low‑coverage regions [5] [16] [1].
7. What to watch in 2025 and beyond
Key indicators to follow are WHO/UNICEF JRF country reports and CDC NNDSS annual summaries: WHO/UNICEF track reported cases and neonatal tetanus elimination status; CDC updates national counts and notes trends in cases and deaths [6] [3]. Also watch serosurveys (NHANES‑style) and published GBD updates to spot changes in population immunity and residual death estimates [10] [16].
Limitations: this report uses only the supplied sources; available sources do not mention 2025 global case totals beyond modeling and data updates cited above, and do not provide a single definitive global 2025 death count in the material provided (not found in current reporting).