Tetanus is a notifiable disease. Tetanus is an acute, often fatal disease caused by a toxin produced by a spore forming bacterium, Clostridium tetani. The spores can remain viable for years and are common in soil, and animal and human faeces. The spores enter the body through breaks in the skin — usually cuts or puncture wounds caused by contaminated objects. Tetanus is not contagious, person to person spread does not occur. Anyone who is not fully protected against tetanus by immunisation is at risk from the disease. Individuals with impaired immunity may be at risk, regardless of their immunisation status.