Whether working outside, with hand tools or fixing up a house, there is a rite of passage: the emergency room trip for an updated tetanus shot.

We live in an area where our yard is filled with buried treasure, if you consider treasure to be rusty nails, old septic systems and wire fencing. Years ago, my husband had a run-in with a defunct septic tank. One rusty scrape brought us to the ER, where he got a tetanus shot. A few years pass, and I’m gardening only to dig up a buried metal fence, which I discover after a piece impales itself into my palm. Between the dirt and blood, I met all the lovely people at our emergency room for the recommended immunization.

According to the Mayo Clinic, tetanus is an infection caused by environmental bacteria Clostridium tetani (C tetani), which attacks the nervous system. The bacteria spores enter the body through a wound, such as a cut, scrape or puncture. Tetanus is not caused by rust. The bacteria is found in animal feces, saliva, dust and soil. The rusty objects usually provide a way the bacteria enters the bloodstream.

Though cases in the U.S. are rare due to the widespread use of vaccines, the disease can be a threat to anyone not up to date with their shots. Commonly known as lockjaw, the infection can be life-threatening. Symptoms can include muscle spasms, difficulty swallowing, and painful seizure-like spasms. Symptoms usually occur between three and 21 days after exposure.

The Centers for Disease Control recommends that all U.S. children get a tetanus shot. In New York state, diphtheria, tetanus, and pertussis are given to children under the age of seven. According to the state Department of Health, “children attending any NYS public, private, and religious schools, pre-K and daycare must get all required vaccinations unless they have a valid medical exemption.” The tetanus vaccine is one of the required immunizations.

This weekend, it was my daughter’s time to update her vaccines. She stepped on an old metal wreath frame, and one of the wire clamps pierced her foot. How did this happen? I threw the old wreath form down the stairs while she rounded a corner. We will discuss the emotional trauma at another time. She is fine. One trip to the ER for an updated tetanus shot, a round of antibiotics, and a bowl of ice cream, and she’s good to go. It goes to show that no good comes from cleaning the house.

Keep in mind a tetanus booster is recommended every 10 years or after five years in case a dirty wound, burn or severe puncture.

Be careful.