A Sydney woman has died from tetanus in the first recorded fatality in the NSW since 1993.
NSW Health confirmed on Thursday that the woman in her 80s died from the bacterial infection on April 1.
Her death follows an additional two notifications of tetanus recorded in the state this year, including another Sydney woman in her 80s, and another woman in her 70s from northern New South Wales.
NSW Health said all three cases stemmed from contaminated garden soil entering their legs via a minor wound.
They are the first tetanus cases reported in NSW since 2019.
"Tetanus is a rare, but potentially fatal disease," director of communicable diseases Dr Christine Selvey said in a statement.
"Vaccination is the best protection against tetanus."
Dr Selvey said the disease mostly occurs in older people, usually women, who have not been adequately immunised.
"This serves as a reminder for all older Australians to check their tetanus vaccination status," she said.
"If there is any doubt, speak to your general practitioner about whether you should have a tetanus vaccine."
NSW Health said two of the women had no prior tetanus vaccinations in their medical records, while the third had received the vaccine over three decades ago.
Tetanus bacteria commonly found in the ground
Dr Selvey told ABC News that while the bacteria is always present in soil, it is still unusual to see the number of recorded cases this year.
She explained that the bacteria that causes tetanus to grow produces a toxin which causes a painful muscle spasm in the face, often referred to as "lock-jaw" as people cannot open their mouth.
The spasms then spread from the head and neck down through the rest of the body, which can eventually prevent breathing.
While she cannot speak to individual cases, Dr Selvey said the cases in New South Wales are a wakeup call.
"If you do get a wound ... particularly if something has penetrated the skin like a thorn or a stick, make sure that those wounds are properly washed with fresh water," she said.
NSW Health pushes for vaccine check-up
The department is urging people in the state to ensure their tetanus vaccinations are up to date.
A three-dose primary course of the tetanus vaccination is offered to infants through the National Immunisation Program.
However, the health department says adults can arrange a booster dose at age 50 and 65 if it has been more than a decade since their last dose.
Those who have never received a primary course should receive three doses of the vaccine, followed by a booster dose after 10 and 20 years, said NSW Health.
