Tetanus is a disease that has been known since ancient times. The famous doctor Hippocrates as early as the 5th century BC described in detail its symptoms. But unfortunately, the topic of tetanus remains relevant in the modern world. This is due to the large number of deaths of this disease. Statistics show that approximately 160 thousand people in the world die from tetanus every year.
a brief description of
Tetanus is one of the serious infectious diseases. It is characterized by the release of a lethal toxin and a fairly rapid clinical course. In order to be able to fully understand the whole problem of the appearance of this disease, it is enough to have information that 30-50% of patients die. Among them are those who have been vaccinated against tetanus. In countries with underdeveloped medicine, this figure reaches 85-90%.
Tetanus causes the vital activity of microorganisms that enter the body through wounds and other skin lesions. The most suitable circumstance for their reproduction is a hot and humid environment. Therefore, most of all reported deaths from tetanus occurred in the equatorial states of Africa, Asia and Latin America. But even in relatively prosperous European countries, thousands of people die from this disease every year. Based on this, it cannot be said that residents of more civilized regions are safe.
Causative agent of tetanus
Tetanus pathogens are representatives of the Bacillaceae family. Under ordinary circumstances, their reproduction occurs in the animal and human intestines. However, they do absolutely no harm. During their penetration into the wound and in conditions of absolute oxygen absence, these quiet bacilli acquire an absolutely opposite character. A lively release of toxin occurs, which is one of the strongest bacterial poisons. Their influence is very rapid, as well as the development of a disease called tetanus. Symptoms in children are sometimes noted within a few hours after infection. The waste products of pathogens are completely harmless when swallowed, because they are not absorbed through the mucous membrane. But during heating or under the influence of ultraviolet rays, they die quickly enough.
How are tetanus infected?
The need for vaccination occurs when a wound or damage to the skin or mucous membranes occurs. The most difficult in this case are cut wounds of great depth, since it is in them that the formation of ideal conditions for the development of harmful microorganisms occurs. Also, activation of the infection can occur with burns, frostbite and inflammatory diseases. A newborn baby can get tetanus through the umbilical cord if it has been cut with poorly crafted tools.
The causative agents of this disease are many in nature. They are:
- in house dust;
- the earth;
- salt and fresh water;
- feces of most animals.
Spores and vegetative configurations of tetanus bacillus are present in the human intestine.
The level of sensitivity to this disease is very high in all age groups, but most of all the disease in children is recorded at 3-7 years.
What incubation period does tetanus have?
How long does tetanus manifest? Incubation of the disease takes a different period of time - from 1-2 days to 2 months. At the same time, the average indicators are 1-2 weeks. The severity of the disease itself depends on the duration of the incubation period: the smaller it is, the harder the disease will go and the greater the chance of death.
At this time, bacteria enter the nutrient medium and their reproduction begins. It is accompanied by the release of a deadly toxin. Patients during this period may notice the presence of the following symptoms:
- headache;
- sweating
- muscle tension
- increased level of irritability;
- chills;
- insomnia and other neuropsychiatric disorders.
The clinical picture and the first symptoms of the disease
The onset of the disease in most cases is acute. Quite rare are cases of registration of a small prodromal period. It is expressed by the appearance of the following symptoms:
- malaise;
- headaches;
- tension and muscle contraction where the wound occurred and tetanus develops.
The first signs in most cases are muffled pulling pain at the wound site, even if it has already healed. Among the first specific signs of the disease, the appearance of which may indicate tetanus, are:
- the manifestation of trismus (convulsive compression) of the masticatory muscles, which is the reason for opening the mouth;
- the presence of a sardonic smile, due to which the expression on the face becomes viciously mocking (a forehead wrinkles, eyes decrease, lips extend in a smile);
- the manifestation of dysphagia (swallowing disorders), the cause of which is a convulsive spasm of the muscles of the pharynx;
- stiff neck muscles.
The presence of the first 3 symptoms is characteristic only for tetanus.
Characteristic features of the period of high tetanus
The duration of the height of this disease is 8-12 days. In severe forms, it increases by 2-3 times. The duration of this phase of the disease depends on the following factors:
- speed of treatment to the doctor;
- the presence or absence of vaccination;
- the extent of damage to the skin.
Tetanus is often found at this stage. Symptoms in children are as follows:
- convulsive contractions of facial muscles, the appearance of a characteristic smile;
- difficulty swallowing food;
- muscles of the limbs and abdomen are very tense;
- painful convulsions;
- significant sweating;
- chronic insomnia;
- apnea, cyanosis; asphyxia;
- violation of the urinary process and blood circulation;
- a significant increase in temperature.
When a tetanus shot was not given, the cause of death is a spasm of the respiratory muscles or paralysis of the heart muscle. Also, among the most common causes of death, the main place belongs to myocardial infarction, sepsis, embolism and pneumonia.
Tetanus in newborns
If we are talking about newborn children, then the course of the disease is the most difficult for them, and in almost 100% of cases there is a fatal outcome. For children, a special form of the course of such a disease as tetanus is characteristic. The first signs are anxiety, a shiver of the chin, a violation of the swallowing and sucking reflex. After that, muscle spasm of the neck and general cramps begin. Often a newborn dies on the first day after the onset of the disease.
Recovery period
If the parents showed the child who has tetanus in time for the medical staff, the treatment is gradual and the symptoms of this disease disappear over time. The duration of this stage reaches 2 months. Throughout this period, the child is very at risk of developing a variety of complications. In this regard, constant monitoring of his condition is required.
After recovery, residual effects can occur that are observed for a sufficiently long period of time. These include muscle stiffness, general weakness, etc.
Forms of the disease
In severity, there is a mild, moderate and severe form of tetanus.
A mild form is extremely rare. The incubation period is 14-20 days, and the development of symptoms occurs over 5-6 days. It is characterized by:
- weak severity of general tetanic convulsions (or their absence);
- local convulsive muscle shudders (tetanus symptoms in a wound or in its area);
- mild muscle hypertonicity ;
- the absence or slight manifestation of dysphagia and tachycardia;
- normal or low-grade fever.
The main characteristics of moderate tetanus:
- the incubation period is 15-20 days;
- the development of the main complex of symptoms - 3-4 days;
- moderate severity of all symptoms of the disease;
- lack of asphyxia and swallowing disorders.
The severe form is characterized by a rather short incubation period of 7-14 days. In this case, tetanus develops within 1-2 days. Symptoms in children manifest themselves quite clearly. But complications that threaten a child’s life are usually rare.
Tetanus treatment
Urgent delivery to a medical institution of a child with suspected tetanus is required. Treatment of especially dangerous forms is carried out after hospitalization in the intensive care unit.
A necessary measure is wound surgery, during which the excision of damaged tissue and the removal of foreign bodies are performed.
To eliminate the vegetative forms of tetanus sticks from necrotic tissues, antibiotic therapy is performed. In most cases, during the course of it, large doses of penicillin are administered intravenously. The duration of such therapy is at least 10 days. In case of penicillin intolerance, an tetanus injection, which consists of tetracycline, is prescribed.
Treatment of sick children is carried out using specific human immunoglobulin. It is administered once intramuscularly. In parallel with it, subcutaneous administration of tetanus toxoid is carried out three times. The interval between administrations is 5-7 days.
In order to alleviate the condition of the child, they provide him with peace and quiet. In addition, there is symptomatic treatment that affects how the tetanus flows. Symptoms in children are eliminated through the following measures:
- wound treatment;
- decrease in convulsive intensity;
- prevention of sepsis and pneumonia;
- improved lung ventilation;
- anesthesia.
Tetanus prophylaxis
Based on the fact that this is a fatal disease, preventive measures are very significant. They contribute to a significant reduction in the number of episodes of the onset of the disease, facilitate the course and consequences of tetanus. Preventive measures are specific and non-specific.
A non-specific type of prevention of the appearance of a disease in children consists in the following measures:
- compliance with sterility during labor and operations;
- scrupulous treatment of wounds, which is recommended to be carried out using antiseptics.
Specific tetanus prophylaxis is carried out as planned or urgently. The main purpose that the tetanus vaccine has is to create personal immunity and immunological memory. Vaccination of children is carried out accordingly with the vaccination schedule - 3 times after the third month of life and revaccination after 1-1.5 years.
A tetanus vaccine for children does not guarantee the presence of persistent immunity to the causative agent of this disease. It only supports artificial immunity and helps to overcome the tetanus sticks found in the body.