Symptoms of tetanus in humans may not appear for a long time - up to one month. During this period, the pathogen manages to multiply greatly and become stronger in the body, which greatly complicates the treatment of pathology. Since tetanus is a serious illness that often leads to death, the vaccination schedule indicates the timing of compulsory vaccination. In addition, people who have suffered major burns or wounds are given a specific substance that helps prevent the development of the disease.
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Is infection possible if vaccinated?
The presence of vaccination in humans does not prevent the pathogen from getting inside, but does not allow it to multiply and adversely affect the body. If all vaccines were administered according to the schedule of vaccinations, then there is nothing to fear. Such a person has a specific immunity, which is configured to destroy the causative agent of tetanus, so the disease will not have time to manifest itself.
For the first time, tetanus vaccination is given to babies - at 2 months, then at 4 months, and the last at half a year. At 18 months of age, the child needs to be revaccinated, and then repeat it at 6 years old. Specific immunity persists for 7-10 years, so once a decade, every person should be revaccinated.
Tetanus infection is possible if the vaccine was administered more than 10 years ago.
Since the more time has passed since the moment of formation of immunity, the weaker it is. People with a high risk of developing tetanus (wounds, burns) should be given anti-tetanus serum, especially if the last vaccination was 7-10 or more years ago.
Children who have completed the vaccination calendar will not need to use serum, since their immune system is able to cope with the pathogenic microorganism itself. The immunity of adults is 100% overcome by the virus itself if the vaccination was given at least 7 years ago.
Ways of human infection with tetanus
The causative agent of infection, spores, can live in a different environment (soil, salt or fresh water). Most often they are found in places where the earth is moist and receives a lot of fertilizer, for example, in the forest. It is interesting to know that tetanus sticks live all the time in the intestines of humans or domestic animals, but they are not capable of causing the disease. Just getting into the ground, the sticks form spores that are able to live in it for several years. Infection occurs through direct contact of the microorganism with the damaged area of the skin - the wound transmission path.
The most dangerous are lacerations that penetrate deep into the tissue and form pockets inside - areas where oxygen cannot penetrate. This creates optimal conditions for the development of spores - an oxygen-free environment, the presence of humidity and heat (temperature over 37).
Also, the disease can occur after burns or frostbite with large areas of damage. Since such injuries greatly weaken the immune system and the body as a whole, the pathogen does not interfere with development. Sometimes by infecting a person with tetanus, shallow scratches can become, but this rarely happens. To mitigate the risk of infection, each scratch must be treated with an antiseptic and cleaned of contamination.
In theory, the tetanus pathogen can enter the body of newborns through an unhealed wound from the umbilical cord. But in practice, such incidents are recorded in underdeveloped countries, where the medical staff do not always correctly assist and do not adhere to asepsis rules. Tetanus in newborns can develop if the baby was born outside a medical facility in septic conditions.
What to do if there was a cut or wound
To reduce the risk of tetanus, you need to be able to competently provide first aid for injuries. Ordinary, shallow damage is enough to rinse and treat with an antiseptic.
But if the wound penetrates far inward or it was inflicted by animals, it is better to protect yourself:
- Firstly, if large vessels were not damaged, there is no need to stop the blood. Let it leak a little and wash the wound. In case of heavy bleeding, it must be quickly stopped to prevent large blood loss and, as a result, complications, in the form of hemorrhagic shock or anemia.
- Secondly, rinse the damaged area as soon as possible under running water. For the best effect, you can use a solution prepared from laundry soap.
- Then, using cotton or gauze balls, remove all foreign elements and dirt - small pebbles, sand, earth.
- Abundantly clean a clean wound surface with an antiseptic - hydrogen peroxide, chlorhexidine.
- Contact a specialist who will carry out emergency prevention.
Emergency immunization is the introduction of a specific substance (serum) to a person that contains ready-made antibodies. Once in the body, they immediately begin to attack the virus and prevent it from multiplying.
There are two types of tetanus toxoid:
- horse - is extracted from the blood of animals. She has a simple manufacturing technology, it is cheap and affordable.But people often develop allergic reactions in response to the ingestion of an animal immunoglobulin into the body, so this tool is used with extreme caution. It is not recommended for children, the elderly and allergy sufferers;
- human - due to the closer structure of proteins, it is transferred much easier. But it’s more difficult to extract human immunoglobulin, so it is far from always available at aid points.
Emergency immunization is stress for the body, in order to avoid unnecessary worries, you need to carry out all vaccinations in accordance with the compiled vaccination calendar. If anti-tetanus immunization has been done, then emergency administration of immunoglobulin may not be necessary.
The incubation period of the disease
After falling into conditions that are favorable for development, the causative agent of tetanus begins to multiply rapidly. At the same time, it produces a special toxin that penetrates the adjacent nerves, and then through the bloodstream - into the brain and spinal cord.
The process of spreading tetanus toxin takes a certain time, which depends on the location of the gate where the infection came from, that is, the site of skin damage. The farther from the central nervous system the wound is located, the more time it takes for the infection to reach the brain, the longer the incubation period of tetanus will be. In addition, its duration is affected by the state of the human immune system and the presence of specific antibodies.
Usually the first symptoms begin to manifest themselves after a week, but sometimes the incubation period can be reduced to several hours or last a month.
How is tetanus manifested?
Manifestations of the disease depend on the stage and form of the pathology. Allocate fulminant, acute and chronic variant of the course of tetanus. They differ in the rate of onset and increase of symptoms. The most dangerous - fulminant form, it begins with general seizures, without the gradual development of symptoms, often the patient dies for 1-2 days. Chronic tetanus can last several months.
The first signs of tetanus in adults and children
The clinical picture of tetanus in adults and children is practically the same. In people after 25 years, the disease often proceeds severely, in connection with the prescription of vaccinations. But if a person carries out revaccination every 10 years, then there should be no differences. A vaccinated child has a minimal risk of infection.
The first symptoms of tetanus begin to manifest themselves at the end of the incubation period. They are less characteristic than the symptoms that occur later, so it is difficult to correctly diagnose them.
Be sure to pay attention to such signs:
- increased sweating;
- difficulty swallowing food and saliva;
- muscle twitching near a lesion or scar if the wound has already healed. You can check the symptom by gently running the tip of a pencil over the skin;
- increased muscle tone in the wounded limb;
- finding a diseased limb in a forced position.
Complaints of sore throat and difficulty swallowing are often attributed to a banal tonsillitis, therefore, for the differentiation, the main role will play increased tone and tendon reflexes.
Stages of the disease and symptoms
During the disease, four stages of tetanus development are distinguished, which follow one after the other.
Incubation
It lasts from the moment the tetanus spore gets into the wound until the first clinical manifestations of the disease. During this period, there are no symptoms, the pathogen multiplies and spreads throughout the body, poisoning it.
initial stage
Its duration is 1-3 days. The first to appear are dull, pulling, painful sensations at the site of infection - in the wound, even if it has already healed. At the same time or after a short period of time, trismus develops.The patient's masticatory muscles begin to shrink convulsively, sometimes their tension is so strong that a person cannot bite his teeth.
High stage
It lasts from one to two weeks, in debilitated patients it can last 3 weeks or more or, conversely, contract, ending in death. During this period, the patient is tormented by convulsions that occur spontaneously or as a result of slight irritation - noise, light, sound.
Stage of recovery
A long process (about 2 months) of gradual recovery. The intensity and frequency of convulsive seizures is gradually decreasing, the patient is returning to normal.
Symptoms of tetanus at the height of the disease
Trism combined with convulsions of facial muscles give the patient a specific look - a sardonic smile appears. A person expresses suffering, crying and at the same time a smile. The mouth is greatly stretched in breadth, its corners sink. The muscles of the pharynx are cramped, because of this there are difficulties with breathing and eating. At the same time, rigidity develops, which begins in the muscles of the neck, and then gradually spreads to the entire body. The abdomen becomes hard, it is impossible to palpate, and the patient cannot move.
After rigidity, cramps occur, they are painful, appear as a result of irritation, or on their own. A sharp sound, light, nervous shock can provoke them. At first, small groups of the muscular system contract, but with the development of the disease, the area of the seizure increases. Perhaps the development of opisthotonus - a general cramp, the patient’s body bends tight, only the heels and head touch the surfaces. Seizures last from a couple of seconds to several minutes, during the interconvulsive periods muscle relaxation does not occur, they are constantly in tension.
During the attack, the patient appears sweat, his face becomes puffy, turns blue. As a result of a spasm, the airways partially or completely overlap, the sphincters of the body cease to fulfill their function - defecation and urination are impaired. Blood circulation is disturbed, stagnation occurs, the heart rhythm breaks down. The temperature rises to high values - more than 41 degrees.
Most often, death occurs due to oxygen starvation due to spasm of the muscles of the upper respiratory tract, or due to paralysis of cardiomyocytes - muscle cells of the heart.
Tetanus diagnosis
Diagnosis of tetanus is based on characteristic clinical manifestations, as well as on an epidemiological history — the presence of cuts, bites, burns or frostbite, even if the lesions have already healed.
A bacteriological examination is usually not required, but the pathogen can be isolated from various biological material, which is taken at the site of penetration of the microorganism.
Tetanus treatment
Treatment of the disease is carried out only in a hospital setting; a separate, specially equipped room is allocated for the patient. The room should be dark, with poor piece lighting, and quiet, as noise and light provoke bouts of seizures. The patient must be placed on a soft bed, an air or water mattress is best suited. All manipulations, including feeding, are carried out exclusively after the introduction of anticonvulsants. The patient is fed only through a probe, if paresis of the gastrointestinal tract develops, then it is transferred to intravenous administration of nutrients. Food should be grated, homogeneous, since a solid particle, passing through the digestive tract, can provoke muscle spasm. Nurses carry out the prevention of pressure sores - gently turn the patient over, wipe the skin with camphor alcohol.
To neutralize the tetanus toxin circulating in the bloodstream, intramuscular administration of a large dose of a specific serum or immunoglobulin is prescribed. The dosage in each case, the doctor selects individually.
The wound or scar from which the microorganism penetrated is re-dissected, cleaned and chipped with the same immunoglobulin that was administered intramuscularly.
Read also: keloid scar
Symptomatic therapy is also carried out:
- antipyretic - to combat hyperthermia;
- anticonvulsants, muscle relaxants - to reduce the intensity, frequency and duration of convulsive seizures;
- means that support the work of the heart and lungs.
With an increase in the frequency and duration of seizures, muscle relaxants with a prolonged effect are prescribed, they intubate the patient and transfer him to the vent. From this moment, instead of a person, the apparatus “breathes”. If a sphincter spasm develops in the urethra, the patient must be catheterized. The treatment is long, it takes 1-3 months to fully recover.
Possible complications
Complications of tetanus can occur in the early stages (at the height of the disease) or in a recovered person.
Early complications develop from a sharp muscle strain, as well as due to congestion in the body, they include:
- bronchitis, pneumonia;
- auto-fracture of the spine or individual bones - does not occur due to a fall, but due to seizures;
- rupture of muscle fibers, tendons;
- acute heart attack;
- vein thrombosis, pulmonary embolism;
- muscle detachment from the point of attachment.
Late complications appear after the pathology, they can last a lifetime:
- constant weakness, palpitations - usually go away after 2-3 months;
- deformation of the vertebrae, curvature of the entire spinal column;
- contractures, due to which a person loses the ability to make full movements of the affected joint;
- paralysis of nerves.
After the end of the disease, a person must be registered with a neuropathologist for at least 2 years and regularly visit him.
Tetanus prophylaxis
There are three types of tetanus prophylaxis:
- specific - vaccination of the population, which is carried out according to a special calendar;
- nonspecific - measures aimed at strengthening the body;
- emergency - the introduction of sera to people who have been injured.
Specific planned prevention
The first time a vaccine (DTP) is administered to very young children - at 2 months. In addition to tetanus, the drug makes the immune system produce antibodies against diseases such as diphtheria and pertussis. Then the vaccination is repeated at 4 months and six months.
Revaccination is done one year after the last vaccination, at 18 months. Then it is carried out at 6 years old, 16, 26 and so on. To maintain immunity at the proper level experts recommend vaccination once a decade.
Nonspecific Prevention
The second type of prevention is aimed at increasing the body's resistance, strengthening immunity and reducing the risk of tetanus infection.
Nonspecific measures:
- quit smoking;
- minimize alcohol intake;
- temper the body;
- consume enough vitamins and minerals;
- engage in all possible sports, lead a healthy life;
- treat all damage with an antiseptic and clean from foreign elements.
Tetanus is a serious disease that cannot be ignored. Without timely treatment, he will be 100% likely to die. With the appointment of correct therapy, more than 80% of patients survive. The sooner the serum is administered, the lower the risk of getting sick. The sooner treatment is started, the greater the chance of a full recovery.
