The incubation period of tetanus and the first symptoms. Tetanus: incubation period, symptoms, treatment, consequences and prevention Tetanus disease description

Tetanus in humans is an acute and life-threatening disease that has a very extensive complex of various manifestations. Emergency therapeutic and preventive measures can save lives if the diagnosis is made on time. Therefore, it is important to know the symptoms of tetanus, and how the disease manifests itself at different stages of infection.

How do you get tetanus

Tetanus refers to zooanthroponic diseases, that is, the disease is inherent in both animals and humans. The infection can be in the soil, in the faeces of animals and birds, in dust particles for quite a long time. The tetanus virus is highly resistant to survival in various environments - it tolerates disinfection, high and low temperatures.

The infection enters the human body exclusively by the contact method, penetrating through wounds (scratches, burns, cracks) on the skin of any origin.

The main ways of infection:

• Burn and surgical wounds;
• dental wounds;
• Frostbite wounds;
• Stab, gunshot wounds;
• Ulcers, cracks, injuries on the leg, feet;
• Open fractures, injuries with crushing of bones;
• Infection through the umbilical wound in newborns;
• Wounds after a dog bite (cat bite).

The risk group for tetanus infection includes agricultural workers and livestock breeders - people who have frequent contact with the soil, children under 10 years of age (due to the high level of injuries), newborns in case of violation of the rules of antiseptics during childbirth.

Tetanus is called "bare foot disease" because more than half of cases of infection occur through damaged feet (with a wound, scratch, crack) from the soil.

Main symptoms

The incubation period from the moment of infection to the first symptoms can be from one to 15 days. The duration of the incubation period and the rate of development of the disease depends on the depth of the wound, the site of the wound through which the infection occurred, and the amount of the virus.

Important! The main symptom of tetanus is twitching of the facial muscles. Such manifestations occur at different periods of time, which makes it difficult to diagnose the disease.

Main symptoms:

• Muscle contraction on the face (the appearance of a "sardonic" smile);
• Difficulty swallowing;
• The appearance of soreness in the muscles;
• Difficulty breathing;
• Strong sweating;
• Increased muscle tone;
• salivation;
• Difficulty breathing;
• Fever;
• Disorders in defecation and urination.

The acute course of tetanus is accompanied by symptoms in which there is a spasm of various muscle fibers.

The beginning of the infectious process is characterized by soreness and "twitching" directly at the site of infection. After, the course of the disease can be conditionally divided into several periods:

1. Incubation (latent);
2. Elementary;
3. The height of the disease;
4. Recovery stage.

Symptoms of the incubation period

During this period, the infection does not manifest itself with pronounced symptoms; the disease can only be detected with the help of tests.

The severity of manifestations depends on the duration of the latent stage - the shorter the incubation period, the less pronounced the signs of tetanus.

Signs of the initial stage:

• The appearance of a migraine;
• aches;
• Muscle tension in the area of ​​injury;
• Feelings of irritation and discomfort;
• Increased sweating.

The average duration of the period is 12 days, but can reach up to a month. In this case, most often the disease begins unexpectedly for a person, especially in cases where the site of infection has not been identified.

Symptoms of the initial stage

This period lasts for 1-2 days and is characterized by the appearance of pain in the area of ​​the wound through which the infection occurred, even if this place has already begun to heal.

There are specific signs:

• Muscle contraction above the wound.
• Trismus is a tonic spasm in the muscles of the temporomandibular region, which limits chewing functions.
• Sardonic smile - the facial muscles contract: the corners of the mouth are stretched, the eyes are screwed up, the forehead is wrinkled (see photo).
• Dysphagia is a specific contraction of the muscles of the pharynx, accompanied by pain.

Important! Dysphagia, trismus, and a sardonic smile are specific symptoms that are unique to tetanus.

There may be spasm of the muscles of the occipital part, in which it becomes difficult to bow the head to the chest.

Hot period symptoms

During this period, there is a peak in the development of tetanus symptoms, the peak of the disease can last 1.5-2 weeks, depending on the severity of the course.

Characteristic manifestations:

• Convulsive contractions cover the entire body, as if descending from head to toe. Convulsions appear unexpectedly, their increase is gradual, and the duration can be from a few seconds to a minute. The intensity of the convulsions is so strong that it literally "breaks" a person - twists the joints and bones, tears the tendons.
• Muscular tonic tension reaches a peak and does not weaken even at night, accompanied by severe pain. There is tetanus opisthotonus (pictured): the abdomen hardens, the torso is arched, the arms are bent at the elbows, and the legs are pulled out in a “string”.
• Breathing due to disturbances in the diaphragm becomes difficult, signs of asphyxia appear.

All these processes are accompanied by fever, profuse salivation, disorders in defecation and urination.

Seizures become more frequent - during the day they can appear dozens of times. In this case, the person's face acquires a bluish tint, expresses pain and suffering, the person may have a fever and blood pressure. The patient screams, groans, grinds his teeth, suffocates.

Muscle contraction is so strong that it can lead to fracture of the vertebrae, rupture of muscles and ligaments.

Important! With intense symptoms of tetanus without treatment and timely assistance, death most often occurs.

Symptoms of the recovery period

The recovery period begins, depending on the severity of the course of the disease, by the end of 2-3 weeks. The frequency of seizures gradually decreases, muscle tone decreases, and the general condition improves.

The process of complete recovery is very long and can take 2-3 months. In the absence of complications, the disease can be cured.

Forms of tetanus and their symptoms

The course of the disease, symptoms and treatment of tetanus depend on the form of the disease:

• Light form. The incubation period can be over 20 days. There is a slight increase in temperature, mild symptoms of tetanus (trismus, dysphagia, sardonic smile). Symptoms may not manifest themselves at all, because. there is a hidden and latent course of pathology. If you do not carry out treatment, a transition to the acute phase of the disease is possible.
• Medium form. It develops within 15-20 days, while clinical symptoms increase in 3-4 days. Typical symptoms (dysphagia, trismus, sardonic smile) become pronounced, convulsions become more frequent, the temperature can reach 39 degrees. There is an increased heartbeat, increased blood pressure, increased sweating appears.
• Severe form. The course of the disease occurs in 7-14 days, the symptoms increase during the day. Muscle tension is pronounced, convulsions occur several times per hour. There are sharp jumps in pressure, fever, tachycardia.
• very severe form. The rapid form of tetanus, most often ending in death. The incubation period is only a few days, the symptoms are growing right before our eyes: convulsions practically do not stop, the temperature mark exceeds 40 degrees. Resuscitation measures are required.

local form

There is also a local form of tetanus, in which the symptoms are expressed locally, and the characteristic signs of the disease are often invisible.

Symptoms of tetanus in adults with a local form depend on the affected area:

• Local twitching in the area of ​​infection without the addition of other specific manifestations of tetanus.
• Soreness of the muscles at the site of the wound.

In this case, the infection does not penetrate very deeply, because the lesion does not affect the internal organs. A lethal outcome in this form of tetanus can only occur due to allergic complications.

Neonatal tetanus

A fairly rare form of the disease, which most often ends in the death of a child. The course of the disease is very severe, a newborn child suffers only from acute forms of tetanus.

In newborns, the disease is manifested by a violation of swallowing and sucking, the appearance of a sardonic smile, and contraction of the muscles of the face. An attack of convulsions in children with low weight may be manifested by arching in only one direction.

Complications of tetanus

The disease can be complicated by various processes in which the treatment of tetanus can be delayed for several months. The most dangerous complication is suffocation (asphyxia), in which oppression of cardiac activity occurs and a heart attack is possible.

Other complications of tetanus:

• Heart failure;
• Rupture of muscles and ligaments;
• Fractures of the spine and bones;
• Bronchitis and pneumonia;
• Sepsis;
• Pain shock.

In children, complications from tetanus manifest themselves in the form of pneumonia, and in the later stages of the disease - anemia, a disorder of the digestive system.

The prognosis of tetanus depends on the form of the course and the severity of the process. In severe stages of the disease with a rapidly developing clinical picture, death most often occurs as a result of untimely assistance.

Tetanus is quite difficult, so it is better to prevent the onset of the disease. For this, vaccination of the population is carried out, in which both adults and children participate. After a tetanus shot, the risk of contracting an infection is minimized.

Tetanus has been known since the time of Hippocrates, who was the first to make a detailed description of this disease. In ancient times, tetanus was common in men during wars. And in women - after childbirth or abortion. At that time, the nature of tetanus was not yet known. The fact that this disease is caused by a bacterium was discovered only at the end of the 19th century.

Tetanus scares people even today. After all, most people know that it is extremely dangerous and very often leads to a painful death. What is this disease? What symptoms does it manifest? Why is death a frequent outcome? How can you protect yourself? What to do if the infection still occurs?

The causative agent of tetanus

What is tetanus? - This is a serious infectious disease in which the nervous system is affected, and multiple severe convulsions occur, often leading to death.

The causative agent of tetanus is Clostridium tetani. It belongs to bacteria that live in an airless environment, oxygen has a detrimental effect on it. However, this microorganism is very stable due to its ability to form spores. Spores are resistant forms of bacteria that can survive in adverse environmental conditions. In the form of spores, Clostridium tetani easily tolerates drying, freezing, and even boiling. And when it gets into favorable conditions, for example, a deep wound, the spore goes into an active state.

Clostridium tetani spores are found in soil, house dust, feces of many animals, and natural reservoirs.

If this spore is so common in our environment, then the question arises, why did not all people become infected with tetanus? The fact is that this microbe is safe if swallowed. Although it is not destroyed by hydrochloric acid and enzymes, it cannot be absorbed through the gastrointestinal tract.

How is tetanus transmitted? This is a wound infection - the pathogen can enter the body through wounds, burn surfaces, frostbite areas. Clostridium tetani loves deep wounds, as they can create oxygen-free conditions.

Where is the disease common?

Tetanus is distributed throughout the world. A high concentration of the pathogen in the soil is seen in areas with a humid and warm climate. The incidence worldwide is about 1 million people a year.

Do they die from tetanus? In terms of mortality, the disease is in second place after rabies among all infectious diseases. Mortality from it, depending on the area, ranges from 40 to 70%. More than 60,000 people die from this disease every year. These statistics do not include unexpressed forms of the disease and unreported cases. In developed countries, where tetanus vaccination is mandatory, the mortality rate is 0.1-0.6 per 100,000 population, and in developing countries - up to 60 per 100,000.

Among children, 80% of cases occur in newborns, mainly in poor countries (Africa, Latin America, Asia). Among the adult population, 60% are elderly people. In rural areas, mortality is higher than in urban areas due to high injuries.

Ways of infection

How can you get tetanus? This is a zooanthroponotic disease, that is, characteristic of both animals and humans. But one person cannot infect another. You can get tetanus if you have a deep wound. This disease is subject to:

• children under the age of 8–9 due to the high level of traumatization (especially boys);
• newborns as a result of violation of the rules of asepsis and antisepsis when cutting the umbilical cord;
• adults with deep wounds (especially feet, palms, face).

The source of infection is man and animal. The Clostridium tetani stick is a normal inhabitant of the intestines, does not harm the host, lives, reproduces and is excreted as spores into the environment with feces.

You can notice the seasonality of the disease. Outbreaks are observed from April to October, during the period of active agricultural work. In 60% of cases, tetanus infection occurs when the feet are injured. Walking barefoot, stab wounds from nails, plant thorns, splinters often lead to the development of tetanus. No wonder it is called "bare feet disease".

The mechanism of origin and development of tetanus

Tetanus is caused by the ingestion of Clostridium tetani spores into a wound. In the absence of oxygen, they turn into active forms. By itself, the bacterium is harmless. But it produces the strongest biological poison - tetanus toxin, inferior in its toxic effect only to botulinum toxin.

Tetanus toxin consists of tetanospasmin, which acts on the nervous system to cause seizures, and tetanohemolysin, which causes hemolysis of red blood cells. The toxin penetrates through the nerve fibers and through the blood into the structures of the brain and spinal cord. There it blocks the nerve cells responsible for the inhibition of muscle contractions. Motor impulses from the brain are continuously sent to the muscles, and they contract sharply and uncoordinated.

Muscle cramps last for a long time, all the muscles of the body are involved in this:

• limbs;
• spine;
• faces;
• larynx;
• hearts.

Tetanus toxin disrupts the circulation of biologically active substances in the brain, damages the respiratory center and other vital structures. Hemolytic ones fade into the background compared to neurological ones.

The first signs and symptoms of tetanus

The incubation period for tetanus from the moment the bacterium enters the wound to the onset of the first symptoms is 1–14 days. Its duration depends on the place of injury, the depth of the wound, the amount of microbe that has entered. Depending on the proximity of the wound to the face, palms or feet, the rate of development of the disease depends on the depth of penetration of the infection and its quantity.

The first signs of tetanus:

• pain in the area of ​​the wound;
• headache;

Symptoms of tetanus in humans:

• spasm of masticatory muscles (difficulty opening the mouth);
• spasms of the muscles of the face (a “sardonic” smile appears, the lips are stretched, their corners are lowered, the forehead is wrinkled);
• convulsions covering all the muscles of the body in a downward direction (a person arches, standing on his heels and back of the head - opisthotonus);
• seizures occur in response to any irritating factor (light, sound, noise).

Convulsive attacks last only a few seconds or minutes, but during this time a person spends a huge amount of energy, is very exhausted and exhausted. As the disease progresses, the frequency of seizures increases. A condition is considered severe when they visit the patient almost continuously one after the other.

During convulsions, a person does not lose consciousness, he feels severe pain all over his body, fear, screams, grinds his teeth. Outside of attacks, he suffers from insomnia.

How else does tetanus manifest itself in humans

Difficulty opening the mouth and spasms of the pharynx lead to dehydration and starvation. Simultaneously with all the muscles, the muscles of the anus, the sphincter of the bladder, also contract, so emptying is difficult. Body temperature rises to 40 °C.

a sign of illness - it is difficult to open your mouth

There are milder local forms of tetanus, for example, facial, when there is only a contraction of the muscles of the face. But they are rare.

The tetanus clinic lasts 2-4 weeks. Recovery occurs in 1-2 months. But a person cannot start work for a long time due to stiffness of movements, compression of the vertebrae, contractures. The prognosis in half of the cases is unfavorable. The possibility of a poor outcome may be indicated by convulsions in the larynx, respiratory muscles, a temperature above 41.0 ° C, slower breathing, and an increase in pulse.

In newborns, tetanus is manifested by a violation of sucking and swallowing, contraction of facial muscles, and a “sardonic” smile. In premature and low birth weight infants, tetanus (an attack of convulsions) may present with arching to one side. The course of the disease in newborns is particularly severe, they suffer only from common forms of tetanus. During the day, more than 30 attacks may appear, different in duration.

Complications

In adults, the disease can be complicated by:

• muscle rupture;
• detachment of ligaments;
• bone fractures as a result of strong muscle contraction;
• bronchitis;
• pneumonia;
• sepsis.

The most common causes of death from tetanus are:

• choking as a result of prolonged spasm of the vocal cords or respiratory muscles;
• heart failure;
• spinal fracture;
• pain shock.

In children, tetanus is complicated by pneumonia, in later periods - indigestion, anemia.

Diagnosis of the disease

Diagnosis of tetanus is based on the clinic of the disease. History is of great importance. Isolation and identification of the microorganism is rarely performed. The content of toxin in the muscles is determined.

At the beginning of the disease, tetanus should be distinguished from periostitis, gingivitis, abscesses of the pharyngeal space, inflammation of the mandibular joints, when the patient cannot open his mouth. With tetanus, there is a prolonged tension of the masticatory muscles and their twitching.

At a later date, tetanus should be differentiated from epileptic seizures, strychnine poisoning, and hysteria in women.

In newborns, tetanus must be distinguished from the consequences of birth trauma, meningitis. In doubtful cases resort to spinal puncture. In older children, tetanus should be differentiated from hysteria and rabies.

Treatment

Tetanus treatment should only be done in a hospital setting. The main goal is to neutralize and quickly remove the toxin from the body.

The complex of therapeutic measures includes:

The patient is placed in a separate darkened room, all possible irritants are minimized. The causative agent is eliminated by surgical treatment of the wound. Neutralization of the toxin is carried out using tetanus toxoid horse serum. It is done once intramuscularly at a dose of:

• - 100,000–150,000 IU;
• newborns -20,000–40,000 IU;
• older children - 80,000–100,000 IU.

In addition to serum, tetanus toxoid human immunoglobulin is administered intramuscularly at a dose of 6 ml.

Anticonvulsants, muscle relaxants, neuroleptics will help alleviate the convulsive syndrome. In very severe forms, only muscle relaxants can cope with muscle contractions.

Disease prevention

The main measures to prevent tetanus are:

• vaccination;
• injury prevention.

Active and passive tetanus prophylaxis is carried out routinely or urgently.

All children aged 3 months to 17 years are scheduled to be vaccinated according to the national vaccination calendar. Vaccination, depending on the circumstances, can be done with isolated tetanus toxoid or a combination vaccine (,). For children, tetanus toxoid as part of the DPT vaccine is done:

When are adults vaccinated against tetanus? Vaccinations are given to adults every 5–10 years at will, or to persons at risk for morbidity: diggers, railway workers, builders and others.

Vaccination of adults against tetanus, if they have not previously been vaccinated, is carried out twice, and then revaccination is done every 10 years.

If a person has been ill with tetanus, then long-term immunity is not formed in him, and he can become infected with this disease again.

What vaccines are available for routine immunization? Both children and adults can be vaccinated with DTP, DTP-M, ADS-M, Pentaxim, Tetrakok, Bubo-Kok, Infanrix vaccines.

Emergency prophylaxis against tetanus is carried out in the following cases:

Emergency prevention of the disease is carried out with tetanus toxoid in a dose of 0.5 ml. If the child or adult has not been previously vaccinated, then an additional anti-tetanus serum is administered at a dose of 3 thousand IU. You can enter 3 ml of human immunoglobulin.

Tetanus vaccination during pregnancy is done only in case of strict indications. It is better to do it in advance during pregnancy planning.

Low incidence in cities can give the impression of a low prevalence and irrelevance of the disease. But it's not. Even though it's peacetime, tetanus is still a big problem. The disease is terrible because, being conscious, a person experiences great torment. Even with modern drugs, techniques and treatments, the death rate from tetanus remains very high. Therefore, the main focus should be on its prevention. If vaccination against tetanus was carried out in a timely and complete manner, then this allows you to almost completely eliminate the occurrence of this dangerous disease.

Among the serious diseases that modern man is afraid of is tetanus. This is a terrible disease that is not only acute, but also causes serious complications. To have more information about the disease, read this article. In it, we will tell you everything about such a disease as tetanus. The incubation period, symptoms, treatment, prevention, etc. will become known to you after reading the material.

What is tetanus?

This is acute. Its pathogens are bacteria that live in the soil (sapronous). The transmission mechanism of the disease is contact. Simply put, the bacterium enters the human body through the skin and causes illness. The first symptoms, signaling a tetanus infection, may appear on the first day, or even a month later.

How does infection occur?

As mentioned above, the bacterium penetrates the human body. This happens through the skin, in places where there are wounds, cuts, abrasions, i.e. integrity is broken.

Carriers can be rats, mice, birds and the person himself. The bacterium is very viable. It can function even at high temperatures. So, at 90 degrees, the bacillus that causes tetanus remains alive for 2-3 hours. In the soil, it remains pathogenic for a very long period, despite any adverse external conditions. The wand can feel comfortable and pose a threat to human life on any objects up to several years. Disinfectants do not work on it either.

Most often, people become infected with tetanus in the spring and summer. Where exactly the bacterium waits for its prey cannot be determined. Once in the body, the wand begins to move very actively throughout the body, infecting more and more areas. A minimal dose of the toxin is required for tetanus to develop.

When did the disease appear?

This disease is not new. It is impossible to say exactly since when people began to become infected with tetanus. The disease has been around for hundreds of years. For the first time they learned about it from the records of Hippocrates. In his treatise, he described the disease from which his son died. The study of tetanus began only in the 19th century. Studies have shown that a particularly large number of deaths from this disease occurred during the war. Later, a vaccine was developed, which was administered as a prophylaxis. It was she who served as a salvation from numerous deaths.

Where is tetanus most common?

Bacteria - the causative agent of the disease loves a humid environment. Very often the disease occurs in Africa, Asia, and even in America. But in recent years there have been cases of tetanus infection in Europe. However, they have a large number.

Tetanus is treatable, but even with timely measures to combat the disease, mortality is high, and the number of deaths is about 80%. The wand begins to act most actively in the warm season, mainly in rural areas.

Tetanus: incubation period. Symptoms. stages

The incubation period for the disease can be different. From 1-2 days to a month. Typically, the incubation period is two weeks. During this time, the person may feel unwell. In the place where he had a wound and was presumably infected with tetanus, there is muscle tension, their twitching. Also, the person becomes irritable, sweating increases.

In total, there are four stages of the disease:

1. Incubation period. Symptoms at this time do not appear clearly. dangerous because it is not possible to recognize the disease. Unless the person starts to worry in advance and decides to get tested.

2. Initial stage. During this period, a person begins aching pain. Mostly in the place of the wound, which seems to have already begun to heal. This period can be about two days. This starts the muscle spasm.

3. Heat stage. How many days is this period? Usually it's about two weeks. The symptoms are very pronounced. The most difficult period for a person, accompanied by constant convulsions, malaise.

4. Stage of recovery. At this time, a person becomes easier. You can understand that the body is on the mend, by the fact that convulsions gradually appear less and less.

Important point! During the recovery period, even though it becomes easier for a person, this time is very dangerous for him. It is at the stage of recovery that complications can begin.

Before talking about the signs of the disease, it is worth noting that the shorter the incubation period, the more severe the disease will be. The symptoms of tetanus in adults and children are as follows:

At the initial stage, tetanus manifests itself quite sharply. The first thing that happens when infected is the contraction of the jaw as a result of convulsions.

The next stage is which is a consequence of a spasm of the muscles of the face.

When the disease reaches its peak, muscle spasm begins throughout the body. It does not affect only the feet and palms.

When the cramps reach the muscles it becomes difficult to breathe. His breathing quickens and is shallow.

In the later stages of the disease, a person's back arches. It becomes noticeable by the way he lies on the bed. Between it and the back, the distance through which you can stick your hand is clearly visible.

One of the extreme conditions in a person is the moment when convulsions fetter a large part of the body, while causing excruciating pain.

Almost the entire period while the disease develops, the patient experiences severe irritation, he starts having problems with sleep, the temperature rises, and sweat profusely flows.

The symptoms of tetanus in adults are similar to those in children and pregnant women.

The likelihood of death in the presence of all these symptoms is high. But even if the treatment showed a positive trend, the recovery process will take several months. The possibility of developing complications is high.

Complications

Complications of tetanus that appear after the disease are directly related to the patient's condition. Simply put, breathing difficulties lead to problems with the lungs, stagnation of the contents occurs, which leads to pneumonia.

Convulsions, which fettered all the muscles, cause their rupture, patients may have fractures of bones, joints, vertebrae, torn ligaments. Spinal curvature may occur. Another complication of tetanus is a heart attack.

Sepsis, abscess, pyelonephritis and other infections of secondary origin may begin to develop.

For children, tetanus in most cases is a fatal disease. An adult recovers more often, but it all depends on the severity of the disease.

Analysis

The test for tetanus is done on the basis of venous blood. It is needed in order to investigate the specific state of immunity before starting vaccinations. It is also required in order to determine the level of antibodies after vaccination.

Any doctor can prescribe an analysis for tetanus: a surgeon, a therapist, a gynecologist, an infectious disease specialist, and so on. It can be done in medical institutions, as well as in immunological laboratories, in diagnostic centers.

Preparation for the delivery of the analysis

You do not need to follow any measures, except that in the morning, before taking the test, you should not eat anything. Also in the previous evening, it is worth avoiding emotional overstrain, various physical activities.

After the analysis and evaluation of the results, which should reveal the protective level of antibodies in the blood, vaccinations are made according to the vaccination calendar. After some time, revaccination is prescribed.

The effect of vaccination

The effect of the tetanus shot is the same as that of the others. A small amount of neutralized toxins of the pathogen is introduced into the human body. The human immune system must identify the microbe and start fighting it. To do this, it produces protective antibodies.

There is an opinion that the tetanus vaccine is very dangerous, because there is a risk of infection. But such an opinion is erroneous, because all vaccines are researched and manufactured in the laboratory in accordance with safety standards.

At what age is the tetanus shot given?

It is necessary to start vaccination from the age of three months. The next vaccination is done at 4.5 months. After - in a year and a half and then already in 6-7 years.

If a full course of vaccination was completed in childhood, then in adulthood, the vaccination should be done only once every 10 years. The first revaccination starts at 18 years of age.

If the full course was not completed in childhood, then the vaccination for the first time in adulthood is given twice. If you are interested in the question of how many days the re-vaccination will be carried out, then according to the rules - no less than a month later.

Side effects and contraindications of the tetanus vaccine

The vaccine is administered intramuscularly. It can be done in the shoulder, shoulder blade or thigh. After that, some side effects may be observed, namely, an increase in temperature, which can be brought down by any antipyretic agent, the skin swells at the vaccination site, and slight pain is also possible. These side effects are normal and should go away in 2-3 days, no more.

Contraindications:

Pregnancy, in case of emergency, it is necessary to administer immunoglobulins to a woman;

Allergy to vaccine components;

Weakened immunity;

Colds at the time of vaccination and transferred less than a month ago;

Chronic diseases.

Tetanus treatment

The sick are treated by infectious disease doctors and resuscitators in the intensive care unit. Sick people are provided with complete rest, the light is dimmed, silence is observed.

To neutralize toxins, specific immunoglobulins are introduced into the body, as well as serum against the disease. To start treatment immediately, it is very important to know how tetanus manifests itself. The incubation period, the symptoms should be known to every person who monitors their health.

If a person has convulsions, then he is prescribed anticonvulsant sedatives. For anesthesia, they inject against convulsions, "Sibazon", "Sudksin" are most often used. As drugs - morphine and "Tramadol". Additionally, treatment with muscle relaxants is carried out.

If a person has impaired breathing, then he is connected to an artificial respiration apparatus. Laxatives are also prescribed, a catheter is placed in the bladder. Viability is provided by devices.

Treatment is also carried out with antibiotics, which belong to the category of tetracyclines, make droppers of plasma, gemodez, albumin. All patients are provided with careful and caring care.

Prevention of tetanus

The most effective measure that helps to avoid serious consequences and death is vaccination. How it is put, we have already said above. The vaccine has been used for several decades, helping a person cope with this terrible disease.

You should also take precautions when working in the garden and garden. If there are wounds or abrasions on the arms or legs, then all actions must be carried out only with gloves and shoes with thick and thick soles. In places where rodents can be, you should be extremely careful.

If an infection has occurred, then at the first symptoms you should immediately go to the hospital. The site of infection is excised. If the vaccination was given no more than five years ago, then the serum is not used.

So, here we are talking about such a terrible disease as tetanus. The incubation period, symptoms, treatment and prevention of a terrible disease are no longer a secret to you. Be careful, and then you will never be at risk of contracting this disease. And if someone you know gets tetanus, you don't have to wait. It is urgent to go to the hospital!

It is an acute infectious disease in which the nervous system is damaged. This lesion is characterized skeletal muscle spasms , due to which it may develop ( ). It is generally accepted that it was this disease that caused the death of the son of Hippocrates, after which the broad masses became aware of such an ailment. It was Hippocrates who named the disease and described its symptoms.

Tetanus occurs due to exposure to the pathogen - tetanus bacillus . It is a spore-forming bacterium that exists as spores in the external environment. These bacteria are highly resistant to antiseptic and disinfectant agents. Moreover, such bacteria can be stored in the soil, on various things and objects, as well as in feces for many years. It does not die at a temperature of 90 ° C for 2 hours. If favorable conditions are created for them, then the disputes actively germinate, during which especially strong tetanus toxins (they are biological poisons). These are highly toxic substances, a stronger poison is only botulinum toxin . Their names are tetanospasmin And hemolysin.

tetanus bacillus isolated from herbivores, especially from rodents, birds, and also from humans. The stick is excreted along with the stool. It is stored in the soil, after which it can get into almost any place and room with dust.

Transmitted by contact. It penetrates through wounds on the mucous membranes, as well as through any damage to the skin. Therefore, it is very important to carefully monitor the condition of the umbilical wound in newborns in order to prevent infection.

This infection cannot be transmitted from an infected person to a healthy one. The human body is highly susceptible to tetanus bacillus. Those people who have already had tetanus do not develop immunity to disease due to the fact that the dose of tetanus toxin that causes the disease is unusually small, therefore, it is not enough to form the body's resistance to the disease. Most often, this disease manifests itself in boys who are in adolescence, due to the high level of injuries. Also, tetanus is often diagnosed in workers of agricultural enterprises, as well as a number of industrial enterprises.

Tetanus symptoms

With this disease, the incubation period can range from 1 to 21 days, as a rule, tetanus appears after one to two weeks. There have also been cases when the disease manifested itself after the complete healing of lesions on the skin or mucous membrane. It is believed that the more difficult it is for the patient to endure tetanus, the shorter the incubation period. Tetanus is always acute. The first noticeable symptom of tetanus, which is most often manifested in patients, is lockjaw . This is a sharp convulsive compression of the jaws. It manifests itself due to spasms in the chewing muscles. After the manifestation of trismus, the following symptoms of tetanus occur: sardonic smile ", which causes a spasm of the mimic muscles, as well as painful sensations and difficulty in swallowing, called and manifested due to contraction of the muscles of the pharynx. These three symptoms of tetanus form the so-called classic triad of symptoms: their manifestation clearly indicates tetanus.

In the process of the development of the disease, convulsions appear already in other parts of the body - they spread to the limbs and muscles of the body. But cramps do not appear on the hands and feet. The patient feels tension in the muscles constantly, even in a dream. Later convulsions take over intercostal muscles and diaphragm , after which it becomes difficult for the patient to breathe, breathing becomes frequent and superficial. The process of defecation and urination is also very difficult due to muscle tension.

If tetanus is severe, then due to strong tension and pain in the muscles of the back, it manifests itself opisthotonus . With this phenomenon, the patient's back bends in an arc, and, to such an extent that a hand can be put under the back if the person is in a supine position. Due to such a strong muscle tone, there may be bone fractures, and separation of muscles from bones. Such convulsions can pass as short-term symptoms of tetanus, and as a permanent phenomenon. Convulsions occur as soon as the smallest stimulus acts. They start from the smallest irritants. If the disease is severe, then convulsions can occur almost continuously and cover many muscles. There are three degrees of tetanus: light, medium And heavy . A lethal outcome is recorded in 25% of cases of tetanus.

Diagnosis of tetanus

The diagnosis of tetanus occurs when the specialist sees a clear manifestation of the "triad" of tetanus symptoms. At the same time, there is no need for laboratory diagnosis of the disease, because in the presence of clinical symptoms of the disease, even the most modern methods do not detect the toxin in the blood. In order to make an early diagnosis of tetanus, it is necessary to have a thorough epidemiological history . So, the specialist needs to know about the presence infected wounds, deep burns And frostbite , to have information about all injuries, after which there was a violation of the integrity of the skin, and which occurred within a period equal to the incubation period. All these data are compared with the presence of symptoms of the onset of the disease.

Tetanus treatment

A person who develops symptoms of tetanus is subject to immediate hospitalization in a hospital. In order to neutralize the tetanus toxin, the patient is given a special one or he takes a specific one. A number of drugs are used as a therapy for convulsive syndrome - narcotic, sedative, neuroplegic . Also used to treat tetanus muscle relaxants .

The doctors

Medications

Prevention of tetanus

In order for the prevention of tetanus to be complete, preventive measures are applied in two directions: firstly, it is necessary to carry out the prevention of various kinds of injuries and methods of specific prevention. A very important method in the process of preventing tetanus is considered tetanus shot . To create immunity against this disease, routine immunization is carried out. For this purpose is used. It is administered to children from three months old, it is included in the composition (complex against, tetanus,), later the tetanus vaccine is given in the form of, ADS (complex diphtheria + tetanus vaccine) or in the form AS-toxoids . Tetanus vaccination is the most effective way to prevent the disease. If the patient is threatened by the development of tetanus, then emergency prophylaxis is immediately carried out, for which anti-tetanus serum is used or . It contains antibodies to the toxin. It is important to consider that it is not always possible to prevent tetanus by passive immunization. For this, patients are given tetanus toxoid .

Prevention of non-specific tetanus is carried out in order to prevent cases of domestic injuries, as well as injuries at work. It is also necessary to monitor sterility during operations in order to exclude infection of wounds after surgery. All stab, cut, frostbite, burns and other injuries should be properly treated immediately and bleeding stopped.

Complications of tetanus

During the development of tetanus, due to the appearance of muscle spasms, as well as congestion in the body, pneumonia and can develop. Also, a complication of tetanus can be , sepsis . Due to convulsive phenomena, fractures of the bones and spine sometimes occur, dislocations of the limbs, muscle detachment may occur, as well as ruptures in the tendons and muscles. Other complications of tetanus can be, pulmonary arteries .

Among the complications that appear at a later stage of the disease, there are tachycardia , weakness , spinal deformity , cranial nerves which appears temporarily. At the same time, compression deformity of the spine may not disappear for two years. After a person is completely cured of tetanus, he can only start work after two months. But for another two years, he must undergo constant examinations by a neurologist. In especially rare cases, relapses of tetanus occur.

List of sources

• Tsybulyak G.N. Tetanus: current state of the problem // Infections in surgery. 2007;
• Postovit V.A. Infectious Diseases: A Guide / V.A. Post it. - St. Petersburg: Sotis, 1997;
• "Complete Handbook of the Infectionist", Group of authors, Moscow, Eksmo Publishing House, 2004.

Tetanus is an infectious disease that manifests itself in an acute and severe form, caused by a bacterial infection and has a contact mechanism of transmission. The infection affects the nervous system and is characterized by rapid clinical development. She is characterized by attacks of tonic (long-term) and clonic (rapid) spasms of skeletal muscles against the background of muscle hypertonicity.

What causes tetanus?

The causative agent of acute disease is the bacterium Clostridium (tetanus bacillus), whose spores have a high degree of survival in various environments. It is resistant to disinfectants and high temperatures.

The spores of the microorganism continue to be pathogenic (contagious) for a long time (even several years). The stick can be found in droppings, dust, dirt, and animal feces. A person can become infected when these bacteria enter the bloodstream through a cut or deep wound. Tetanus infection is also associated with:

• dental injuries;
• burns;
• puncture wounds from piercings, tattoos, or drug injections;
• animal bites.

Tetanus symptoms

General symptoms

The first symptoms of tetanus are:

• irritable muscle pain. They become stiff, they are “cramped”, so the body begins to feel tired.
• problem (difficulty) swallowing food.

Sometimes the patient may observe several other symptoms, such as:

• rapid heart rate;
• fever;

Symptoms appear within eight days of the initial infection. The starting point for the development of the disease is mild spasms in the muscles of the jaw and face. The chest, neck, back, abdominal muscles, buttocks may also be affected.

Associated symptoms

• heat;
• hypertension (high blood pressure);
• tachycardia (rapid heartbeat);
• convulsions.

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Stages of the disease and their symptoms

Tetanus disease is accompanied by four main periods. Accordingly, the symptoms appear depending on the periodic features of the disease.

Stage 1 - the period of incubation.

Stage 2 - initial.

Stage 3 - the stage of the height of the disease.

Stage 4 - the stage of recovery.

Incubation period: important points

The incubation period for tetanus can be several months, but usually lasts about eight days (sometimes the incubation period is reduced to 4 days or extended to a month). The stage of the incubation period is the time when the microorganism penetrates the nutrient medium and multiplies, filling the body with toxic substances.

The disease during the incubation period may begin to accompany the following symptoms:

• headache;
• increased irritability;
• sweating;
• tension in muscle tissue;
• twitching of muscle tone at the site of the wound.

A slight feeling of malaise is replaced by an acute course of the disease.

The initial stage and the first signs of the disease

The initial period of tetanus is always a sequence of symptoms.

1. Pulling pain at the site of the infection (most often the area where the wound or bite is located) is an early sign that indicates the onset of a long-term illness.
2. Trismus appears - this is a feeling of tension and frequent contraction of all chewing muscles. It is difficult for the patient to open the mouth. Sometimes (in severe cases) the teeth are clenched so tightly that the mouth cannot be opened at all.
3. Spasms of the muscles of the face (facial muscles) develop. A "terrible picture" appears on the patient's face - a smile and cry at the same time. In medicine, such a distorted face is commonly called a sardonic smile. She is characterized by:

• wrinkled forehead;
• forehead stretched in width;
• narrow palpebral fissures;
• downturned corners of the mouth.

1. Following a smile, symptoms such as difficulty swallowing due to convulsive spasm of the muscles in the throat, and painful stiffness (stiffness) of the occipital muscles appear.

Stage of the height of the disease: symptoms and its manifestations

This period lasts an average of 10 days. If the disease has a severe form, then the length of the course of the peak stage naturally increases.

The height of the disease is accompanied by:

• Increased seizures, the frequency of which varies from a couple of seconds to a whole minute. Attacks occur unexpectedly, and in severe cases can last tens of minutes. Muscles spasm gradually. Seizures can be severe enough to cause fracture or dislocation of bones and joints.
• Painful tension of all muscle tissues of the body, as well as limbs, except for the muscles of the hands and feet. They don't relax even when they sleep. The muscles of the abdominal wall harden, the legs are extended, so the motor apparatus practically does not function.
• Pronounced muscle contour (especially in men).
• Increased sweating, salivation.
• The skin and mucous membranes acquire a “bluish” tint (the so-called cyanosis appears - it becomes different).
• Asphyxia. The body does not have enough oxygen, so its general condition worsens significantly: breathing quickens and becomes superficial. The muscles responsible for breathing can suffer during any stage of the manifestation of the disease. The results can be fatal if medical attention is not provided on time.
• . There is a periodic blocking of respiratory movements, sometimes breathing can be interrupted.
• Unstable work of the urination and circulatory systems. Urination is accompanied by painful sensations, possibly retention of bowel movements (feces and urine do not pass well) and pulling intense pain in the perineum. Also difficult to defecate.
• An increase in body temperature.

Unbearable pain in the patient is accompanied by a groan and a cry and, as a result, insomnia and irritability to everything around.

recovery stage

The process of complete recovery is long and takes about 60 days. Despite the improvement in the state of health of the patient for a long time is at risk of developing various complications.

Forms of tetanus and their symptoms

Based on clinical data and taking into account the peculiarities of external manifestations, four types (forms) of the course of the disease were identified

1. General tetanus

Covers all skeletal muscles. This is the most common form and also the most severe form of the four types. About 80% of cases of the disease are represented by general tetanus.
First signs

• lockjaw;
• facial spasms;
• neck stiffness;
• difficulty in swallowing;
• stiffness of the pectoral and calf muscles.

Associated symptoms include:

• elevated temperature;
• excessive "unaccustomed" sweating;
• increased pressure;
• accelerated heart rate.

Convulsions may occur, the duration of which reaches 30 days. Full recovery takes several months.

1. local tetanus

Patients feel persistent muscle contractions in the same anatomical region where the injury is located. Spasms of bacterial-infected muscles near the wound may persist for a long time before gradually easing. Local tetanus precedes the onset of general tetanus.

Characterized by:

• lack of seizures;
• spasms and twitches in the muscles.

1. head tetanus

Restricts the functioning of the muscles and nerves in the head. This usually happens after an injury. It can be a skull fracture, eye injuries, tooth extraction, otitis media. Other cranial nerves may also be affected. Within a couple of days after a head injury or ear infection, the first symptoms may appear:

• the mouth does not open well;
• trismus in the head and neck - reduction of the jaw with severe muscle tension in the temples;
• sardonic smile;
• dysfunction of the cranial nerves.

Due to the rare form, doctors may be unfamiliar with the clinical picture and may not immediately suspect tetanus as a clear illness. Treatment can be complicated as the symptoms are very similar to the injury that caused the infection. The disease progresses rapidly. Head tetanus is more likely than other forms to be fatal.

1. Neonatal tetanus

In terms of symptoms, it is similar to general tetanus, except that it is observed only in newborns (the age of the child does not exceed 1 month). The disease manifests itself almost immediately and may be associated with non-compliance with the norms and rules of sanitation methods when caring for the umbilical cord of newborns, as well as with the lack of appropriate vaccination in the mother.

Complications: what to fear?

Severe muscle spasms resulting from tetanus can cause serious complications. Most often it is:

• breathing problems due to narrowing of the airways;
• damage to the brain system (cause - lack of oxygen);
• bone fractures, breaks in the bone;
• uncontrolled (involuntary) muscle contraction of the vocal cords (laryngospasm);
• pulmonary embolism - blockage of the main artery of the lungs or one of its branches by a blood clot that has moved from another place in the body through the bloodstream (pulmonary embolism);
• pneumonia (lung infection);
• Difficulty breathing. Can lead to death (analytics suggests that 10-20% of cases are fatal).