Tetanus in children: ways of transmission, symptoms, diagnosis, treatment and prevention

Tetanus in children

In fact, tetanus in children is very rare. In Russia, fixed in the year barely a few dozen cases. But the problem is that this disease is fatal, and ends with a fatal outcome in 50-70% of cases. A pathogen it is so widespread that face them anywhere.

How is the infection?

Tetanus bacteria can live in the ground, dust, salt and fresh water on the surface of objects, and so on. In the environment it gets from the faeces of animals, particularly wild and agricultural plant-eaters. However, she can live in the intestines of other animals, including humans. They do not harm the media, but constantly are in the environment in the form of spores.

Importantly! The risk of getting spores in an open wound or scratch, where they can go into an active form.

The most dangerous deep wounds, punctures, extensive damage to skin and tissue, torn wounds, animal bites, if they got dust or dirt. For breeding disputes the right humidity, temperature more than 37 degrees, and the lack of oxygen.

But even a small surface scratch can under certain conditions be the entrance gate for infection.

Historical fact. Father Vladimir Mayakovsky got tetanus, pricking her finger with the sewing needle.

Often ill children 3 to 7 years when they are most active, often get injured playing on the street. It occurs most commonly in the countryside, in the woods, the private sector in the summer.

What happens when infected with tetanus?

If the wound where the bacteria, they have created favorable conditions, the spores pass into the vegetative state and begins active growth of bacteria.

The incubation period can last from 7 to 45 days. Often before the appearance of the first symptoms is 15-20 days.

At this time, bacteria trapped in the body, multiply, releasing a dangerous toxin – cyanotoxin. This is responsible for the manifestations of tetanus.

The toxin gradually affects the nerve fibres, rising from the place of infection to the spinal cord and medulla oblongata. When the disease affects them, start symptomatic – generalized seizures and muscle spasms.

Early symptoms of tetanus

The danger of this disease is still in a long incubation period. It can last from 10 to 45 days, in some cases even more. Often, when the first signs, the child's parents have already forgotten that a month ago he scratched his knee and can't connect these events. And it is more difficult to diagnose and often reduces the rate of seeking medical attention.

Early symptoms of tetanus is not specific, it is difficult to suspect the beginning of this disease. But if the child has not been vaccinated or vaccination was incomplete, and the last time he was injured, which theoretically could hit the causative agent of tetanus, they can help to recognize the disease before the beginning of the active stage.

Most often patients complain of the following symptoms:

  • Drawing, jerking pains in the region of the entrance gate of infection. They can appear, even if the wound is long healed and doesn't bother me.
  • Convulsive twitching of the muscles located above the place of infection.
  • Just before the transition of tetanus in the active phase note insomnia, irritability, irritability, sweating.
Importantly! These symptoms can be slabovrajenna or absent.

The main symptoms of tetanus

Signs of active stages of tetanus is quite specific, so that it can be distinguished from other conditions:

  • Dysphagia. Difficult, painful swallowing.
  • Sardonic smile. Characteristic grimace in which the lips are tensed and stretched to the side, drooping of lips, eyebrows raised.
  • Lockjaw. Spasmodic tension of the facial muscles, rendering it difficult or impossible to open his mouth.
Listed triad of symptoms specific to tetanus. Her reason – the nerves responsible for facial and facial muscles. As a rule, they appear in the first place.

With the development of the disease to the primary triad connect new symptoms:

  • Tension of the occipital muscles.
  • Sweat.
  • High temperature.
  • Painful tonic spasms of all muscles.
  • Tension of all muscles.
  • Generalized seizures that can be provoked by an irritant.
  • Painfulinsomnia.
  • Tachycardia.
  • Difficulty or impossible urination and defecation.

If you have cramps, contact your doctor immediately. The earlier a child receives treatment, the better the chances of recovery.

How is the disease?

In the advanced stage of the disease all the muscles of the patient's body tense, appears all skeletal muscles, the diaphragm retracts. Develops opisthotonos is characteristic of tetanus is spasm of all the muscles in which the body is curved arch. The patient touches the surface of the occiput and heels, the lower back is raised, his hands pressed to the body.

In the context of total muscle tone, periodically start generalized seizures. For minor they may appear 2-3 times a day, with heavy dozens of times. Typically, seizures provoked by stimuli – light, touch, smells and so on. Seizures begin abruptly and last for a few minutes.

As a rule, the duration of the active phase is 3-4 weeks. The most dangerous period comes on day 10-14. If he passed safely, the chance of a favorable outcome increases.

One of the dangers of tetanus – connected diseases and conditions. Due to muscle tension, impair the expectoration of sputum from the bronchi, which can lead to pneumonia and pulmonary edema. Poisoning the body with toxins and triggers the liver, kidneys, nervous system. Due to the strong spasms of possible ruptures of muscles, ligaments, and even bone fractures.

Often cause muscle paralysis and asphyxiation during a convulsive seizure.

If you were able to cope with complications, recovery may take up to 3-4 months. For the longest time to return to normal muscle tone.

Diagnosis of tetanus in a child

A tetanus shot

Tetanus is one disease in which the speed of treatment to the doctor is a critical factor. Therefore, when the slightest suspicion is necessary to call an ambulance and diagnose. This is especially true of children who were not vaccinated or were not full course.

In most cases, diagnosis requires only inspection and survey. The doctor draws attention to the spasm, muscle rigidity neck, mouth, lockjaw.

If there is suspicion for the development of tetanus, the emergency introduction of tetanus toxoid.

For confirmation of the diagnosis may require laboratory diagnosis:

  • Bacterial seeding. The difficulty is that the material should be taken from areas where the infection has penetrated, and this can be difficult in case after infection was for a long time.
  • Examination of smears from the mucous membrane of different localisation.
  • Biological sample. Prepared blood serum is administered to laboratory mice. If they develop tetanus, a disease is considered confirmed.

The complexity of the diagnosis of tetanus in a child is that all of these methods require time and not give 100% guarantee of results. So often for treatment, doctors focus on the characteristic symptoms of tetanus.

It is important to establish when an infection has taken place. The rate of development of disease is a highly important diagnostic symptom. The higher it is, the harder the forecast.

Treatment of tetanus in children

At admission to hospital of a child with symptoms of tetanus treatment is initiated immediately. The first and most important part is the introduction of tetanus toxoid.

It is of two types: horse and human, derived from vaccinated donors. This serum contains immunoglobulin, specializing in the neutralization of tetanus toxin. Dose is calculated in each case individually and depends on age and body weight of the child, severity of symptoms, health and so on.

It is important to reduce the likelihood of seizures. For this purpose the child is placed in a darkened room, at most isolating from any irritants which can cause seizures.

Because the most dangerous are generalized convulsions, the doctors are doing everything to reduce their intensity and quantity. In mild cases, prescribe sedatives, antipsychotics and muscle relaxants. In a difficult child connected to a ventilator, the food is served through a tube directly into the stomach, urine withdrawn from the bladder through the catheter. In this case, often use drugs to stabilize the condition.

It is important to constantly monitor the child's condition, what is available around the clock.

Proper care during the acute phase of tetanus reduces the risk of complications, including death.

Neonatal tetanus

Tetanus in the newborn

This is a special form of tetanus in which the infection occurs in the first days after birth, most commonly through the umbilical wound.

Importantly! Infection is possible when violation of the rules of care of the umbilical wound.

Most often this condition develops in children born outside of a hospital, especially in the regions, unfavorable from the point of view of the epidemiology of tetanus, especially tropical. In the more prosperous regions of neonatal tetanus is disappearing rare form. But still, it is possible, given the numberand prevalence of pathogens.

If the mother were promptly vaccinated against tetanus and has a stable immunity to the disease, during pregnancy it passes the cells of specific immunity to the child. So the risk group includes children of unvaccinated mothers.

As a rule, the disease begins to develop rather quickly, 7-15 days after infection. Symptoms: constant hysterical crying, fever, refusal of the breast or difficulty with feeding, spasm of facial muscles, difficulty opening the mouth. Then join the spasms of all the muscles, the child takes a "frog pose", cramps.

Although the neonatal tetanus today is a rarity, just to eliminate it too. Therefore, it is important to take proper care of the umbilical wound and to draw attention to unusual behavior and signs of disease and report any suspicions to tell your doctor as soon as possible.

To prevent the development of this disease can: tetanus shot for children from 3 months included in the national immunization calendar. Immunizations in the series ends in 6 months – just at the age when it stops the action of the parent immunoglobulin. This specific immunity the baby receives from the mother during fetal development, provided that it has been timely vaccinated.

Thus, the ideal situation is as follows: timely vaccinated mother gives the baby antibodies that protect him up to 6 months. By this age, he gets his own vaccinations, then the likelihood of Contracting tetanus are virtually eliminated. After to maintain the formed immune vaccinated again in a year and a half, 7 and 14 years of age and every 10 years until the end of life.

If it so happened that an unvaccinated child was injured and could theoretically be infected with tetanus when you visit the doctor or the emergency hospital he administered tetanus toxoid and vaccine to accelerate the development of their own immunity. As a rule, such actions enough.

Most importantly: do not assume that the tetanus was in the past, and your child even without vaccination are protected from it. The risk, though not large, is always present.