Tetanus: symptoms in children. Signs and pathogens of tetanus. Prevention and treatment

Tetanus is a disease that has been known since ancient times. The famous physician Hippocrates described in detail its symptoms in the 5th century BC. But to the great general regret, the subject of tetanus remains relevant in the modern world. This is due to the large number of deaths of this disease. Statistics show that about 160,000 people die each year from tetanus.

a brief description of

Tetanus is one of the serious infectious diseases. It is characterized by the isolation of lethal toxin and a fairly rapid clinical course. In order to fully understand the entire problem of the appearance of this disease, it is enough to have information that 30-50% of patients die. Among them, there are those who have been vaccinated against tetanus. In countries with underdeveloped medicine, this figure reaches 85-90%. Tetanus causes the life of microorganisms, penetrated into the body through wounds and other skin injuries. The most suitable circumstance for their reproduction is a hot and humid environment. Therefore, most of all recorded deaths from tetanus occurred in the equatorial states of Africa, Asia and Latin America. But even in relatively safe European countries thousands of people die of this disease every year. Proceeding from this, one can not say that residents of more civilized regions are safe.

The causative agent of tetanus

Tetanus pathogens are representatives of the family Bacillaceae. In ordinary circumstances, their reproduction occurs in the animal and human intestines. However, they do absolutely no harm. During their entry into the wound and in conditions of absolute oxygen absence these quiet bacilli acquire an absolutely opposite character. There is a lively release of toxin, which is one of the strongest bacterial poisons. Their influence is very rapid, as is the development of a disease called tetanus. Symptoms in children are sometimes noted within a few hours after infection. The products of vital activity of pathogens are absolutely harmless if swallowed, because they are not absorbed through the mucous membrane. But during the heating or under the influence of ultraviolet rays, they die fast enough.

How do they get tetanus?

The need for grafting occurs when the wound or damage to the skin or mucous membranes. The most complex 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 conditions. Also, the activation of infection can occur with burns, frostbite and inflammatory diseases. A newborn baby can get tetanus through the umbilical cord, if it was cut with poorly worked tools.

There are many causative agents of this disease in nature. They are:

• In house dust;
• Land;
• Salty and fresh water;
• Feces of most animals.

Spores and vegetative configurations of tetanus rods are found 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 in 3-7 years.

What incubation period does tetanus have?

Through how much is tetanus manifested? 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 it will be to undergo the disease and the greater the possibility of a fatal outcome.

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;
• Muscular tension;
• Increased level of irritability;
• chills;
• Insomnia and other psychoneurological disorders.

The clinical picture and the first symptoms of the disease

The onset of the disease in most cases is acute. It is rare enough to register a small prodromal period. It is expressed by the appearance of the following symptoms:

• malaise;
• headache;
• A stressed state and a contraction of the muscles where the injury occurred and tetanus develops.

The first signs in most cases are muted drawing pains in the wound site, even if it has already healed. Among the first specific signs of the disease, the appearance of which may indicate a tetanus, belong:

• Manifestation of trismus (convulsive compression) of the masticatory muscles, which is the cause of the opening of the mouth;
• Presence of a sardonic smile, because of which the facial expression becomes maliciously mocking (frowning, eyes diminished, lips grow lengthen in smile);
• Manifestation of dysphagia (violation of swallowing), the cause of which is convulsive spasm of the muscles of the pharynx;
• Stiff neck muscles.

The presence of the first 3 symptoms is peculiar only for tetanus.

Characteristic features of the peak period of tetanus

The duration of the peak period of this disease is 8-12 days. In severe forms, it increases 2-3 times. The duration of this phase of the disease depends on the following factors:

• Speed of treatment to a doctor;
• Presence or absence of vaccination;
• The extent of damage to the skin.

At this stage, tetanus is often found. Symptoms in children are as follows:

• Convulsive contractions of facial muscles, the appearance of a characteristic smile;
• Inconvenient ingestion of food;
• The muscles of the extremities and abdomen are very tense;
• Painful convulsions;
• Significant sweating;
• Chronic insomnia;
• Apnea, cyanosis; asphyxia;
• Violation of the urinary process and circulation;
• A significant increase in temperature.

When there was no injection of tetanus, the cause of the patient's 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 it is a question of newborn children, then the course of the disease is the most difficult, and in almost 100% of cases there is a lethal outcome. For toddlers, a particular form of the disease such as tetanus is characteristic. The first signs are anxiety, chin shudder, disturbance of the swallowing and sucking reflex. After this, muscle neck spasm and general convulsions begin. Often a newborn dies on the first day after the onset of the illness.

Period of recovery

If the parents showed the medical workers of a child who has tetanus in time, the treatment is gradual and the symptoms of this disease disappear with 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 connection, constant monitoring of his condition is required.

After recovery, residual effects may occur, which are observed for a sufficiently long period of time. These include stiffness of muscles, general weakness, etc.

Forms of the disease

By gravity, there is an easy, moderate and severe form of tetanus.

The light form is extremely rare. The duration of the incubation period is 14-20 days, and the development of symptoms occurs during 5-6 days. It is characterized by:

• Weak manifestation of general tetanic convulsions (or lack thereof);
• Local convulsive shudders of muscles (symptoms of tetanus with a wound or in its area);
• Mild hypertonic muscle ;
• Absence or slight manifestation of dysphagia and tachycardia;
• Normal or low-grade fever.

The main characteristics of the medium-heavy form of tetanus:

• The incubation period is 15-20 days;
• Development of the main complex of symptoms - 3-4 days;
• Moderate severity of all the symptoms of the disease;
• Absence of asphyxia and violation of swallowing.

Heavy form is characterized by a fairly short incubation period - 7-14 days. In this case, tetanus develops within 1-2 days. Symptoms in children are quite bright. But complications that threaten a child's life are usually rare.

Treatment of tetanus

An emergency delivery to a medical institution of a child with suspected tetanus is required. Treatment of especially dangerous forms is carried out after admission to the intensive care unit.

A necessary measure is wound surgery, during which excision of damaged tissues and removal of foreign bodies is performed.

To eliminate the vegetative forms of tetanus rods from necrotic tissues, antibiotic therapy is performed. In most cases, large doses of penicillin are given intravenously during this procedure. The duration of such therapy is not less than 10 days. In the case of penicillin intolerance, a tetanus injection is prescribed, which consists of tetracycline.

Treatment of sick children is carried out with the help of a specific human immunoglobulin. It is administered once intramuscularly. In parallel with it, subcutaneous injection of tetanus toxoid is performed three times. The interval between administrations is 5-7 days.

In order to alleviate the child's condition, he is provided with peace and quiet. In addition, there is a symptomatic treatment that affects how tetanus is flowing. Symptoms in children are eliminated through the following activities:

• Treatment of wounds;
• Decreased convulsive intensity;
• Prevention of sepsis and pneumonia;
• Improvement of pulmonary ventilation;
• anesthesia.

Prevention of tetanus

Proceeding from the fact that this is a deadly 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 nonspecific.

A non-specific type of prevention of the onset of the disease in children is the following:

• Compliance with sterility during labor and operations;
• Scrupulous processing of wounds, which is advised to be carried out using antiseptics.

Specific prophylaxis of tetanus is carried out plannedly or urgently. The main purpose of the vaccine against tetanus is the creation of personal immunity and immunological memory. Vaccination of children is conducted accordingly with the calendar schedule of vaccinations - 3 times after the third month of life and revaccination after 1-1,5 years.

The vaccine against tetanus for children is not a guarantee of the presence of persistent immunity to the causative agent of this disease. It only supports artificial immunity and helps to overcome tetanus sticks, found in the body.