Is infectious characterizes severe toxic damage tetanus. Differential diagnosis of tetanus

Tetanus - wound anaerobic infection, characterized by toxemic damage to the motor centers of the nervous system and the development of clonal-tonic convulsions of striated muscles.

The causative agent of tetanus Clostridium tetani was discovered in 1883 by N. D. Monastyrsky, and in 1884 isolated by A. Nikolaier from animals infected with garden soil.

Morphology. C1. tetani are gram-positive rods located singly or in chains, 4-8 µm long and 0.3-0.8 µm thick. Their flagella are located at the periphery

ria, and the size exceeds the size of the stick itself. The spores are located terminally, so morphologically the pathogen has the appearance of a racket or drumstick.

Culture and enzymatic properties. Strict anaerobe, pH 7.0-7.9, grows at 37 0 C (growth limits 14-45 ° C), has the appearance of delicate coatings, grayish-yellow colonies with an uneven surface, a compact center and thread-like processes.

On blood agar, zones of hemolysis form around the colonies. On semi-liquid agar, its colonies take the form of fluffs (S-form) or lentil grains (R-form). In the Kitta-Tarozzi liquid medium, due to the breakdown of proteins, turbidity appears and gas is released.

Spores are resistant to physical and chemical influences:

when boiled, they die after 30 minutes - 1 hour, in a 1% solution of sublimate and 5% phenol - after 8-10 hours.

Enzymatic properties of C1. tetani are manifested by the ability to slowly liquefy gelatin and coagulate milk with the formation of small flakes, and exhibit fibrinolytic activity.

Antigenic structure. Mobile strains C1. tetani contain O- (somatic, group) and H- (flagellar specific) antigens; motionless - only O-antigen.

Based on the H-antigen, tetanus pathogens are divided into ten serovars.

Virulence factors. Tetanus toxin consists of two fractions:

tetanospasmin, which selectively acts on the nervous system and causes the main symptom of the disease - tonic contractions of striated muscles;

tetanolysin - causing nonspecific hemolysis of red blood cells, tissue necrosis, destruction of phagocytes.

Both fractions are thermolabile and have extremely strong biological activity. A dose of 0.0000005 ml kills a white mouse weighing 20 g; dry toxin precipitated with ammonium sulfate at a dose of 0.000000005 is fatal to white mice. When tetanus toxin is treated with formaldehyde and then heated, a toxoid is obtained.

Epidemiology. Tetanus occurs all over the world, not only in war, but also in peacetime, as a complication of household and work injuries. on his infectious nature was first pointed out by N.I. Pirogov. 80-86% of cases are residents rural areas, workers Agriculture; 47-70% are children from one year old and young people up to 20 years old. Of the total number of patients under the age of 14 years, in 79.5% the disease occurred as a result of injury while walking barefoot. Characteristic feature Tetanus is seasonal, with an increase in incidence in the spring and summer and a decrease in the autumn and winter.

At the site of introduction of spores, they transform into vegetative forms that release an exotoxin, which enters the blood and lymph and has a irritant effect on the body - from peripheral nerve branches to motor centers of the spinal cord, medulla oblongata and pons. The toxin causes focal overexcitation of nerve cells, as a result of which muscle groups are reflexively affected. First, clonic and then tonic convulsions occur.

Spreading across spinal cord, the toxin affects new groups of motor neurons, resulting in generalized tetanus.

It can be descending and ascending. Ascending observed in white mice, guinea pigs, rabbits, dogs and lower monkeys, descending - in humans and equids. The latter is characterized by initial rigidity of the muscles of the head and neck, stiffness, then damage to the muscles of the entire trunk and limbs and, finally, general cramps.

Depending on the severity of the disease, three clinical forms are distinguished:

mild, in which there are no convulsions;

moderate severity, in which convulsions easily occur at the slightest external irritation;

severe, with spontaneous, difficult to control convulsions.

The incubation period lasts 7-20 days. IN clinical course Tetanus in humans is divided into the following stages: trismus;

opisthotonus; tonic convulsions; general increase reflex excitability; reflex spasms of the pharyngeal muscles; asphyxia, sharp increase fever, paralysis lower jaw, death.

The disease begins with a headache, malaise, and nagging pain throughout the body. Then comes a tonic contraction of the masticatory muscles (trismus) and facial muscles. At the same time, wrinkles appear on the forehead and around the eyes, the eyes narrow, and Risus sardonicus is formed. Following rigidity occipital muscles opisthotonus develops with forward bending of the spine (see inclusion V). The patient bends into an arc, touching the bed with the back of his head and heels. Back muscle spasms can be so severe that they can lead to a spinal fracture.

After some time of muscle stiffness, general cramps occur, frequency, duration and intensity

which increase as the disease progresses. Convulsions occur suddenly, at the slightest external irritation. The duration of the attack is from several seconds to a minute, in severe cases they occur every 3-5 minutes.

During attacks, the patient's face expresses suffering and horror, his tongue is bitten. If the attack lasts more than a minute, then asphyxia occurs even without assistance. medical care the patient dies.

At favorable course the convulsive period lasts up to 15 days. If by the end of this period the attacks become less frequent or stop, the prognosis is favorable. Tonic muscle tension continues for another 22-25 days. Trismus goes away even more slowly.

Immunity antitoxic, unstable.

Laboratory diagnostics. IN The basis of diagnosis is the detection of the pathogen or its toxin. The material used is pieces of dead tissue taken from the wound, tampons soaked in wound exudate, sputum or mucus from respiratory tract, scars left after injury.

They combine bacterioscopy (imprint smears) and culture on nutrient media. Before inoculation, the test material (pieces of tissue) is homogenized in a double volume of physiological solution and sown on Kitt-Tarozzi medium. To eliminate the accompanying microflora, infected crops are heated for 20 minutes at 80 °C.

To detect the toxin, the test material (or culture liquid) ground in a mortar is kept at room temperature for 1 hour, after which it is mixed with antitetanus serum (1 ml of extract plus 0.5 ml of diluted serum containing 200 IU in 1 ml). The mixture is kept for 40 minutes and administered intramuscularly to white mice. Control animals were administered the test material without serum.

Agglutinating and luminescent serums are also used.

Treatment and prevention. The basis of treatment is the use of antitoxic antitetanus serum or immunoglobulin. IN incubation period For prevention, they combine the administration of serum and toxoid.

Prevention - DPT, chemical sorbed typhoid-paratyphoid-tetanus vaccine, DS-toxoid.

Related information.

Tetanus is an infectious disease of the sapronosis type (the name comes from the Greek sapros, meaning rotten, and nosos, meaning disease). Characteristic of this group of diseases is the contact mechanism of transmission of the pathogen and its habitat.

The habitat for tetanus bacteria is objects (not the human or animal body) located around us - for example, water, soil, chair, table. Thus, the causative agent of Legionnaires' disease, which belongs to this group of diseases, chose an air conditioner, shower and similar objects as its habitat.

Tetanus is not characterized by an epidemiological nature of spread, since the patient does not pose a danger to others - he is not contagious. Although immunity to tetanus does not develop after illness.

For reference. Tetanus is an acute saprozoonotic disease infectious nature, caused by Clostridium tetani. The pathology is manifested by severe damage to nerve tissue tetanus toxins, leading to the development of pronounced muscle hypertonicity and tetanic convulsions.

Tetanus infection is one of the most ancient diseases. First detailed description pathology belongs to Hippocrates. After his son died of tetanus, he compiled a detailed description of this infection, giving it the name tetanus.

The infection is also mentioned in books such as Ayurveda and the Bible. It should be noted that in all descriptions of tetanus, its development was always associated with contamination of open wound surface earth. In some countries, soil contaminated with feces was even treated with weapons instead of poisons.

For reference. For a long time tetanus was considered absolutely not curable disease with a 100% mortality rate. On this moment, tetanus is considered a curable disease (subject to early adequate wound treatment and administration of anti-tetanus serum). However, severe tetanus is still accompanied by a high mortality rate. Hospitalization for tetanus is strictly mandatory.

Self-medication is impossible, and the only effective specific remedy against tetanus is antitetanus serum, which must be administered no later than 30 hours from the moment the first symptoms of the disease appear. Later administration of the drug is ineffective.

Why is tetanus dangerous?

For reference. The disease is known all over the world. Sensitivity to tetanus bacillus is high in people of all races and ages. The mortality rate for tetanus (in the absence of timely specific treatment) is ninety-five percent for adults and one hundred percent for newborns.

Before the development of a specific serum by Gaston Ramon (1926), obstetric tetanus was one of the main causes of death in mothers and infants in maternity hospitals.

At the moment, tetanus is quite rare. This is due to the fact that in 1974, WHO introduced a special strategy to reduce the incidence and completely eradicate vaccine-preventable diseases (diphtheria, tetanus, polio, etc.).

Attention. Now high level The incidence of tetanus is observed only in developing countries, With low level economy and insufficient coverage of the population with preventive vaccinations. This applies to tourists traveling to such countries.

The leading causes of death in patients with tetanus are:

• respiratory arrest or cardiac arrest at peak seizures;
• severe metabolic and microcirculatory disorders leading to multiple organ failure;
• secondary purulent complications, sepsis with septic shock.

The causative agent of tetanus

Clostridium tetani belongs to the large gram+ rods of the genus Clostridium. Tetanus clostridium is a strict obligate anaerobe, that is, for adequate development and reproduction it requires conditions with complete absence oxygen access.

Vegetative toxin-producing forms are absolutely not viable in the environment. Therefore, under unfavorable conditions, the tetanus bacillus turns into spores, characterized by the highest level of resistance to physical and chemical influences.

The tetanus spores themselves are not pathogenic. They are not capable of producing a toxin (tetanospasmin) and, in the absence of favorable conditions, do not cause disease.

This explains the fact that, depending on the area of ​​residence, approximately five to forty percent of people are carriers of tetanus bacilli in the intestines. Such carriage is transient and is not accompanied by clinical symptoms and does not lead to the development of the disease.

However, when exposed to anaerobic (oxygen-free) conditions, spores are able to transform back into pathogenic, toxin-producing forms.

Attention. In terms of toxic properties, tetanospasmin produced by tetanus bacilli is second only to botulinum toxin. This toxin is produced and is considered the strongest poison known.

How can you get tetanus?

The source of infection for tetanus is animals. Clostridia in the form of vegetative forms or spores is found in the stomach and intestines of many ruminants. IN environment The causative agent of tetanus is excreted along with feces.

In the soil (especially in humid, warm climates), the pathogen can long time maintain viability, and under adequate conditions (lack of direct access to oxygen) and actively reproduce. In this regard, soil is the most significant natural reservoir of tetanus bacillus.

Infection occurs when soil containing tetanus spores comes into contact with a damaged skin surface (wound). The highest incidence of tetanus occurs during wartime. At shrapnel wounds, crush and gunshot wounds, the most favorable (oxygen-free) conditions are created, allowing the pathogen to actively multiply.

For reference. In peacetime, most common reasons tetanus are various foot injuries (puncture of the heel with a rusty nail, thorn, damage to the feet with a rake while working in the country, etc.). Tetanus can also occur when soil gets into burn wound, frostbite contamination or trophic ulcers, after illegal (out-of-hospital) abortions, etc. In developing countries, there is still a high rate of neonatal tetanus infection due to infection of the umbilical wound.

Susceptibility to the causative agent of tetanus is extremely high in all age groups and does not depend on gender, however, most often the disease is registered in boys under 10 years of age (due to frequent injuries during outdoor games).

How the disease develops

After contact with the wound surface, spore forms of clostridia tetanus remain in it.
Transition to vegetative form, with further development infectious process is possible only if oxygen-free conditions are created in the wound:

• deep puncture injuries with a long wound channel;
• entry into the wound of pyogenic flora, which actively consumes oxygen;
• unprofessional wound treatment;
• blockage of the wound lumen with crusts, blood clots, etc.

For reference. After the spores transform into pathogenic forms, they begin to actively multiply and produce tetanus toxins (tetanospasmin). Toxins quickly spread throughout the body and accumulate in nerve tissues.

Subsequently, the transmission of inhibitory impulses is blocked, as a result of which the striated muscle tissue Spontaneous exciting impulses begin to flow continuously, causing her tonic tension.

The first signs of tetanus are always manifested by damage to the striated muscles, as close as possible to the wound, as well as facial and masticatory muscles.

Sympathetic signs of tetanus in adults and children include:

• high body temperature,
• elevated blood pressure,
• severe profuse sweating,
• profuse salivation (against the background of pronounced sweating and salivation, dehydration may develop).

Against the background of constant tonic convulsive syndrome occurs serious violation microcirculation in organs and tissues, leading to the development of metabolic acidosis.

For reference. As a result, a vicious circle is formed: metabolic acidosis contributes to increased seizures, and seizures support the progression of metabolic and microcirculatory disorders.

Tetanus – incubation period

The incubation period of tetanus is from one to thirty days. Usually the disease manifests itself a week or two after clostridia enter the wound.

Attention. It must be borne in mind that minor wounds may heal by the time the first symptoms appear, so identify entrance gate for infection is possible only when collecting anamnesis.

The severity of the disease is directly related to the length of the incubation period. The shorter it is, the more severe the tetanus.

Tetanus symptoms

Most often, the first symptoms of the disease are:

• the appearance of pulling and aching pain in the area of ​​the wound;
• stiffness and difficulty swallowing;
• slight twitching of muscles in the wound area.

In some cases, there may be a short period of prodromal manifestations, occurring with fever, chills, weakness, irritability, and headaches.

Important. First high specific symptom Tetanus is considered to be the appearance of chewing trismus (tonic tension of the chewing muscles, leading to difficulty, and subsequently complete impossibility, to open the teeth).

On initial stages diseases, this symptom can be detected by a special technique that provokes muscle spasms: they rest a spatula on the teeth of the lower jaw and begin to tap on it.

Subsequently progressive damage nerve fibers toxins leads to severe and specific damage to the facial muscles:

• distortion of facial features;
• the appearance of sharp wrinkles on the forehead and around the eyes;
• stretching the mouth in a tense, forced smile;
• raising or lowering the corners of the mouth.

As a result of this, the patient's facial expression takes on a simultaneously crying and smiling appearance. This symptom is called a sardonic smile.

Severe swallowing disorders (dysphagia) also appear.

Attention. The combination of a forced smile, swallowing disorders and trismus of the masticatory muscles occurs only in patients with tetanus and is considered the most specific triad of symptoms, allowing for differential diagnosis and diagnosis as early as possible.

Further, within 3-4 days, a sharp increase in tone (hypertonicity) appears, affecting the muscles of the back, neck, abdomen and limbs. Due to this, the patient’s body takes on strange, pretentious poses. They can lie on the bed, touching it only with part of the back of the head and heels (this phenomenon is called opisthotonus) or arching their back in a bridge (emprostotonus).

In all muscle groups, except for the muscles of the hands and feet, pronounced stiffness of movements is observed.

For reference. The spread of tonic convulsive syndrome to the intercostal muscles and diaphragm leads to the appearance of respiratory disorders.

Defeat muscular system in patients with tetanus is accompanied by the appearance of severe pain syndrome, constant muscle hypertonicity, as well as specific tetanus convulsions of a tetanic nature.

Convulsive attacks are accompanied by excruciating pain, profuse sweating and salivation, high blood pressure, and fever. Depending on the severity of the disease, seizures can occur from 1-2 to 10-15 times per hour. The duration of a convulsive attack can also vary from 20-30 seconds to several minutes.

At mild flow tetanus with long period After incubation (about twenty days), generalized convulsive syndrome may be absent.

At the height of convulsive syndrome, the following may occur:

• muscle tears;
• cardiac and respiratory arrest;
• bone fracture (with severe course possible spinal fracture);
• tendon ruptures.

After the end of the convulsive attack, with an uncomplicated course, the temperature gradually decreases. In case of severe or complicated (attachment of secondary bacterial infection) During the course of the disease, constant fever is possible.

For reference. Duration of tetanus (period of bright clinical symptoms) depends on the severity of the infectious process. For mild forms - about 2 weeks, for severe forms - more than 3 weeks.

For localized forms of tetanus (including Rose's tetanus, which occurs after head injuries) in initial period convulsions can only be local in nature. That is, only the muscles located as close as possible to the wound surface are affected, however, as the disease progresses, the convulsive syndrome still generalizes.

Tetanus - symptoms in children

For reference. The symptoms of tetanus in children are no different from those in adults, but the disease is always more severe. Convulsive syndromes longer, severe microcirculatory disorders and the clinical picture of metabolic acidosis occur more quickly.

The first symptoms of tetanus are also manifested by damage to the muscles around the wound surface, the appearance of a sardonic smile and chewing trismus, however, generalized seizures develop much faster than in adults.

Prevention of tetanus

Prevention of tetanus includes specific and nonspecific preventive
Events. Under nonspecific prophylaxis imply injury prevention (closed clothing and shoes when working on land plots, use of protective gloves when replanting plants, etc.).

Specific preventive actions include:

• carrying out routine vaccination;
• administration of antitetanus serum for emergency indications;
• professional surgical treatment of the wound;
• primary nonspecific wound treatment.

Attention. Primary processing wounds is carried out immediately after injury. The wound must be washed generously with hydrogen peroxide. To begin with, carefully remove surface contaminants from the wound with a cotton swab soaked in peroxide (earth that has gotten into the wound, etc.) and treat the surface around the wound itself.

After treatment with peroxide, the wound and the skin around it should be lubricated with brilliant green or iodine. Subsequently, it is necessary to apply sterile bandage(the bandage should not be tight and simply cover the damaged area of ​​skin, protecting it from new contaminants).

Attention. After the initial nonspecific treatment, you should go to the emergency room for primary surgical treatment. It is necessary to understand that independently, when deep wounds it is impossible to completely clean the wound channel from blood clots, impurities, excise non-viable tissue, etc. This should only be done by a surgeon.

Also, according to indications, the wound is injected with anti-tetanus serum. The most effective is the administration of serum in the first thirty hours after injury.

Tetanus - acute illness, in which the exotoxin secreted by bacteria causes damage to the nervous system, leading to tonic spasms of skeletal muscles.

After past illness immunity does not develop, so infection can occur many times. However, it should be remembered that 30-50% of people die from tetanus, even after toxoid is administered. The sick person himself is not contagious, since the clostridial bacterium requires special conditions for habitation, reproduction and acquisition of pathogenic properties.

Routes of transmission of tetanus:

Clostridium tetani- a bacterium that requires anaerobic conditions. It is activated and acquires pathogenic properties in the presence of deep damage in the tissues and the absence of oxygen in them.

The main route of transmission is contact. Infection can occur when:

• injuries - puncture, incised wounds;
• burns and frostbite;
• during childbirth, through the umbilical cord;
• microtraumas;
• bites from animals or poisonous insects.

Mechanism of action of the toxin:

Tetanus bacterium entering favorable conditions, begins to actively multiply and secrete exotoxin. He consists of two factions:

• tetanospasmin - acts directly on motor fibers nervous system, causing constant tonic contraction of striated muscles. This tension spreads throughout the body and paralysis of the respiratory and cardiac muscles can occur. When contracting vocal cords asphyxia occurs.
• tetanolysin - acts on red blood cells, causing their hemolysis.

During tetanus there are 4 stages:

• incubation period- the duration can range from several days to a month, it all depends on the distance of the lesion from the central nervous system. The further you go, the longer the period and the easier the disease progresses. During this period, the patient may be bothered by intermittent headaches, slight twitching in the wound area, and irritability. Before the onset of the disease, the patient may notice a sore throat, chills, loss of appetite, and insomnia. However, it should be remembered that there may be an asymptomatic course.
• initial period - duration about two days. The patient notices nagging pain in the area of ​​the wound, even if it has already completely healed. During this period there may appear standard symptoms tetanus (triad): trismus (tonic contraction of the masticatory muscles without the ability to open the mouth), sardonic smile (tonic convulsions of the facial muscles make a facial expression, either smiling or suffering - the forehead is furrowed, the eyebrows are raised, the mouth is slightly open, and the corners of the mouth are lowered) , opisthotonus (tension of the muscles of the back and limbs, leading to a posture of a person lying on the back of the head and heels in the form of an arc).
• peak period - duration on average 8-12 days. There is a clearly visible triad of symptoms - trismus, sardonic smile and opisthotonus. Muscle tension can reach such a degree that complete stiffness of the torso occurs, with the exception of the hands and feet. The abdomen feels board-shaped. This period is accompanied by painful cramps that can last up to several minutes. During an attack, sweating increases, temperature rises, tachycardia and hypoxia appear. The person’s face takes on a puffy shape, turns blue, and the facial expression conveys suffering and pain. During periods between convulsive contractions, muscle relaxation does not occur. The patient also notes difficulty swallowing, defecating and urinating. From the respiratory side, apnea may be observed, from the larynx - asphyxia, and due to insufficient cardiac activity, cyanosis is visible on the skin.
• convalescence period- lasting up to two months. During this period, muscle strength and the number of cramps slowly decrease. By 4 weeks they stop altogether. Restoration of normal heart activity occurs by the end of the third month. At this time, complications may arise, and if this does not happen, then complete recovery occurs.

The degree of severity is assessed according to several indicators:

• mild degree- the triad of symptoms is moderate, convulsions are usually absent or insignificant. Body temperature does not exceed subfebrile levels. Tachycardia is rarely present. Duration up to two weeks.
• average degree- occurs with a typical clinical picture, there is tachycardia with an increase in body temperature. Convulsive attacks are recorded 1-2 times within one hour with a duration of up to 30 seconds. Complications, as a rule, do not arise. Duration up to three weeks.
• severe- symptoms are pronounced, heat constant, seizures are recorded every 15-30 minutes, lasting up to three minutes. Severe tachycardia and hypoxia are noted. Often accompanied by complications. Duration more than three weeks.

TO characteristic features Tetanus include:

• lockjaw;
• sardonic smile;
• opisthotonus;
• difficulty swallowing, as well as its pain;
• tachycardia;
• temperature increase;
• tonic convulsions;
• apnea;
• cyanosis;
• increased sweating;
• hypersalivation.

The diagnosis is made on the basis of the patient’s complaints, which are clearly expressed already in the initial period, the history of the disease (tissue damage is present) and reliable clinical picture(presence of signs that appear only with tetanus). Laboratory diagnostics, as a rule, do not give results. To determine the presence of exotoxin, material is taken from the wound and cultured nutrient medium, and also conduct a biological test on mice.

Treatment is carried out in an inpatient department intensive care for constant monitoring of vital functions important organs. The patient is placed in a separate room to avoid external irritants (light, noise, etc.).

Treatment is carried out according to the following plan:

• Administration of antitetanus serum - even if there is just suspicion, this point must be followed.
• Wound sanitation - primary surgical treatment, wide opening of tissue flaps to improve aeration, sutures are not applied in any case.
• Relief of convulsive attacks - muscle relaxants are administered.
• Transfer of the patient to artificial ventilation lungs (correction of hypoxia), control of the cardiovascular system.
• Combating complications.
• High-calorie nutrition, tube or parenteral.

The most serious consequence is death. It can occur from asphyxia (spasm of the vocal cords), hypoxia (tension of the intercostal and diaphragmatic muscles - decreased pulmonary ventilation), damage to the brain stem - respiratory and cardiac arrest.

Tetanus is dangerous infection which amazes nervous system and causes severe muscle cramps. In many cases, the disease ends in death.

Tetanus occurs in all parts of the world. More than 160 thousand people die from tetanus every year. Even when using the most modern methods treatment in developed countries, 30-60% of hospitalized patients die. Instead, in regions where there is no required quantity Antitetanus serum mortality reaches 80%. The mortality rate among newborn children is about 95%.

Causes of tetanus

The disease occurs from infection with spores of the anaerobic bacillus Clostridium tetani, which most often live in the soil together and, with its particles, enter the human body through various damages skin, even ordinary cuts.

However, treating the wound with such antiseptics like: hydrogen peroxide, iodine, brilliant green, will not be able to neutralize tetanus spores.

The causative agent of tetanus is the anaerobic bacillus Clostridium tetani infected with spores.

Tetanus symptoms

Doctors highlight 4 forms tetanus: fulminant, acute, subacute and chronic. The disease begins with general weakness, irritability, headache, muscles “pulling” in the area of ​​the wound.

Next, the muscles begin to change, especially near the wound and in the masticatory muscles - it is difficult for the patient to open his mouth due to cramps and pain. A crippling pain occurs in the muscles of the neck, back of the head, back, and lower back. The patient may experience feelings of anxiety and fear, and sleep disturbances.

Subsequently, the spasms cover all the muscles of the body, causing the patient to arch over. Doctors note that if treatment is not started immediately, the person cannot be saved.

Research also shows that people who have had tetanus do not develop immunity to the disease. Therefore, there is a risk of getting sick again.

Tetanus symptoms

Prevention of tetanus

According to experts, the most effective method tetanus warnings – preventive vaccinations, which are carried out from early childhood.

In case of injury, you can be protected from the disease if no more than 5 years have passed since the last vaccination. If more has passed, then emergency tetanus prophylaxis is carried out.

Emergency prevention is surgical treatment of the wound and immunoprophylaxis by administering tetanus toxoid, antitetanus serum, antitetanus immunoglobulin.

Most effective prevention Tetanus is a vaccination that is given from an early age

Which drug to administer and its quantity depends on the patient’s condition and the timing of treatment. Emergency prevention tetanus should be carried out as quickly as possible.

Doctors also recommend paying close attention to body hygiene and keeping your underwear clean. If you worked or were in the countryside or outdoors, you should wash thoroughly, change clothes and wash it at a hot temperature.

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