What are the signs of tetanus? What is tetanus in humans, signs, symptoms in adults and children, treatment, prevention

Tetanus in humans is an acute and life-threatening disease that has a very wide range of different manifestations. Emergency treatment 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 is a zoonotic disease, that is, the disease is inherent in both animals and humans. The infection can be present in the soil, in the feces of animals and birds, and 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 through contact, penetrating through wounds (scratches, burns, cracks) on the skin of any origin.

Main routes of infection:

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

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

Tetanus is called “bare foot disease” because More than half of the cases of infection occur through damaged feet (wounds, scratches, cracks) from the soil.

Main symptoms

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

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

Main symptoms:

• Contraction of the muscles on the face (appearance of a “sardonic” smile);
• Difficulty swallowing;
• The appearance of muscle soreness;
• Difficulty breathing;
• Heavy sweating;
• Increased muscle tone;
• Salivation;
• Difficulty breathing;
• Fever;
• Disturbances in defecation and urination.

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

The onset of the infectious process is characterized by pain and “twitching” directly at the site of infection. Afterwards, the course of the disease can be 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 through tests.

The severity of the 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 migraine;
• Aches;
• Muscle tension in the area of ​​injury;
• Feeling 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.

Specific signs appear:

• Muscle contraction above the wound site.
• Trismus is a tonic spasm in the muscles of the temporomandibular region, limiting chewing functions.
• A sardonic smile - the facial muscles contract: the corners of the mouth are stretched, the eyes are squinted, the forehead is wrinkled (see photo).
• Dysphagia is a specific contraction of the pharyngeal muscles, accompanied by pain.

Important! Dysphagia, trismus and sardonic smile are specific symptoms characteristic only of tetanus.

There may be spasm of the muscles of the back of the head, which makes it difficult to tilt the head to the chest.

High period symptoms

This period marks the peak development of tetanus symptoms; the height 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 feet. Convulsions appear unexpectedly, their increase is gradual, and the duration can be from several seconds to a minute. The intensity of the cramps is so strong that it literally “breaks” a person - it twists joints and bones, tears tendons.
• Muscle tonic tension reaches a peak and does not subside even at night, accompanied by severe pain. Tetanus opisthotonus is observed (pictured): the stomach hardens, the torso bends in an arched manner, the arms bend at the elbows, and the legs are stretched out like a string.
• Breathing due to disturbances in the diaphragm becomes difficult, signs of asphyxia appear.

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

Convulsions become more frequent - they can appear dozens of times during the day. In this case, the person’s face acquires a bluish tint, expresses pain and suffering, and the person’s temperature and blood pressure may increase. The patient screams, groans, grinds his teeth, and chokes.

The muscle contraction is so strong that it can lead to vertebral fractures, muscle and ligament rupture.

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 disease by the end of 2-3 weeks. The frequency of seizures gradually decreases, muscle tone decreases, and 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 treatment is not carried out, a transition to the acute phase of the disease is possible.
• Moderate form. It develops over 15-20 days, with clinical symptoms increasing within 3-4 days. Typical symptoms (dysphagia, trismus, sardonic smile) become pronounced, convulsions become more frequent, and the temperature can reach 39 degrees. An increased heart rate occurs, blood pressure rises, and increased sweating appears.
• Severe form. The course of the disease occurs over 7-14 days, symptoms increase during the day. Muscle tension is pronounced, cramps occur several times per hour. There are sharp surges in pressure, temperature increases, and tachycardia.
• Very severe form. A rapid form of tetanus, most often ending in death. The incubation period is only a few days, the symptoms increase right before our eyes: the convulsions practically do not stop, the temperature exceeds 40 degrees. Resuscitation measures are required.

Local form

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

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

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

In this case, the infection does not penetrate very deeply, so the damage does not affect the internal organs. Death with this form of tetanus can only occur due to allergic complications.

Neonatal tetanus

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

In newborns, the disease manifests itself as impaired swallowing and sucking, the appearance of a sardonic smile, and contraction of the facial muscles. An attack of seizures in children with low weight may manifest itself as arching in only one direction.

Complications of tetanus

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

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 later stages of the disease – anemia, disorders 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 delay in providing assistance.

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

Tetanus (tetanus) is an acute infectious bacterial disease of humans and warm-blooded animals, occurring with symptoms of damage to the nervous system in the form of generalized convulsions and tonic tension of skeletal muscles. Trismus, “sardonic smile” and dysphagia are strictly specific symptoms of tetanus. The disease is often fatal.

A person with tetanus is not dangerous to others

The causative agent of tetanus

The causative agent of tetanus (Clostridium tetani) is a ubiquitous bacterium. It is an opportunistic microorganism that lives in the intestines of animals and humans, where it lives and reproduces. Bacteria enter the soil with feces, contaminating the soil of vegetable gardens, orchards and pastures.

The presence of oxygen and low ambient temperature are factors in the formation of spores, which exhibit tremendous stability in the external environment. They do not collapse when heated for 2 hours at a temperature of 90 °C, in dry form they remain viable when heated to 150 °C, and live in sea water for up to six months.

Rice. 1. The photo shows the causative agents of tetanus.

The causative agent of tetanus is a spore-forming bacterium. Under unfavorable environmental conditions, bacteria form spores that are extremely resistant to a number of chemical factors, disinfectants and antiseptics. Clostridium tetani persists as spores for many years.

Under favorable conditions (in the absence of free oxygen and sufficient humidity), the spores germinate. The resulting vegetative forms produce the exotoxin tetanospasmin and the exotoxin hemolysin. Tetanus exotoxin is a powerful bacterial poison, second in strength only to the toxin secreted by the spore-forming bacillus Clostiridium botulinum (botulinum toxin). Heat, exposure to sunlight and an alkaline environment have a detrimental effect on the exotoxin.

Rice. 2. The photo shows spore-bearing tetanus bacteria. They look like sticks with rounded ends (photo on the left). In unfavorable environmental conditions, bacteria form spores that resemble rackets in appearance (photo on the right).

Rice. 3. The photo shows a tetanus bacterium. The bacterium has up to 20 long flagella, as a result of which it has good mobility.

Prevalence and incidence rate

Up to 400 thousand people die from tetanus every year. The prevalence of the disease on planet Earth is uneven. Hot and humid climate, lack of preventive work and medical care are the main reasons for the spread of the disease. In such regions, the mortality rate from tetanus reaches 80%, and in newborns - 95%. In countries where modern methods of treatment and prevention of tetanus are used, about ¼ of those affected die annually. This is due to severe complications of the disease caused by tetanus toxin that are incompatible with life.

Rice. 4. Dark red and red colors indicate incidence rates (very high and high, respectively) for the period from 1990 to 2004.

Epidemiology of tetanus

Tetanus bacteria are permanent inhabitants of the intestines of herbivores (herbivores, horses, sheep). Released into the external environment along with feces, microbes contaminate the soil. Tetanus most often affects older people. In regions where children are actively immunized, the disease develops extremely rarely.

The gates of infection are:

• injuries, abrasions and splinters of the skin,
• deep pyoderma in the form of boils and carbuncles,
• skin damage due to bedsores, trophic ulcers and gangrene,
• extensive wounds in wartime,
• burns and frostbite,
• postpartum and postoperative wounds, skin damage due to injections,
• umbilical wound of newborns,
• bites of poisonous animals and spiders.

Sometimes it is not possible to identify the entrance gates of infection.

The condition for the development of tetanus bacteria is an oxygen-free environment. These include puncture wounds and wounds with deep pockets.

Rice. 5. Injuries, abrasions and splinters of the skin are the main entry points for bacteria.

A sick person is not a spreader of infection.

Pathogenesis of tetanus

When spores of tetanus bacteria enter through damaged skin, they germinate. The resulting vegetative forms produce exotoxin. The exotoxin tetanospasmin is a high molecular weight protein consisting of 3 fractions - tetanospasmin, tetanohemolysin and protein.

Neurotoxin tetanospasmin- the most powerful of all exotoxins. The toxin passes through the blood and lymphatic vessels, along the perineural tract and is firmly attached to the cells of the nervous system. Tetanospasmin blocks the inhibitory effect of interneurons on motor neurons and impulses that spontaneously arise in motor neurons begin to be freely transmitted to the striated muscles in which the tonic tension. Initially, muscle tension is recorded on the side of the affected limb. Next, muscle tension affects the opposite side. Next - the torso, neck and head. Tonic tension of the intercostal muscles and muscles of the diaphragm leads to impaired ventilation of the lungs, which leads to the development of metabolic acidosis.

When touched, loud sounds and the appearance of various odors, the patient develops tetanic convulsions. Prolonged convulsions are accompanied by large expenditures of energy, which aggravates the development of metabolic acidosis. A block of neurons in the brain stem region leads to inhibition of the parasympathetic nervous system. The respiratory and vasomotor centers are affected. Spasm of the respiratory muscles and paralysis of the heart muscle are the main causes of death in tetanus.

Rice. 6. In the photo, signs of tetanus in a child are convulsions (left) and opisthonus (right).

Signs and symptoms of tetanus

Signs and symptoms of tetanus during the incubation period

The incubation period for the disease lasts from 5 to 14 days. Fluctuations range from 1 day to 1 month. Tetanus almost always begins acutely. The prodrome period is rare. Its main manifestations are restlessness and irritability, insomnia, yawning and headache. In the area of ​​damage to the skin, nagging pain occurs. Body temperature rises. Appetite decreases.

The further the lesion is located from the central nervous system, the longer the incubation period. With a short incubation period, the disease is more severe. A short incubation period is observed for injuries to the neck, head and face.

Rice. 7. In the photo there is a “sardonic smile” with tetanus. With tonic tension of the facial muscles, the mouth stretches, its corners drop, the wings of the nose rise, the forehead wrinkles, and the palpebral fissures narrow.

Signs and symptoms of tetanus in the initial period

Tetanus almost always begins acutely. Its first symptom is a tonic contraction of the masticatory muscles, characterized by the inability to open the mouth. Trismus is often preceded by “fatigue of the masticatory muscles.” With tonic tension of the facial muscles, the mouth stretches, its corners drop, the wings of the nose rise, the forehead wrinkles, and the palpebral fissures narrow ). As a result of contraction of the pharyngeal muscles, dysphagia. The duration of the initial period is 1 - 2 days.

Rice. 8. The first symptom of tetanus is a tonic contraction of the masticatory muscles (trismus) and facial muscles (“sardonic smile”).

Trismus, "sardonic smile" and dysphagia are strictly specific symptoms of tetanus

Signs and symptoms of tetanus during the height of the disease

The duration of the peak period of the disease is from 8 to 12 days. In severe cases - from 2 to 3 weeks.

During the height of the disease, symptoms of skeletal muscle irritation appear. Muscle hypertonicity accompanied by severe pain. Extensor reflexes predominate, which is manifested by rigidity of the neck muscles, throwing the head back, hyperextension of the spine ( ), straightening the limbs. Hypertonicity of the muscles involved in breathing leads to hypoxia.

When touched, loud sounds and the appearance of various odors, the patient develops tetanic convulsions. Prolonged convulsions are accompanied by large expenditures of energy, which contributes to the development of metabolic acidosis. During convulsions, body temperature rises, increased salivation and tachycardia are noted. Spasm of the perineal muscles is manifested by difficulties in urination and defecation. Convulsions last from a few seconds to one minute. Spasm of the respiratory muscles and paralysis of the heart muscle are the main causes of death in tetanus. In the absence of qualified medical care and preventive vaccinations, the mortality rate from tetanus reaches 80%. When vaccination is used and timely qualified medical care is provided, the mortality rate is 17 - 25%.

Rice. 9. The photo shows opisthonus (hyperextension of the spine) in a patient with tetanus.

Rice. 10. In the photo there is opisthonus in a child.

A patient with tetanus has no meningeal symptoms, and consciousness remains clear throughout the entire period of the disease.

Signs and symptoms of tetanus during recovery

The recovery period for tetanus lasts 3 to 4 weeks. In some cases - 8 weeks. Already on the 10th day of the disease, an improvement in the patient’s well-being is noted. Signs of infectious-toxic myocarditis and asthenovegetative syndrome appear.

Severity and prevalence of tetanus

• Mild form of the disease lasts about 2 weeks. Patients with this form of the disease have partial immunity from tetanus. Muscle hypertonicity, tetanic convulsions and dysphagia are mild. Convulsions are rare or absent.
• Moderate form of tetanus occurs with typical symptoms of the disease. The patient experiences convulsions every 1 to 2 hours. Their duration is short - 15 - 30 seconds.
• At severe tetanus There is a high body temperature, frequent seizures - every 5 - 30 minutes, their duration is 1 - 3 minutes. Hypoxia and cardiac weakness develop. Pneumonia occurs.
• It is especially difficult encephalic form of the disease(Brunner's cephalic bulbar tetanus), which affects the medulla oblongata and the upper spinal cord. The disease develops with injuries and injuries to the neck and head. The swallowing, respiratory and facial muscles are involved in the spasms. The incubation period for bulbar tetanus is short. Mortality is extremely high.
• Very rarely observed local tetanus. Its variety is facial paralytic tetanus (Rose's cephalic tetanus), which develops with injuries and wounds of the neck and head, sometimes with otitis media. It is characterized by trismus (contraction of the masticatory muscles), paralysis of muscles that are innervated by cranial nerves (either one or more). Most often, the disease affects the nervus facialis (facial nerve).

Rice. 11. The photo shows facial paralytic tetanus.

Complications of tetanus

• Hypertonicity of the muscles involved in breathing leads to hypoxia. Mucus production increases. The drainage function of the bronchi is impaired. Against the background of congestion, bronchitis and pneumonia occur, complicated by pulmonary edema. Thrombosis of the pulmonary arteries develops.
• The great strength of the muscles during the contraction period leads to the fact that they can be torn away from the place of attachment, fractures of the vertebral bodies, joint dislocations, ruptures of the muscles and tendons of the limbs and the anterior abdominal wall occur, compression deformation of the spine and muscle contractures develop.
• Extensive wounds are often complicated by abscesses and phlegmon.
• Later complications include spinal deformities, muscle contractures, and temporary cranial nerve palsies.

After recovery, the patient has been worried about general weakness, weakening of cardiovascular activity and stiffness of skeletal muscles for a long time.

In regions where there is no preventive work and proper medical care, the mortality rate from tetanus reaches 80%, and in newborns - 95%. In countries where modern methods of treatment and prevention of the disease are used, up to 25% of patients die annually. This is associated with severe complications of tetanus that are incompatible with life.

Rice. 12. In the photo, a child has tetanus. Above - opisthonus, below - tetanic convulsions.

Relapses of the disease are extremely rare. The reasons for their occurrence are unknown.

Diagnosis of tetanus

Epidemiological history

Epidemiological history when diagnosing tetanus is of paramount importance. Domestic injuries, burns, frostbite, criminal abortions and surgical interventions are most often the cause of the disease.

Clinical symptoms of tetanus during the height of the disease make it easy to make a diagnosis. Trismus, dysphagia and “sardonic smile” at the beginning of the disease, hypertonicity of skeletal muscles, periodic tetanic convulsions and opisthonus are the main diagnostic signs of the disease.

Rice. 13. The photo shows tetanus in adults.

Laboratory diagnostics

Laboratory diagnosis is of secondary importance. Tetanus toxin cannot be detected even when symptoms appear. Detection of antitoxic antibodies indicates previous vaccinations. The exotoxin does not cause an immune response, so there is no increase in antibody titer.

To diagnose the disease, microscopy of smears, histological examination of the material and culture of wound discharge on nutrient media are used.

Among the serious diseases that modern people fear is tetanus. This is a terrible disease that is not only acute, but also causes serious complications and 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 mechanism of transmission of the disease is contact. Simply put, the bacterium enters the human body through the skin and causes illness. The first symptoms indicating infection with tetanus may appear on the first day, or even after a month.

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. the integrity is broken.

Carriers can be rats, mice, birds and humans themselves. The bacterium is very tenacious. It can function even at high temperatures. So, at 90 degrees, the stick that causes tetanus remains alive for 2-3 hours. In the soil it remains pathogenic for a very long period, despite any unfavorable external conditions. The stick can feel comfortable and pose a threat to human life on any objects for up to several years. Disinfectants also have no effect on it.

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

When did the disease appear?

This disease is not new. It is impossible to say exactly when people began to become infected with tetanus. The disease has existed for hundreds of years. They first 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 military operations. Later, a vaccine was developed and administered as a preventive measure. It was she who served as salvation from numerous deaths.

Where is tetanus most common?

The bacterium that causes the disease loves a moist environment. The disease is very common in Africa, Asia, and even America. But in recent years, cases of tetanus infection have been observed in Europe. Moreover, they have a considerable number.

Tetanus is treatable, but even with timely measures taken to combat the disease, the mortality rate 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 may vary. From 1-2 days to a month. Typically, the incubation period is two weeks. During this time, a person may feel unwell. In the place where he had a wound and presumably became infected with tetanus, there is muscle tension and twitching. The person also becomes irritable and sweating increases.

There are four stages of the disease in total:

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

2. Initial stage. During this period, a person begins to experience aching pain. Mainly at the site of the wound, which seems to have already begun to heal. This period can be about two days. At the same time, muscle spasm begins.

3. High stage. How many days does this period last? Usually this is about two weeks. The symptoms appear very clearly. The most difficult period for a person, accompanied by constant cramps and malaise.

4. Stage of recovery. At this time, the person feels better. You can understand that the body is on the mend by the fact that cramps gradually appear less and less often.

Important point! During the recovery period, although it becomes easier for a person, this time is very dangerous for him. It is during the recovery stage 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. Symptoms of tetanus in adults and children are as follows:

At the initial stage, tetanus manifests itself quite acutely. The first thing that happens when infected is a clenching of the jaw as a result of spasms.

The next stage is the one that results from spasm of the facial muscles.

When the disease reaches its peak, muscle spasms begin 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 becomes shallow.

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

One of the extreme conditions in a person is the moment when cramps constrain most of the body, causing excruciating pain.

Almost the entire period while the disease develops, the patient experiences severe irritation, he begins to have problems sleeping, his temperature rises, and sweat flows profusely.

Symptoms of tetanus in adults are the same as those seen in children and pregnant women.

The likelihood of death if all these symptoms are present is high. But even if the treatment showed positive dynamics, the recovery process will take several months. The possibility of complications developing is high.

Complications

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

Cramps that constrain all muscles cause them to rupture; patients may have fractures of bones, joints, vertebrae, and ligament ruptures. Curvature of the spine 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 is in most cases 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 study the specific state of immunity before starting vaccinations. It is also required to determine the level of antibodies after vaccination.

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

Preparing for the test

You do not need to take any precautions, except that you should not eat anything in the morning before taking the test. Also, the previous evening you should avoid emotional stress and various physical activities.

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

Effect of vaccination

The effect of the tetanus shot is the same as that of 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 begin to fight 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 this opinion is wrong, because all vaccines are researched and manufactured in laboratory conditions in accordance with safety standards.

At what age is the tetanus vaccine given?

Vaccinations should begin as early as three months of age. The next vaccination is given at 4.5 months. After - at one and a half years and then at 6-7 years.

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

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

Side effects and contraindications of the tetanus vaccine

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

Contraindications:

Pregnancy, in case of emergency, immunoglobulins should be administered to the woman;

Allergy to vaccine components;

Weakened immunity;

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

Chronic diseases.

Treatment of tetanus

Patients are treated by infectious disease specialists and resuscitators in the intensive care unit. Sick people are provided with complete rest, the lights are dimmed, and silence is maintained.

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

If a person has seizures, he is prescribed anticonvulsant sedatives. For pain relief, they inject. Against seizures, “Sibazon” and “Sudksin” are most often used. The drugs used are morphine and Tramadol. Additionally, treatment with muscle relaxants is carried out.

If a person has trouble breathing, he is connected to an artificial respiration apparatus. Laxatives are also prescribed and 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, and droppers of plasma, hemodez, and albumin are given. All patients are provided with careful and caring care.

Prevention of tetanus

The most effective measure that helps avoid serious consequences and death is vaccination. We have already discussed above how it is installed. The vaccine has been used for several decades, helping people cope with this terrible disease.

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

If infection has occurred, then at the first symptoms you should immediately go to the hospital. The site of infection is excised. If the vaccine 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 this terrible disease are no longer a secret to you. Be careful and you will never be at risk of contracting this disease. And if someone you know gets tetanus, there is no need to wait. You need to go to the hospital urgently!

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

What causes tetanus?

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

The spores of the microorganism continue to remain pathogenic (infectious) for a long time (even several years). The rod 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 and “cramped”, so the body begins to feel tired.
• problematic (difficulty) swallowing food.

Sometimes the patient may experience slightly different symptoms, such as:

• increased heart rate;
• fever;

Symptoms appear within eight days of 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, and buttocks may also be affected.

Associated symptoms

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

Click to enlarge

Stages of the disease and their symptoms

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

Stage 1 – incubation period.

Stage 2 – initial.

Stage 3 is the stage at the height of the disease.

Stage 4 – recovery stage.

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.

During the incubation period, the disease may begin to be accompanied by the following symptoms:

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

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

Initial stage and first signs of the disease

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

1. A nagging pain at the site of infection (most often this is 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 - a feeling of tension and frequent contraction of all masticatory muscles. It is difficult for the patient to open the mouth. Sometimes (in severe cases) the teeth are clenched so tightly that it is impossible to open your mouth at all.
3. Facial muscle spasms (facial muscles) develop. A “horrible picture” appears on the patient’s face – smiling and crying at the same time. In medicine, such a distortion of the face is usually called a sardonic smile. It is characterized by:

• wrinkled forehead;
• forehead stretched across the width;
• narrow palpebral fissures;
• drooping corners of the mouth.

1. Following the smile, symptoms appear such as difficulty swallowing, caused by convulsive spasms of the muscles in the throat, and painful rigidity of the neck muscles.

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

This period lasts on average 10 days. If the disease is severe, then the duration of the peak stage naturally increases.

The height of the disease is accompanied by:

• Intensifying 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. The muscles spasm gradually. Cramps can be severe enough to cause bones and joints to fracture or dislocate.
• Painful tension in all muscle tissues of the body, as well as in the limbs, except for the muscles of the hands and feet. They don't relax even in their sleep. The muscles of the abdominal wall harden, the legs are stretched, so the musculoskeletal system practically does not function.
• Pronounced muscle contour (especially in men).
• Increased sweating, salivation.
• The skin and mucous membranes acquire a “bluish” tint (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 shallow. The muscles responsible for breathing can be affected during any stage of the disease. The results can be fatal if medical attention is not provided on time.
• . Periodic blocking of respiratory movements occurs, and sometimes breathing may be interrupted.
• Unstable operation of the urinary and circulatory systems. Urination is accompanied by painful sensations, possible retention of bowel movements (feces and urine are difficult to pass) and nagging, intense pain in the perineal area. Defecation is also difficult.
• Increased body temperature.

Unbearable pain in the patient is accompanied by moaning and screaming and, as a result, insomnia and irritability to everything around him.

Recovery stage

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

Forms of tetanus and their symptoms

Based on clinical data and taking into account the characteristics of external manifestations, four types (forms) of the course of the disease have been 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 swallowing;
• stiffness of the pectoral and calf muscles.

Associated symptoms include:

• elevated temperature;
• excessive “unusual” sweating;
• increased blood pressure;
• accelerated heart rate.

Convulsions may occur, lasting up to 30 days. Full recovery takes several months.

1. Local tetanus

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

Characterized by:

• absence of seizures;
• spasms and twitching in muscle tissue.

1. Head tetanus

Limits the functioning of muscles and nerves in the head. This usually occurs after an injury. This could 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:

• mouth opens poorly;
• trismus in the head and neck area - contraction of the jaw with severe muscle tension in the temples;
• sardonic smile;
• dysfunction of the cranial nerves.

Due to its rare form, doctors may be unfamiliar with the clinical picture and may not immediately suspect tetanus as an overt illness. Treatment can be complicated because the symptoms are very similar to the injury that caused the infection. The disease progresses quickly. Cephalic tetanus is more often fatal than other forms.

1. Neonatal tetanus

In terms of symptoms, it is similar to general tetanus, except that it is observed only in newborns (the child’s age does not exceed 1 month). The disease manifests itself almost immediately and may be associated with non-compliance with the rules and regulations 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 worry about?

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

• breathing problems due to narrowing of the airways;
• damage to the brain system (caused by lack of oxygen);
• bone fractures, breaks in the bones;
• 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 show that 10-20% of cases are fatal).

Tetanus is an acute infectious disease caused by the spore-forming anaerobe Clostridium tetani (C.tetani), which produces one of the most powerful toxins - tetanospasmin, and when it enters the human body through a wound or cut, it affects the central nervous system, causing convulsions. For humans, the lethal dose of the toxin is only 2.5 nanograms per kilogram of weight.

Tetanus bacillus is very resistant to various external influences, tolerates boiling, and is resistant to phenol and other chemical agents. It can persist for decades in the soil and on various objects contaminated with feces. It can be found in house dust, soil, salt and fresh water, and feces of many animal species.

What it is?

Tetanus is a zooanthroponotic bacterial acute infectious disease with a contact mechanism of pathogen transmission, characterized by damage to the nervous system and manifested by tonic tension of the skeletal muscles and generalized convulsions.

The patient is not contagious to others. Epidemiological measures are not carried out in the outbreak of the disease. Immunity does not develop after illness. Recovery from clinical tetanus infection does not provide protection against new disease. A small amount of tetanus toxin, sufficient for the development of the disease, does not ensure the production of the necessary antibody titers.

Therefore, all patients with clinical forms of tetanus must be immunized with tetanus toxoid - immediately after diagnosis or after recovery.

Pathogen

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 unfavorable environmental conditions. In the form of spores, Clostridium tetani easily tolerates drying, freezing and even boiling. And when exposed to favorable conditions, for example, a deep wound, the spore becomes active.

Clostridium tetani spores are found in soil, house dust, feces of many animals, and natural bodies of water. If this spore is so common in our environment, then the question arises, why do 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, and frostbite areas. Clostridium tetani loves deep wounds, as they can create oxygen-free conditions.

Mechanism of disease development

From the moment the tetanus bacillus enters favorable conditions, it actively begins to multiply, producing exotaxin, which is so harmful to a living organism. With the bloodstream, exotaxin spreads throughout the body and affects the spinal cord, parts of the medulla oblongata and the reticular formation.

The composition of tetanus toxin includes tetanospasmin, which poses a great danger to the nervous system. By acting on it, it leads to the appearance of tonic muscle contractions, and also triggers the process of tetanohemolysin, during which the process of destruction of red blood cells occurs.

Symptoms of tetanus in humans

There are several clinical periods in the development of tetanus in humans:

1. The incubation period for tetanus is usually about 8 days, but can last up to several months. When the process is generalized, the more distant the source of infection is from the central nervous system, the longer the incubation period. The shorter the incubation period, the more severe the disease. The incubation period of neonatal tetanus averages from 5 to 14 days, sometimes from several hours to 7 days. The disease may be preceded by headache, irritability, sweating, tension and muscle twitching in the area of ​​the wound. Immediately before the onset of the disease, chills, insomnia, yawning, sore throat when swallowing, back pain, and loss of appetite are noted. However, the incubation period may be asymptomatic.
2. Initial period. Its duration is about two days. Initially, the infected person feels a nagging pain in the area of ​​the wound, while the wound is purposefully getting better. At the same time or a little later, a person experiences trismus, which is usually understood as tension and contractile movements of the masticatory muscles, resulting in problems with opening the mouth. In severe cases of the disease, there may be a complete inability to open the mouth as a result of very strong closure of the teeth.
3. The peak period of the disease lasts on average 8-12 days, in severe cases up to 2-3 weeks. Its duration depends on the timeliness of seeing a doctor, the early start of treatment, and the availability of vaccinations in the period preceding the disease. A tonic contraction of the masticatory muscles (trismus) and convulsions of the facial muscles develop, as a result of which the patient develops a sardonic smile. risus sardonicus: the eyebrows are raised, the mouth is stretched wide, its corners are lowered, the face expresses both a smile and a cry. Next, the clinical picture develops with the involvement of the muscles of the back and limbs (“opisthotonus”). There is difficulty swallowing due to spasm of the pharyngeal muscles and painful rigidity (tension) of the muscles of the back of the head. Rigidity spreads in a descending order, affecting the muscles of the neck, back, abdomen and limbs. Tension appears in the muscles of the limbs and abdomen, which becomes hard as a board. Sometimes there is complete stiffness of the torso and limbs, with the exception of the hands and feet. Painful cramps occur, initially limited, and then spreading to large muscle groups, which last from a few seconds to several minutes. In mild cases, convulsions occur several times a day, in severe cases they last almost continuously. Seizures can occur spontaneously, or they can appear as a result of a stimulus, which can be a bright light, touch or sound. When convulsions occur, a person experiences increased sweating, the face turns blue and all facial expressions reflect terrible suffering. Muscle spasms lead to dysfunction of swallowing, breathing, and urination. Congestion and metabolic disorders occur in the body, which adversely affects cardiac activity. Body temperature rises above 40 degrees.
4. The recovery period is characterized by a slow, gradual decrease in the strength and number of cramps and muscle tension. May last up to 2 months. This period is especially dangerous for the development of various complications.

Severity

Depending on the severity of the course, tetanus can be:

1. Mild – has a long incubation period (more than 20 days), mild trismus, sardonic smile and dysphagia. There is practically no tension in other muscles, body temperature is normal or increased to 37.5°C. Symptoms of the disease develop within 5-6 days. This form of the disease develops in patients who have partial immunity.
2. The moderate-severe stage lasts from 2 to 3 weeks. All symptoms appear and increase within three days. A convulsive syndrome is typical, occurring once a day. Signs of hyperhidrosis, tachycardia and low-grade fever remain within moderate limits.
3. Severe - the incubation period is 7-14 days, symptoms appear within 24-48 hours. Severe muscle tension is accompanied by convulsive twitching several times an hour. Heart rate, blood pressure, and temperature are sharply increased.
4. The stage of the extremely severe course of the disease is characterized by a very short incubation stage (up to seven days) and immediate development - regular, prolonged convulsive syndromes, up to five minutes, and muscle spasms accompanied by tachypnea (shallow rapid breathing), signs of tachycardia, suffocation and skin cyanosis.

What does tetanus look like: photo

The photo below shows how the disease manifests itself in humans.

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Diagnostics

Diagnosis of tetanus is based on the clinical presentation of the disease. Anamnesis is of great importance. Isolation and identification of the microorganism is rarely carried out. The toxin content in the muscles is determined.

At the onset of the disease, tetanus should be distinguished from periostitis, gingivitis, abscesses of the retropharyngeal space, inflammation of the mandibular joints, when the patient cannot open his mouth. With tetanus, there is prolonged tension in 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 and meningitis. In doubtful cases, they resort to spinal puncture. In older children, tetanus should be differentiated from hysteria and rabies.

Consequences

Complications can be different: sepsis, myocardial infarction, ruptures of muscles and tendons, dislocations and spontaneous fractures, thrombosis and embolism, pulmonary edema, temporary paralysis of the cranial nerves, muscle contractures, compression deformity of the spine (remains in some cases up to 2 years) etc.

Treatment of tetanus

A person who exhibits symptoms of tetanus should be immediately admitted to a hospital. In order to neutralize the tetanus toxin, the patient is injected with a special antitetanus serum or takes a specific immunoglobulin. A number of medications are used to treat convulsive syndrome - narcotics, sedatives, neuroplegics. Muscle relaxants are also used to treat tetanus.

If the patient has severe respiratory distress, then before starting treatment for tetanus, it is necessary to carry out all the necessary resuscitation measures. Next, laxatives are used for treatment, a gas outlet tube is placed in the patient, and if there is such a need, the patient undergoes catheterization of the bladder. To prevent the patient from developing pneumonia, the patient with tetanus should be turned over very often, and constant stimulation of breathing and coughing is also necessary. To prevent further treatment of bacterial complications, antibiotics are used.

Treatment of tetanus also involves managing dehydration by using intravenous infusions of sodium bicarbonate solution. A number of other drugs are used for this purpose: polyionic solutions, hemodez, albumin, rheopolyglucin, plasma.

Tetanus shot

Children are vaccinated against tetanus five times. The first vaccination is given at 3 months, then at 4.5 months, at six months, at 1.5 years, then at 6-7 years.

Revaccination of adults is carried out at the age of 18 years. If a full course of tetanus vaccination was carried out in childhood, then one vaccination every 10 years is sufficient. During the primary vaccination of an adult, 2 vaccinations are given at a monthly interval, and a year later another one. The vaccine is given intramuscularly (usually under the shoulder blade, shoulder or thigh). After vaccination, side effects are possible: swelling at the vaccination site, moderate pain, fever (it can be brought down with antipyretic drugs). All such symptoms should normally subside within 2-3 days.

You can get a tetanus vaccination and get detailed advice at any clinic near your place of residence.

Prevention of tetanus

Nonspecific prevention of the disease consists of preventing injuries in everyday life and at work, observing the rules of asepsis and antisepsis in operating rooms, maternity rooms, and when treating wounds.

Specific prevention of tetanus is carried out on a planned or emergency basis. According to the national vaccination calendar, children from 3 months of age are vaccinated three times with DPT (or DPT) vaccine, the first revaccination is carried out after 1–1.5 years, followed by revaccinations every 10 years.