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

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

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 much to everyone's regret, the topic of tetanus remains relevant in the modern world. This is associated with a large number of deaths from this disease. Statistics show that approximately 160,000 people worldwide die from tetanus every year.

Short description

Tetanus is one of the serious infectious diseases. It is characterized by the release of a lethal toxin and a fairly rapid clinical course. In order to be able to fully understand the whole problem of the appearance of this disease, it is enough to have information that 30-50% of patients die. Among them are those who have been vaccinated against tetanus. In countries with underdeveloped medicine, this figure reaches 85-90%.

Tetanus causes the vital activity of microorganisms that have entered the body through wounds and other skin lesions. The most suitable circumstance for their reproduction is hot and humid. Wednesday. That is why most of all registered deaths from tetanus occurred in the equatorial states of Africa, Asia and Latin America. But even in relatively prosperous European countries, thousands of people die from this disease every year. Based on this, it cannot be said that residents of more civilized regions are safe.

Tetanus Pathogen

Tetanus pathogens are members of the Bacillaceae family. Under normal 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 brisk release of a toxin by them, 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 observed within a few hours after infection. The waste products of pathogens are completely harmless if swallowed, because they are not absorbed through the mucous membrane. But during heating or under the influence of ultraviolet rays, they die quickly enough.

How do you get tetanus?

Vaccination is needed when there is injury or damage to the skin or mucous membranes. The most difficult in this case are incised wounds of great depth, since it is in them that the formation of ideal for the development of harmfulmicroorganism conditions. Also, activation of the infection can occur with burns, frostbite and inflammatory diseases. A newborn baby can get tetanus through the umbilical cord if it has been cut with badly cut instruments.

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

• in house dust;
• earth;
• s alt and fresh water;
• feces of most animals.

Spores and vegetative configurations of tetanus bacillus are present in the human intestine.

The level of sensitivity to this disease is very high in all age groups, but most of the disease in children is recorded at 3-7 years old.

What is the incubation period for tetanus?

How long does it take for tetanus to show up? The 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 more severe the disease will be and the greater the possibility of death.

At this time, bacteria penetrate into 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 signs:

• headache;
• sweating;
• muscle tension;
• increased level of irritability;
• chill;
• insomnia and other neuropsychiatric disorders.

Clinical picture and first symptoms of the disease

The onset of the disease in most cases is acute. Quite rare are cases of registration of a small prodromal period. It is expressed by the appearance of the following symptoms:

• malaise;
• headaches;
• tense state and muscle contraction where the injury occurred and tetanus develops.

The first signs in most cases are muffled pulling pain at the wound site, even if it has already healed. Among the first specific signs of the disease, the appearance of which may indicate tetanus, are:

• manifestation of lockjaw (convulsive contraction) of chewing muscles, which causes the opening of the mouth;
• the presence of a sardonic smile, due to which the facial expression becomes maliciously mocking (the forehead wrinkles, the eyes shrink, the lips lengthen in a smile);
• manifestation of dysphagia (swallowing disorders), the cause of which is convulsive spasm of the muscles of the pharynx;
• stiff neck.

The first 3 symptoms are unique to tetanus.

Characteristic features of the peak period of tetanus

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

• speed of access to a doctor;
• presence or absence of vaccination;
• scaleskin damage.

Tetanus is often found at this stage. Symptoms in children are:

• convulsive contractions of facial muscles, the appearance of a characteristic smile;
• difficulty swallowing food;
• the muscles of the limbs and abdomen are very tense;
• painful convulsions;
• significant sweating;
• chronic insomnia;
• apnea, cyanosis; asphyxia;
• violation of the urinary process and blood circulation;
• significant increase in temperature.

When a tetanus injection has not been given, the cause of death of the patient 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

When it comes to newborn children, the course of the disease is the most severe for them, and in almost 100% of cases there is a fatal outcome. For babies, a special form of the course of such a disease as tetanus is characteristic. The first signs are anxiety, a shudder of the chin, a violation of the swallowing and sucking reflex. After this, muscle spasm of the neck and general convulsions begin. Often a newborn dies on the first day after the onset of the disease.

Recovery period

If parents show a child who has tetanus to medical workers in time, treatment is gradual and the symptoms of this disease disappear over 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 regard, constant monitoring of its condition is required.

After recovery, there may be residual effects that are observed for a sufficiently long period of time. These include muscle stiffness, general weakness, etc.

Disease forms

There are mild, moderate and severe forms of tetanus according to severity.

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

• weak severity of general tetanic convulsions (or lack thereof);
• local convulsive muscle spasms (symptoms of tetanus at or near the wound);
• mild muscle hypertonicity;
• no or slight manifestation of dysphagia and tachycardia;
• normal or subfebrile temperature.

Main characteristics of moderate tetanus:

• incubation period - 15-20 days;
• development of the main complex of symptoms - 3-4 days;
• moderate severity of all symptoms of the disease;
• no asphyxia and swallowing disorders.

The severe form is characterized by a fairly short incubation period - 7-14 days. In this case, tetanus develops within 1-2 days. Symptoms in childrenappear quite clearly. But life-threatening complications are usually rare.

Tetanus treatment

A child with suspected tetanus needs urgent delivery to a hospital. Treatment of especially dangerous forms is carried out after hospitalization in the intensive care unit.

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

To eliminate the vegetative forms of tetanus bacillus from necrotic tissues, antibiotic therapy is performed. In most cases, it involves the appointment of large doses of penicillin intravenously. The duration of such therapy is at least 10 days. In case of intolerance to penicillin, a tetanus shot is prescribed, which consists of tetracycline.

Sick children are treated with specific human immunoglobulin. It is administered once intramuscularly. In parallel with it, subcutaneous injection of tetanus toxoid is carried out three times. The interval between injections is 5-7 days.

In order to alleviate the condition of the child, he is provided with peace and quiet. In addition, symptomatic treatment takes place, which affects how tetanus proceeds. Children's symptoms are managed by doing the following:

• wound treatment;
• decrease in seizure intensity;
• prevention of sepsis and pneumonia;
• improved ventilation;
• pain relief.

Preventiontetanus

Because this is a fatal 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 non-specific.

A non-specific type of prevention of the onset of the disease in children is to carry out the following activities:

• observance of sterility during labor and operating activities;
• meticulous wound care recommended with antiseptics.

Specific tetanus prophylaxis is carried out routinely or urgently. The main purpose of the tetanus vaccine is to create personal immunity and immunological memory. Vaccination of children is carried out according to the schedule of vaccinations - 3 times after the third month of life and revaccination after 1-1.5 years.

Tetanus vaccine for children is not a guarantee of permanent immunity to the causative agent of this disease. It only supports artificial immunity and helps to overcome tetanus bacilli that find themselves in the body.