Tetanus vaccination: after it. Symptoms, signs and treatment of the disease, how to get infected

“We bought a dacha, now I’m constantly digging in the ground. Naturally, I can hurt myself with tools and cut myself with sedge. Do I need to be vaccinated against tetanus? I had this vaccination when I was a child.” Svetlana, 37 years old

Tetanus is an infectious disease caused by the bacillus Clostridium Tetani. It lives in the intestines of animals, and the spores of this bacillus, entering the soil through feces, become a source of dangerous infection. Therefore, in case of soil-related injuries, as well as in a number of other cases, it is necessary to carry out emergency prevention.

Vaccine options

To prevent tetanus, all children are given tetanus toxoid as part of combination vaccines.
Types of tetanus vaccines: AC - tetanus toxoid (if necessary, for example, for puncture injuries, etc.), DTP - adsorbed diphtheria-tetanus-pertussis vaccine, ADS - Adsorbed diphtheria-tetanus vaccine, ADS-m - Adsorbed diphtheria-tetanus vaccine vaccine with reduced content of diphtheria toxoid.
And also the vaccines “Bubo-Kok”, “Bubo-M”, “Infanrix Penta”, “Infanrix Hexa”, “Pentaxim”, “Tetraxim”, “Infanrix”.

In what way should we remove chips from the mature bark?

Adults can develop chips in the cortex in any age, since there are no medical records about vaccination in childhood, contact with the sick and the analysis does not show the presence of antibodies to the virus in the blood. If vaccination was carried out during childhood (on the 1st and 6th birthdays), revaccination is not required, since immunity is developed throughout life.

When we grow up, if we haven’t lost the skin in childhood, for the formation of the immune type, we need to administer the vaccine twice at an interval of 1 month. Therefore, people who have been ill with the virus or have been infected with the virus may have good immunity against the disease, however, if a blood test does not show the presence of antibodies to the virus, the test should be repeated.

Principles and purposes of vaccination

Since natural immunity does not exist, that is, immunity after an illness is short-lived, susceptibility to the disease is very high, and the course of the disease is extremely severe, with a high probability of death, you should be vaccinated against this dangerous infection. Tetanus can be rapidly prevented through immunization and vaccines containing tetanus toxoid, which are included in childhood immunization programs worldwide.

Isolated tetanus vaccination can be successfully used to immunize people of any age group, both children and adults. It is especially important to vaccinate pregnant women who have not previously been vaccinated against tetanus, as this can reduce the risk of maternal and neonatal (infant) tetanus to virtually zero. In addition, antibodies against tetanus are passed from mother to newborn, protecting the baby for two months. To develop full immunity to infection, it is necessary to administer five doses of tetanus vaccine. It is recommended that adults, especially women of childbearing age, be revaccinated throughout their lives, which will ensure immunity to infection for life. In Russia, adults are recommended to receive a booster vaccination against tetanus every 10 years.

Vaccination is carried out three times, with an interval of 45 days and a single revaccination 12 months after the 3rd vaccination, i.e. at 18 months of age. Further, according to the vaccination calendar, revaccination is carried out with ADS-M toxoid at 7 and 14 years of age and subsequently every 10 years. Emergency prevention of tetanus consists of primary surgical treatment of the wound and the simultaneous administration of a vaccine (ADS or ADS-M) and human tetanus immunoglobulin (TSHI), or purified concentrated antitetanus serum (PTS).

Classification

1. Depending on the location of the lesion:
   Local tetanus (paralysis is limited to one or several muscle groups in the wound area and is typical for previously vaccinated people);
2. Generalized tetanus (convulsions involve all muscle groups).
3. According to the severity of the course (assessed in patients with a generalized form):
   Mild degree;
4. Moderate degree;
5. Severe degree;
6. Extremely severe.
7. Forms of tetanus depending on the entrance gate:
   Traumatic (after operations, injuries, childbirth, burns, wounds and frostbite);
8. Inflammatory-necrotic (in patients with disintegrating tumors, ulcerations of the skin and mucous membranes, bedsores);
9. Cryptogenic (the entrance gate is not defined, the incubation period is extended to several months, the wound has long healed and the patient has forgotten about it).

Vaccine effectiveness

The effectiveness and efficiency of tetanus toxoids have been documented. In most clinical trials, effectiveness ranged from 80% to 100%. The introduction of tetanus vaccination in the United States in the 1940s caused the overall incidence of tetanus to decline from 0.4 per 100,000 population in 1947 to 0.02 per 100,000 population in the late 1990s. In a double-blind, controlled study conducted in rural Colombia, neonatal tetanus did not occur in neonates born to mothers receiving double or triple doses of the vaccine, while in an unvaccinated control group of neonates the mortality rate was 78 deaths per 1000 live births. The only means of prevention is vaccination, the effectiveness of which is 95-100%. Strong immunity against diphtheria and tetanus lasts approximately 5 years, after which it gradually fades, so revaccination against these diseases is required every 10 years.

Why is it necessary to get vaccinated against tetanus?

Tetanus vaccination is included in the compulsory vaccination calendar, since this infection cannot be eradicated. Important facts about tetanus infection:

• The disease belongs to zooanthroponoses and its causative agent is normally present in the body of both humans and animals (in the intestines). With feces, tetanus bacteria enter the soil and water, which significantly increases the likelihood of contracting the disease when the skin is injured.
• The causative agent of the disease is a gram-positive rod, which under unfavorable conditions outside a living organism is transformed into spores. Tetanus spores tolerate low temperatures well, remain viable when boiled for three hours, and live in soil for up to 100 years.
• A previous infection (if a person has had tetanus) does not form lifelong immunity, so you can get tetanus again.
• Tetanus has a very high mortality rate. Infected children die in 96% of cases, and adults in 16–80%.

Adverse reactions

If vaccination is carried out with the DPT vaccine, then it should be remembered that vaccines are the most reactogenic, “heavy” childhood vaccines. On average, post-vaccination reactions occur in a third of vaccinated people, and not for every vaccination. They are manifested by a moderate increase in body temperature and mild malaise within 24 hours after vaccination. As a rule, all adverse events when administering the DPT vaccine develop no later than 72 hours (3 days) after vaccination and last no more than 48-72 hours.

Other types of tetanus vaccines have very low reactogenicity, that is, the development of post-vaccination reactions is very rare. Usually the vaccination is easily tolerated.

Local reactions such as redness of the injection site, swelling, induration or the formation of a “bump” are relatively common. These reactions are normal and go away on their own. Today, according to the World Health Organization, tetanus vaccination can cause a number of side effects that are not a serious health disorder and can be easily treated. Possible side effects of the tetanus vaccine include the following conditions: seizure activity, dermatitis, rhinitis, bronchitis and pharyngitis.

Clinical manifestations

The incubation period of the disease varies from a day to a month, but more often it is 7–14 days. The initial symptoms of tetanus (prodromal period) are not observed in all patients and include headache, twitching and muscle tension in the wound (complete healing of the wound is often observed), sweating, malaise, and irritability. More often, the first manifestation of the disease is a dull, nagging pain at the site of infection. Later, specific signs of the disease appear:

• There is convulsive compression and tension of the masticatory muscles, which makes it difficult to open the mouth and is called trismus;
• A “sardonic smile” appears, which can be described as both malicious and mocking (the forehead wrinkles, the eyes narrow, the lips stretch into a smile, but the corners of the mouth droop);
• A swallowing disorder or dysphagia develops, as a convulsive spasm of the pharyngeal muscles occurs, making it difficult and painful for the sick person to swallow;
• There will be stiffness (tension) of the neck muscles, but there are no other meningeal symptoms.

The presence of the first three symptoms in a person confirms a tetanus infection.

• The height of the disease

It is characterized by the occurrence of tonic spasms that spread to the muscles of the trunk and limbs, excluding the hands and feet. Tonic muscle tension is very painful and constant, persisting during sleep. On the third or fourth day of the disease, the abdominal muscles become stiff, movements in the limbs become difficult, the intercostal and diaphragmatic muscles spasm, which is accompanied by rapid shallow breathing. Tonic spasms also spread to the muscles of the perineum, intestines and urethra, resulting in difficulty urinating and defecating.

• Convulsive syndrome

Later, convulsive syndrome occurs. In the case of a mild course of the disease, convulsions occur no more than 5 times a day and last several minutes; severe tetanus is characterized by constant and continuous convulsions. Any stimulus can provoke convulsive contractions: light, sound, tactile contact. Cramps are very painful and can involve arbitrary muscle groups, resulting in the patient taking bizarre positions. During convulsions, the patient's face turns blue, becomes puffy and covered in perspiration.

• Development of opisthotonus

Total muscle contraction, including severe tension of the back muscles, leads to opisthotonus: the patient arches, touching the surface of the bed only with the back of the head and heels, the elbows are bent, the hands are clenched into fists, and the legs are extended. The patient begins to experience severe fear and scream due to sharp pain, suffocates and clenches his hands into fists or grabs the edges of the bed. At the same time, the temperature rises, sweating and salivation increase.

Tetanus in adults can manifest itself as local symptoms or generalized ones. The duration of the incubation period depends on the proximity of the entry gate of infection to the brain and spinal cord. If the wound is located on the face or neck, the incubation period is reduced to 1 - 3 days. Tetanus in children (newborns) is characterized by a shortening of the incubation period to several hours (the infection penetrates through the umbilical cord, from where it quickly reaches the central nervous system through the bloodstream).

Risk of post-vaccination complications

As with any other vaccine, in rare cases allergic reactions to vaccine components are possible. These complications are not related to the properties of the vaccine, but to the amount of excipients in specific preparations, whether the child is allergic to them and, in some cases, non-compliance with vaccination rules. It is significant that, according to statistics of post-vaccination complications in the United States, even severe allergic reactions to DTP vaccines have not led to serious consequences in any case since 1978, taking into account the fact that about 80 million vaccinations were given during this period. Possible specific complications of DTP vaccines include neurological complications, which are extremely rare. It is assumed that they may be caused by the fact that the toxins of pertussis bacillus (even inactivated) in combination vaccines tend to irritate the meninges of an extremely small proportion of susceptible children. Complications in the form of encephalopathy are less than 1 case per 300 thousand vaccinated people.

Currently, in the world, convulsions without fever are not considered a complication of vaccination. Research conducted in Great Britain in 1960-1970. indicate the same frequency of seizures in vaccinated and unvaccinated children. Moreover, the first manifestations of diseases such as epilepsy, organic damage, and are associated with vaccination only by a temporary factor.

The development of afebrile seizures indicates the presence of an organic lesion of the nervous system in the child, which was not taken into account and identified or could not be identified before vaccination for objective reasons. Therefore, in the event of afebrile seizures, a comprehensive neurological examination is necessary to make a diagnosis.

Who shouldn't get vaccinated?

Medical standards have a clear answer to this question - for persons who have documented proof of vaccination within the previous 5 years. That is, if at a regional emergency room at a doctor’s appointment about a wound, a dog bite or a fracture, you show a vaccination certificate with an “expiration” date for vaccination, the doctor will calmly let you go home without an anti-tetanus injection.

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This happens extremely rarely. Most of us have difficulty remembering when and what we were vaccinated with. Therefore, emergency rooms and emergency departments of multidisciplinary hospitals always have a supply of packs with these drugs.

Contraindications

DPT vaccines are temporarily or absolutely contraindicated if the child has a progressive pathology of the nervous system or has had seizures without fever (afebrile). In this case, children are vaccinated with a vaccine without a pertussis component (PVC). Temporary and relative contraindications are exacerbation above 40 C, swelling and hyperemia at the site of vaccine administration over 8 cm in diameter).

There are practically no absolute contraindications to ADS and ADS-m vaccines, with the exception of severe allergic reactions to their previous administration.

What kind of chips are needed to leave the cordon?

To travel beyond the cordon, you will need illnesses indicated in the sovereign calendar, as well as additional illnesses that have developed in the region where you plan to go. Overflow of the recommended chips is cut into the skin.

You can find out whether it is not safe to move beyond the border without any security or there will be barriers to entry on the website of the Ministry of Foreign Affairs of the country where the trip is planned. Wart that it is necessary to revitalize the immune system from 2 to 8 days, so the chips need to start working later. Obviously, after vaccination, fill out documents to confirm the presence of splintering.

Touch Sensitivity

As Aspergers themselves state, their world is much louder than that of the average person. This is due to increased sensitivity to any stimuli, be it smells, touches, sounds, or visual images. It has been established that a similar phenomenon occurs in approximately 40% of people with AS. A hypersensitivity reaction can be triggered by anything: air temperature, bright light, food, clothing such as scratchy wool or labels on the underside, the touch of other people or large accumulations of them.

For example, when riding on public transport (subway, train, bus), Aspies sometimes use earplugs or headphones that play their favorite music. The mass of people, stuffiness and noise irritate them, unbalance them and lead to stressful conditions. Music helps to distract and calm down. When the situation becomes extremely tense, they have to leave it, go off the route to stand alone and enjoy the silence, and then continue on foot.

There are special types of therapy to cope with sensory problems. One of them is sensory integration therapy. Its essence lies in deliberate contact with unpleasant stimuli, occurring gradually and in doses. Thus, a person begins to get used to such collisions, no longer feeling irritability and panic.

It is very important for Aspergers to identify a method or strategy for neutralizing unpleasant impulses. For some, this solution is a small dose of alcohol.

According to Aspies, it muffles all obsessive sensations and helps reduce stress levels. Someone needs to retire for a while, wander through empty streets, someone swings on a swing.

Is it necessary to treat splinters for adult hepatitis?

It is necessary for adults to become infected with hepatitis B if they were not vaccinated in childhood or if the person is in a risk group (medical workers, people whose relatives are sick with hepatitis B). Hepatitis is an infectious disease that can lead to liver cirrhosis and cancer. You can only get caught if you have killed chips. The vaccination regimen is selected by the doctor after the patient has been cleared and the patient’s illness history has been examined.

Vaccination against hepatitis A is recommended for people who have problems with the liver or are planning a trip to the regions of Africa, Asia or Northern America, where illness often occurs. In order to develop a stable immune system, we need 2 doses of the vaccine at an interval of 6-12 months.

How to avoid unpleasant consequences?

No specialist can give a 100% guarantee that there will be no post-vaccination reaction, since each patient reacts individually.

But with the help of simple rules it is possible to minimize or even avoid side effects after vaccination.

Actions before vaccination:

1. It is recommended to spend more time outdoors.
2. Medical examination and testing.
3. 2 days before the injection, do not visit crowded places.
4. Avoid contact with infectious and contagious people.
5. Before and after the injection, do not introduce new foods with high allergens into the diet.

Everyone handles this load differently. Typically, side effects are extremely rare.

Vaccination against human papilloma virus

Vaccination against human papillomavirus (HPV) is necessary for the protection of cancer of the cervix, oropharynx, organs and anus. The virus also manifests itself on mucous papilomas and condylomas (new growths that reach a size of 2-3 cm). These good growths can turn into bad ones and lead to cancer.

Vaccination is most effective before the beginning of life, since transmission of the virus can occur through the first sexual contact. Basically, it was recommended for girls to try, but in recent years they began to recommend it to young men, in order to reduce the transmission of IDPs to their social contacts, as well as to protect people from the development of cancer.

WHO recommends the use of splitting for girls and boys of the pre-pubescent age, starting from 9-11 days. However, splintering against IDPs can be carried out in the older age - up to 45 years.

The vaccination schedule depends on the vaccine and is selected individually after consultation with a doctor. The chipping allows the development of immunity against illness that affects IDPs for a period of at least 15 years.

A little theory

The main causative agent of this infectious pathology is tetanus bacillus or a gram-positive flagellated bacterium, which is capable of growing, developing and multiplying in oxygen-free conditions.
In fact, the bacterium itself does not pose any danger to the human body, but the exotoxin it produces can be very unsafe and lead to death. Once in the body, this substance enters the medulla oblongata and spinal cord through the motor fibers of the peripheral nerves. When this stick is active, a person may notice severe cramps in the arms and legs, and difficulty breathing.

The composition contains horse blood immunoglobulins, which are pre-vaccinated with tetanus toxin and toxoid. During the manufacturing process, this whey goes through many stages of purification, and in the end it is intensively concentrated using salt fractionation. Visually, it does not look like blood at all, since the serum has a clear or slightly yellowish tint, without any sediment, and is available in the form of a liquid for injection in clear glass ampoules.