Tetanus

Tetanus's disease overview

What is

tetanus?

tetanus is a severe acute infection, caused by the toxin of tetanus bacteria called Clostridium Tetani. This toxin affects the whole body, damaging the brain and the central nervous system leading to muscle stiffness, which can be fatal.

In Vietnam, tetanus is scattered in provinces and cities across the country and is available at all ages. The disease may be encountered at any time of the year, not significantly seasonal. The newborn tetanus exclusion program has been implemented since 1992. Since 2005, Vietnam has eliminated newborn tetanus according to the district scale with the incidence of newborn tetanus below 1/1000 babies. The death of tetanus is higher than those who do not vaccinate and adults over 60 years old.

Causes of Tetanus's disease

pathogens are tetanus bacteria (Clostridium tetani). This is Gram -positive bacillus, hair around the body, relative mobile, living in anaerobic environment. The bacillus often creates a spherical sphere in the form of free or drum shaped. The tetanus bacteria die at 560C, but the tetanus is very sustainable, can also cause tetanus after 5 years in the soil. Disinfectant solutions such as phenol, formalin can kill dentistry after 8-10 hours and boil for 30 minutes also kill the dentist.

This bacterium is present around the world and is mainly found in the soil. Infections of wounds, often open wounds, contaminated wounds, worms, many foreign objects are favorable environments that are often encountered with tetanus bacteria. The spores enter the wounds on the skin, proliferate and create toxins that stick to the tail of the nerve fibers. The toxin will spread into the spinal cord and brain. Toxins prevent chemical signals from brain and spinal cord to muscle. The muscle will have severe convulsions, patients may stop breathing and die if the respiratory muscle group has prolonged spasms. Newborn tetanus is usually derived from infections due to cord cutting in newborns that do not guarantee aseptic principle.

Symptoms of Tetanus's disease

Tetanologic disease usually starts with mild jaw muscle spasms, then affects other muscles in the face and different positions in the body such as chest, neck, back, back , abdomen and buttocks. Costs lumbar muscles create a unique bent position. Contracting respiratory muscles affect respiration. Strong, sudden, prolonged muscle contraction causes muscle pain, can tear both muscles and fractures. Other symptoms include fever, headache, restlessness, discomfort, urinary retention, burning when urinating and losing control.

Tetanese body tetanus is the most common disease. Symptoms of tetanus are many muscles that are stiff and painful seizures within 7 days from the bacteria invade. The muscles are affected most often in the jaw, neck, shoulders, back, upper abdomen, hands and thighs. The facial muscles are shrinking, so the face is wrinkled. Some people have strong muscle convulsions, pain throughout the whole body, even muscle tear and fracture. The disease may be mild when the muscle spasms with a few seizures, just if there is hardness and difficulty swallowing or severe if fierce convulsions or apnea.

Local tetanus is not common. Local tetanus symptoms appear in muscles near the wound. Local tetanus usually has a better prognosis than the body tetanus, the mortality rate is only about 1%. However, local tetanus can also be a warning sign of body tetanus.

Transmission route of Tetanus's diseaseTetanus

Normally, tetanus is entering the body through deep wounds, contaminated, through tears, burns, crushed wounds, minor wounds, or injecting Injecting contamination. Record cases of tetanus after surgery, or after abortion under unsanitary conditions. There are cases where the body of the body is necrotic and/or foreign objects that invade the contaminated body to create anaerobic environment for tetanus cells to grow.

Newborn babies with neonatal tetanus is due to the process of cutting and care for the umbilical cord is not hygienic. The tetanus cells penetrate through the umbilical cord because the umbilical cord is cut with dirty tools or after birth, the child does not care for the umbilical cord, the umbilical cord gauze is not sterile, so it has been contaminated with tetanus. Newborn tetanus often occurs in children who are born, giving birth at home is taken care of according to backward customs, especially in mountains, remote areas.

Toget tetanus is not transmitted from person to person.

People at risk for Tetanus's disease

Risk factors increase the likelihood of tetanus:

Immune system reduction, no tetanus vaccination

Do not get TIG vaccination promptly against tetanus;

The appearance of other infected bacteria;

Magic damaged tissue

Swelling around the wound.

The following wounds are favorable conditions for tetanus:

Open wounds, including tattoos, piercing, injection traces

Wounds contaminated, many foreign objects

Wounds caused by shot bullets

Open bone fractures

Burns

Surgical wounds

Animal bite of animals

Prevention of Tetanus's disease

How to prevent tetanus disease :

Tetanic vaccination is the best way to prevent disease. Tetanese vaccine to proactively prevent tetanus for mothers and newborn tetanus for children. Pregnant women need to be injected with at least 2 doses of tetanus vaccines at least 1 month apart and the second dose must be injected 1 month before birth. Pregnancy after the injection should be reminded 1 dose of tetanus before birth 1 month. Children under 1 year of age will be vaccinated in combination with diphtheria, pertussis, tetanus, hepatitis B and pneumonia/meninges caused by Hib bacteria.

Use tetanus immune globulin when there are deep wounds, contamination, many foreign objects, which prevent infection.

For people with deep wounds, a lot of contamination, containing foreign objects, susceptible to tetanus, it is necessary to handle as follows:

In case of injury, full tetanus vaccine:

For minor wounds, no contamination and the last tetanus vaccine At that time> 10 years must be injected with 1 dose of tetanus vaccine.

For serious or contaminated wounds and within 5 years before, tetanus vaccine must be vaccinated, a dose of tetanus vaccines must be reminded in the wounded day.

In case the injured person has not been fully immunity with tetanus vaccine

need to be injected with 1 dose of tetanus vaccine as soon as possible after injury. If the wound is seriously or contaminated, it is necessary to inject more tig.

Injections do not have enough doses

In case the injured person has not been injected with 3 doses of tetanus vaccine or unknown a history of tetanus vaccination and deep or contaminated wounds, then the lowest tig injection is 250 IU or SAT at a dose of 1500-5000 IU. Toget tetanus vaccine, tiged or SAT vaccine at the same time, but must use separate needles and injection pumps in different positions. Before the Sat injection is derived from animals, the reaction must be tested to prevent anaphylaxis by the skin test. In case the injured person has been injected with animal serum, before the injection must be tried to react with a negative controller by physiological saline injection. Read the results after 15-20 minutes. If the negative control and the test place appears with a 3mm wide red circles, it is a positive test result and need to do sensitive solution.

Also need to propagate health education on the necessary information related to tetanus and newborn tetanus, danger and first aid of wounds caused by poking and closed wounds and The need for active vaccination or passive immunization after injury, the need to comply with the principle of aseptic in health.

Diagnostic measures for Tetanus's disease

Diagnosis of tetanus is mainly based on tetanus manifestations with muscle spasms. There is currently no blood test to diagnose tetanus and not isolate tetanus bacteria in humans.

Testing with a tongue stick is a clinical trial performed by touching the back of the throat wall with the tongue and observing reaction. A positive result when there is a voluntary shrinkage of the jaw (bite down "spoon"). A short report in the Journal of Tropical and Hygiene Medicine said that in an affected object study, this test has a high specificity (no fake positive test results) and degrees. High sensitivity (94% of infected people give positive results).

Tetanus's disease treatments

Before treating tetanus, it is necessary to clean wounds to prevent infection. The wound must be filtered for contaminated or necrotic organizations and must maintain the airy condition of the wound.

Tetanic immunity (TIG) is injected as soon as possible, even if it has been vaccinated against tetanus vaccine before. Injecting tig with a dose of 3000 - 6000 IU. If there is no tig, it can be replaced by intravenous injection. However, this therapy only works short and cannot replace other methods. Health experts say that this method can be safe for pregnant and lactating women.

Doctors can appoint penicillin or metronidazole antibiotic groups for 7-14 days with high doses, these antibiotics prevent toxic bacteria causing muscle spasms and stiffness in the joints. . Patients with allergies to penicillin or metronidazole may be replaced by tetracycline.

Can use painkillers, muscle relaxants combined with trachea opening or intubation, respiratory support by mechanical ventilation to emergency patients. Simultaneously with treatment, must cause active immunity with tetanus vaccine for patients.

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