Tetanus - This is an acute infectious disease, which is characterized by severe damage to the nervous system. It is manifested by convulsions of skeletal muscles with the possible development of suffocation (asphyxia). The first description of the disease and its name belongs to Hippocrates.
Tetanus - causes
The causative agent of tetanus is a spore-forming bacterium - tetanus bacillus. A characteristic feature of these bacteria is their existence in nature in the form of spores. In stools, on soil and on various objects, they are stored for years. Extremely resistant to disinfectants and antiseptics. They can withstand temperatures of 90 ° C for about two hours. Spores under favorable conditions germinate and produce the strongest tetanus toxins - hemosilin and tetanospasmin.
The source of tetanus bacillus is birds, humans, and herbivores (rodents). Tetanus bacillus enters the environment with feces. The causative agent is also widespread in nature (for example, in the soil), where it is stored and propagated for a long time. Bacteria from the soil get together with dust on any objects and in any premises.
The tetanus transmission mechanism is contact. Tetanus bacillus enters the human body through damaged mucous membranes (frostbite, wounds, burns) and skin. Newborns can become infected if the umbilical wound is infected without observing aseptic rules.
Entrance gates of tetanus bacillus can be completely different wounds - scuffs, burns, cuts, open fractures, bites. The transmission of infection from the patient to a healthy person is excluded.
In patients with tetanus, immunity to the disease is not formed. This is because a small dose of tetanus toxin, which causes the disease, is insufficient to provide immunity. Most often, teenagers suffer from tetanus (due to high morbidity) and agricultural workers.
Tetanus - Symptoms
The incubation period of tetanus lasts approximately 7-14 days. Sometimes clinical manifestations may occur after the healing of infected wounds. Doctors believe that a short incubation period of the disease causes a more severe course of tetanus.
A disease always begins very acutely. The first and most common symptom of tetanus is jerking of the jaw (trismus) due to a spasm of the chewing muscles. Other tetanus signs immediately join in - difficult painful swallowing (dysphagia) and a “sardonic smile” (spasm of facial muscles). The combination of these signs form a classic triad and is found exclusively in tetanus.
The height of the disease is marked by the spread of painful cramps to the muscles of the limbs and trunk, without capturing the feet and hands. Muscles are tense all the time, even in a dream. When cramps seize the diaphragm and intercostal muscles, breathing becomes rapid and shallow. Muscle tension in the perineum leads to difficulty urinating and defecating.
With a fairly severe course of tetanus, an opistonus can develop (the patient's back bends in an arcuate manner). Strong muscle tone leads to bone fractures, as well as muscle detachments from the bones. According to the severity of tetanus, there are severe, medium and light forms. Fatal outcome is noted in 25% of cases.
Tetanus - diagnosis
A diagnosis is made based on a characteristic triad of tetanus symptoms. In this disease, laboratory diagnosis is not of particular importance, since the toxin in the blood cannot be detected even by the most modern methods.
In the diagnosis of tetanus, great importance is attached to a thorough epidemiological history (burns, infected wounds, injuries sustained in a period that corresponds to the incubation period).
Tetanus - treatment and prevention
A patient with tetanus is subject to immediate hospitalization. Specific immunoglobulin or tetanus toxoid is administered to neutralize tetanus toxin. Convulsive syndrome is removed with sedative, narcological and neuroplegic drugs.
In case of respiratory distress, resuscitation measures are performed. Antibiotics are used to prevent bacterial complications. Dehydration is controlled by intravenous infusion of plasma, polyionic solutions and albumin.
Tetanus prophylaxis is carried out in two directions - specific prophylaxis and injury prophylaxis. Immunity against tetanus is created by routine immunization with tetanus toxoid. Nonspecific disease prevention is designed to prevent injuries at work, at home, and also to eliminate infection of surgical wounds.
