Prophylaxis of tetanus and indications to it

In contrast to the known infectious diseases, the entrance gates for which are the airways of the human respiratory system, tetanus is caused by the anaerobic rod Clostridium tetani, which lives mainly in the soil in the form of spores and infects the body through contaminated wounds, burned and frostbitten surfaces. Enzymes and acidic environment of the gastrointestinal tract act on it is disastrous, therefore at oral penetration of bacteremia does not occur.

Prevention of tetanus is the main means of combating this rapidly developing disease, because it does not respond to etiologic treatment. The main target organ for this microorganism is the central nervous system, and the severe condition of the patient develops due to the action of two toxins of clostridium. Thetanolysin causes hemolysis of red blood cells, and, as a consequence, anemia and tissue ischemia. The visible convulsive syndrome is explained by the action of tetanospasmin. It is on them that prophylaxis of tetanus in the form of parenteral administration of tetanus toxoid and serum is directed.

Emergency methods

According to the type of energy metabolism C. tetany refers to obligate anaerobes that do not survive in the atmospheric environment. In connection with this, the local (surgical) method of its neutralization in the wound is excision of the scars and edges of the entrance gate of the infection - thereby ensuring maximum access of oxygen. Also, emergency tetanus prophylaxis also includes primary surgical treatment of the wound. It is carried out to prevent contamination by other microorganisms. The treatment should be performed immediately after any accidental injury, severe burns and frostbite, animal bites, as well as gangrenous tissue lesions.

A specific method of prevention is active immunization, in which the doctor injects tetanus vaccines for children in the DTP, starting at 3 months of age.

Vaccination

For children aged 7 years, as well as for adults, there is another vaccine - ADA, which is administered in three stages with intervals between doses of 4-8 weeks and 6-12 weeks. Further active immunization should be repeated every 10 years, but for it there are other indications.

If the casual wound is clean, has smooth edges and small sizes, then tetanus prophylaxis is performed in case of incompleteness of the administration of all doses or at the expiration of 10 years from the last immunization. However, if the wound is contaminated, vaccination is given after 5 years from the last date.

Passive immunization has other indications. The introduction of human immunoglobulin is carried out only with contamination of wounds. After that, within 4-6 weeks, the antibody titer in the patient's blood grows to provide protection for the body in the next 10 years.

Prevention of tetanus for newborns is provided by vaccination of the mother before pregnancy (in extreme cases during pregnancy). Therefore, district doctors are obliged to monitor the vaccination of women of fertile (reproductive) age especially carefully.