Neonatal tetanus is also a disease that we should pay attention to, and it usually happens from time to time. For such diseases, we should not only know the reason, but also know the effective prevention methods.
Neonatal tetanus route of infection
1, the source of infection with tetanus bacteria and animals are the source of infection of this disease. Under normal circumstances does not cause disease, only in the event of trauma and invasion by Clostridium tetanus can cause disease. Incubation period of 2 hours to several months.
2, transmission routes tetanus bacillus is one of the common soil flora, a very wide distribution in nature. Clostridium tetani is widespread in the gut of humans and poultry, livestock and other intestinal tract, with the excretion of contaminated soil with the excrement, and with the soil or dust trauma or wound into the body. The main ways of infection are:
(1) Traumatic infection: Infection by trauma with tetanus or other foreign body with tetanus bacteria.
(2) umbilical cord infection: with dirty utensils cut the umbilical cord, umbilical cord or with dirty dressing treatment, the umbilical cord wound caused by tetanus bacteria.
(3) other infections: birth canal, ear canal, tooth extraction, rat bite and infection after surgery.
3, susceptible populations are generally susceptible, but will not cause the spread of the crowd, sick children can not recover after the immune system immunity.
4, the epidemic features throughout the world, mostly distributed; there are significant regional differences, and high mortality.
Neonatal tetanus causes
1, the etiology
Infections are often non-sterile scissors, wire to break the umbilical cord, ligation of the umbilical cord; the recipient’s hand or cover the umbilical cord stump cotton gauze is not strictly sterilized, Clostridium tetani can invade, neonatal tetanus Can occur after vaccination is not strict disinfection, colibacillosis is not tissue invasive bacteria, only by tetanus spasm toxins pathogenic; tetanus toxin known toxins in the second ranked toxins, second only to botulinum toxin, which Lethal dose of about 10-6mg / kg.
(1) The necrotic umbilical stump and its covering reduce the potential of redox potential, which facilitates the spore-forming of Tetanus Clostridium sp. And the tetanus spasm toxins that cause the disease. With the release of toxins, toxin-producing bacteria die , Dissolved, tetanus toxins through lymph lymphocytes into the blood, attached to globulin reached the central nervous system.
(2) can also be absorbed by the muscular nerve junction, through the peripheral nerves of the intima and adventitia, or the motor nerve axis up to the spinal cord and brainstem, once the toxin with ganglioside in central nervous tissue binding, antitoxin can not Neutralization, toxin and ganglioside in the gray matter in the synaptic membrane after binding, so that it can not release inhibitory nerve mediators (glycine, aminobutyric acid), so that the motor system to enhance the reflex of afferent stimuli, resulting in flexor Muscle and extensor at the same time strongly sustained contraction, the more frequent activity of the muscle group, the more involved, so the masticatory muscle spasm so that the teeth closed, hemifacial spasm was smile face, abdominal muscles when spasms strong, the formation of angular bow Zhang, this toxin can also be excited sympathetic, leading to tachycardia, hypertension, hyperhidrosis and other performance.
Neonatal tetanus incubation period
Neonatal tetanus incubation period is generally 4-12 days, an average of 7 days, so there are folk “lock mouth wind”, “umbilical cord wind”, “seven days wind”, “four winds,” said the first symptom of neonatal tetanus, Often manifested as can not breast (due to masticatory muscle spasm). Early symptoms of crying, mouthless, difficulty eating, such as tongue depressor, the greater the force, the more difficult mouth, help early diagnosis.
Neonatal tetanus incubation period, generally refers to the time from birth to onset. Short incubation period, indicating strong virulence of bacteria, resulting in more toxins, so sick. Latency shorter than 6 days, the prognosis is more serious. There is a group of data showing a case-fatality rate of 44.4% (11/25) with a latency of less than 6 days and a case-fatality rate of only 20% (4/20) with a latency of more than 6 days. It is generally accepted that the incubation period is longer than 10 days Most, most can be cured.
Neonatal tetanus prevention
1, to the regular hospital delivery.
2, the new law delivery: to promote new law delivery. The scissors should be burnt red, after cooling or with 2% iodine scissors to be dried off the umbilical cord, the cord is also applied 2% iodine disinfection after ligation of the umbilical cord, and leave the umbilical cord stump a few centimeters, for 24h within the cord press Disinfection method reprocessing. Cut off the remnants of the remaining umbilical cord and re-ligate.
3, emergency situations: In case of emergency, in addition to the umbilical cord should be strictly disinfected, at the same time:
(1) penicillin: muscle penicillin 3-4 days.
(2) tetanus antitoxin: intramuscular tetanus antitoxin 1500-3000U.
(3) Tetanus immunoglobulin: Intramuscular body tetanus immunoglobulin 75-250U.
4, pregnant women intramuscular injection of tetanus toxoid: due to maternal antibodies and neonatal antibodies were positively correlated. Antibody serum tetanus antitoxin levels at 0.01U / ml, can effectively protect the body from tetanus infection. For pregnant women who can not guarantee aseptic delivery, 0.5 ml of tetanus toxoid 2 may be injected during the third trimester of pregnancy separated by 1 month and the second at least 2 weeks before delivery (preferably at 1 month).
5, maternal newborn abortion, 24 hours cut the remnant of the remnant umbilical cord and re-ligation, the proximal end with 3% hydrogen peroxide or 1: 4000 potassium permanganate coated with iodine after washing, and intramuscular injection of tetanus Antitoxin.