Tuberculosis is a difficult to treat disease transmitted by airborne droplets. Mass vaccination with Mantoux does not guarantee avoidance of the disease, but allows one to identify the body’s reaction to a tuberculin test.
Mantoux determines the level of immunity to infection with mycobacteria and the ability to produce antibodies.
Official medicine insists that the first Mantoux test was carried out at 12 months, and was repeated every year.
Parents are frightened by such a frequency of vaccinations and want to know: “up to what age is Mantoux given to children?”
Why is the Mantoux test done?
Parents are shocked not by the fact that Mantoux is administered in kindergartens and schools, but by the fact that the tuberculin test is done once a year. In their opinion, annual vaccination can cause irreparable harm to physical and psychological health.
Is it really?
Annual vaccination allows tuberculosis to be detected at an early stage; unfortunately, there are no other diagnostic methods.
For adults, fluorographic examination of the lungs and heart is used. The method is extremely harmful for children, it is rarely carried out, during the procedure it is necessary to ensure that the x-ray affects the chest, but not the heart and other organs.
The Mantoux vaccine is administered subcutaneously and consists of tuberculosis antigens called tuberculin.
The immune system, after the introduction of aggressive mycobacteria, begins to react differently: in one case a violent allergic reaction appears, in another the temperature rises, the baby feels sick.
Analyzing the body’s reaction to vaccination, a decision is made on further BCG vaccination, thanks to which it is possible to develop additional immunity to fight tuberculosis bacteria.
After introducing the solution into the skin, after a few hours or days a papule appears - a small bump of skin, which is used to assess the level of the child’s immune system.
Features and stages of the procedure
Mantu is placed annually at approximately the same time. Before the child begins to attend kindergarten or school, all manipulations are carried out in the treatment room of the children's clinic. When a child attends preschool or general education institutions, all responsibility rests with medical workers.
A visit to the local pediatrician is considered a mandatory condition. He will examine the little patient and, if there are no problems, give a referral to the treatment room. Parents must sign consent to carry out the manipulation. On the same day, you must visit the treatment room with a map and directions. In kindergartens and schools, as a rule, diagnostics are carried out en masse in one day. Before this, each parent signs a document consenting to vaccination.
A blister appears for a while at the injection site immediately after the injection.
The tuberculin injection is given subcutaneously. With a child in a sitting position, a special syringe with a thin needle is used to inject 0.1 ml of the substance into the middle third of the forearm from the inside. Where exactly, in which arm to inject, is not important. A white tubercle with a diameter of about 10 mm immediately forms at the injection site. This is normal.
Pediatricians recommend taking antihistamines 3 days before the procedure and for 3 days after it - although Mantoux is not a vaccine, allergic manifestations after it are not uncommon. Fenistil, Zodak, Zyrtec are the main drugs that doctors recommend as a preventive measure for allergies. You should not self-medicate or give your child antihistamines, especially if the child does not suffer from allergies. They are prescribed by a pediatrician if indicated.
Child's age and Mantoux
Until what age is Mantoux made?
If the child was vaccinated with BCG in the maternity hospital, then the first time is done at 12 months and continues until 15-16 years. In Russia it is done up to 17 years of age.
If the reaction to BCG was absent or normal, then Mantoux can be performed no more than 2 times a year, and then look at the results. If one of your immediate relatives has been diagnosed with tuberculosis, then you need to make mantu at least 2-3 times a year.
Possible complications in children
- It is impossible not to mention alternatives to the Mantoux reaction: Diaskintest;
- Suslov's test;
- Pirquet test;
- serological research methods.
Diaskintest is the only exact analogue of the Mantoux test
- The child’s body’s reaction to the drug that is administered during the test can indeed be unpredictable. But this is not only from the injection, but also from the capabilities of the body itself.
- In our society, there is a widespread position that the Mantoux test has only a negative result. Horrible cases of a child’s body reacting to an injection have been repeatedly reported in the media. But we still advise you to weigh all the factors before refusing vaccination.
It is always necessary to be conscious about the health of your child. The vaccine is not a direct cure for tuberculosis disease. But, during the Mantoux reaction, the child’s body still gets the opportunity to prevent the development of the disease. Remember - the choice is yours!
Currently, preference is given to Diaskintest, a more modified Mantoux reaction. It is carried out according to the same rules as tuberculin diagnostics, but it has greater specificity.
A similar diagnosis of childhood tuberculosis is carried out until the age of 17-18 years. This is primarily due to the fact that from this age it is already possible to perform fluorography of the chest organs (normally it is not done until the age of 18 due to the radiation dose).
From the moment a person reaches 18 years of age, annual fluorography is indicated. This screening method is much simpler than the Mantoux test, since it does not require special costs (in the case of a test, the annual purchase of tuberculin, syringes, as well as training of personnel involved in these injections is required), and has a high throughput.
The only drawback is the radiation dose transmitted to the body, which is why it is not recommended to take a photo more than once a year. If there are certain indications (a predisposition to tuberculosis, an unclear past image), then in this case repeated fluorography is permitted (the dose of radiation received must be indicated in order to prevent the development of radiation sickness or its signs).
The first Mantoux sample is made per year. It makes no sense to perform the analysis earlier, since the baby’s immune system is still at the stage of formation and the test results will be false. The plan provides for the first administration of tuberculin at 12 months. Further, the check is performed annually, at approximately the same time.
Interpretation of results
Until what age is Mantoux performed and then the results interpreted?
The Mantoux reaction is expressed in the appearance of a papule at the injection site, which is a manifestation of an allergy to tuberculin. The appearance of a papule indicates a reaction of the immune system to antigens of tuberculin mycobacteria.
After vaccination, the nurse should take measurements of the papule a few days later, which should not exceed 12 mm. The norm varies from 4 to 12 mm. If the size of the papule is smaller or larger, then it can be argued that the child has abnormalities and possibly pathology.
A papule less than 4 mm indicates that the child is susceptible to the influence of mycobacteria, and therefore tuberculosis. The absence of a papule at all indicates that the child has developed a severe immune deficiency syndrome. If, after administering a tuberculin test, the body does not react in any way, then the child is in great danger.
At the slightest contact with a sick person or inhalation of tuberculosis pathogens, the child may become ill, because has absolutely no protective autoimmune barriers.
If the papule is more than 14 mm, this is also an alarming sign. Such a reaction indicates that the child has an increased functioning of the immune system.
This pathology can lead to a number of serious diseases, namely:
- if you do not register your child with a doctor, then at the slightest infection of the body with mycobacteria, a severe allergic reaction will occur, accompanied by Quincke's edema or anaphylactic shock;
- a large papule may also indicate that tuberculosis has already appeared.
In the latter case, doctors must determine the true cause of the enlarged papule: disturbances in the functioning of the immune system or the presence of tuberculosis.
Rules
The reliability of the results obtained is also affected by the test conditions.
To obtain optimal results, you must familiarize yourself with the basic rules of vaccination:
- if a child suffers from colds and other diseases, then vaccination should be postponed;
- a month must have passed since the last vaccination;
- Do not scratch or wet the vaccination site; such actions may affect the accuracy of the result;
- It is unacceptable to bandage the injection site; it is also recommended to abandon the plaster - this does not allow the skin to breathe;
- do not treat the affected area with alcohol or other antiseptic agents;
- The size of the papule should be checked no later than a week after administration of the drug. Results will be most accurate if a healthcare professional measures the papule after three days.
This type of vaccination is often carried out in schools and kindergartens, so medical workers need to tell children about these rules in advance.
Some medical professionals do not prohibit water procedures after vaccination.
Child's health status and Mantoux
Before vaccination, the child must be examined by a physician or nurse. This is done in order to avoid deviations in the result and deterioration of health.
Regardless of the age at which the test is performed, the child should not have the following signs:
- allergic reactions and skin rashes;
- fever and cough;
- weakness or dizziness;
- surgical or other interventions.
If a child exhibits at least one alarming sign, the Mantoux procedure is postponed until the baby has fully recovered. When manta is given, they never vaccinate in the same arm; they alternate each year. For example, for even years - to the left, and for odd years - to the right.
After the procedure, do not wet, scratch, pick or lubricate it with anything. All this can be done only after 1 day. After several days (4-5), signs of redness and papules at the injection site disappear.
Mantoux timing for missing vaccinations
If the timing of BCG was not met, then vaccination can be done 4-6 months after birth. Before the manipulation, a Mantoux reaction is performed. The condition for further vaccination is a negative result. The result is checked after 5 days. The extended waiting period is also explained by the incomplete formation of immunity and the high risk of a false negative reaction.
If the baby has already had contact with a person infected with tuberculosis before the BCG vaccination, he is prescribed preventive treatment in a reduced dosage. The course of preventive therapy is completed by the Mantoux test. If the reaction is positive, therapy continues. If negative, BCG is performed after 7 days and isolated from the environment for 5-6 days.
Indications for the test
Mantu is made for the timely identification of a potentially dangerous and unprotected child in a group. Not protected primarily by your own immune system. Sometimes, a test is performed to confirm tuberculosis disease.
Indications for performing Mantoux will be:
- a prolonged cough accompanied by chest pain and a temperature above 38 degrees. Sometimes, such a cough lasts for years and is not treated with medication;
- diabetes mellitus of any type gradually leads to the development of immunodeficiency, which means the body’s resistance to any aggressive effects of mycobacteria decreases;
- long-term hormonal therapy for oncology or other diseases of the thyroid gland;
- children whose parents refused their BCG vaccination in the maternity hospital or subsequent periods;
- presence of relatives with tuberculosis.
Also, it is carried out for children whose reaction to Mantoux last year was pronounced, but was normal (10-12 mm). Such children are checked the next year, if the pronounced reaction has disappeared, then everything is fine, if not, they are sent for additional examination to a tuberculosis dispensary.
Why is the sample needed?
Tuberculosis is a serious disease from which, even in the modern world, despite the level of development of medicine, thousands of people die every year. It is not at all easy to identify tuberculosis at the beginning of the development of the disease; the patient is bothered by a weak cough and a slight increase in temperature, which is mistaken for a common cold. Finding the cause of a child’s cough is even more difficult. Often the disease does not manifest itself at all, especially if internal organs are affected and not the respiratory system.
The Mantoux test is a simple but effective diagnostic method. It is performed on children, since x-rays have a negative effect on the growing body. Adults undergo fluorography or x-rays annually. The advantage of the Mantoux test is that it can detect tuberculosis of any type before any symptoms appear. The reaction will be positive even if tuberculosis develops in the bones or internal organs. The procedure is carried out in a kindergarten or school with the written consent of the parents.
Many mothers refuse vaccinations, guided by the fact that the vaccine harms the body more than the disease, which may not affect the child. This is a wrong position, especially with regard to the Mantoux reaction.
The Mantoux vaccination is not really a vaccination. Tuberculosis is vaccinated immediately after birth (BCG vaccination), and Mantoux contains a specific antigen - tuberculin. This is a kind of allergy test that does not harm the body if everything is done correctly, with the exception of rare individual intolerance to the active substance.
Diaskintest: analogue of Mantoux
Mantoux or its analog Diaskintest is given to children until what age?
Diaskintest is done over the skin, without a syringe or needle. Diaskintest is considered a more gentle procedure than the standard Mantoux vaccination, so it can be done, if necessary, several times a year and up to 18 years of age.
All schools and kindergartens are gradually switching to this procedure due to the low cost of materials, the lack of stress in children and more accurate results.
In the next 10 years, official medicine should switch to a tuberculin skin test, without measuring papules and other allergic reactions.
