Content
- At what age are children tested for the Mantoux test?
- What does the reaction to a tuberculin test look like?
- Mantoux vaccination: after how many days is it checked?
- Is it possible to test Mantu on day 4
- How to test Mantoux for tuberculosis
The Mantoux test is an intradermal or cutaneous test that is performed to identify the specific response of the immune system to the introduction of tuberculin. Thus, it is not intended to develop immunity to the disease in the baby, like other vaccinations, but to identify immunity to tuberculosis. The tuberculin test (the second name for the Mantoux reaction) is a very important diagnostic procedure for every child. The reaction to the test is checked by a doctor several days after the procedure. Many parents, worried about the health of their baby, want to know the preliminary result even before being examined by a doctor. In this article we will tell you on what day Mantu is checked and how to do it yourself. It is important to remember: independent “diagnosis” in no case can replace an examination by a professional.
How to reduce the side effects of tuberculin?
Sometimes tuberculin causes allergies, inflammation of the lymph nodes and lymphatic vessels, headache, and fever. These ailments can be relieved in two to three days by taking Enterosgel (see instructions for use). If you (or your child) feel unwell after the Mantoux reaction for a longer period of time, you should consult a doctor.
Typically, tuberculin diagnostics are planned for September, when children return to schools and kindergartens after the summer holidays. It is advisable not to carry out tuberculin diagnostics during seasonal infections (influenza, acute respiratory infections), during exacerbation of diseases such as bronchial asthma, rheumatism, allergies, or during quarantine for childhood infections.
When to check Mantoux
The Mantoux reaction, although not a vaccination in the full sense of the word, is included in the list of mandatory vaccinations that a child must receive. For the first time, a tuberculin test is performed on one-year-old babies. If the procedure is performed earlier, due to possible skin reactions, it is difficult to determine the result.
Then the Mantoux reaction is checked every year at approximately the same time until the child turns 14 years old. Children who have not been vaccinated against tuberculosis are given a Mantoux test twice a year. And for children who are at risk, i.e., who have close contact with a person with tuberculosis, the Mantoux reaction is checked 2-4 times a year. The Mantoux reaction is checked after a few days by doctors.
After tuberculin is injected intradermally into the child, bacterial particles begin to attract T-lymphocytes. Thus, T-lymphocytes that have already dealt with Koch’s bacillus react to the introduction of the substance. This is the Mantoux reaction, which externally looks like a compaction, a “button” on the inner surface of the forearm. It must be of a certain size and shape; if there are deviations, the doctor may suspect tuberculosis in the child. In order not to sound the alarm ahead of time, scaring yourself and your child, it is important to know after how many days Mantoux is checked. During the first days, the injection site may become red and inflamed, and may be too swollen, making examination difficult.
The substance tuberculin itself, which is used to test, is not capable of causing tuberculosis. It consists of weakened tuberculosis pathogens and is not dangerous to humans.
Registration of a child for kindergarten or school. Refusal of Mantoux - what to do in this situation.
The Mantoux test is a test that shows that a child does not have tuberculosis. That is, it will not infect anyone in kindergarten, school or children's camp. Without a Mantoux test, as a rule, they will not be accepted into kindergarten at all, and the school may isolate the child (remote learning). If you do not want to give your child a subcutaneous injection of Mantoux, the way out of the situation is to undergo an examination by a TB doctor and obtain the appropriate certificate. Natalya Viktorovna Glukhova, a phthisiatrician at the Phoenix-Med children's center, helps to understand the situation.
— What should I do if I don’t want to do the Mantoux test for my child? How to avoid isolation in kindergarten or school?
— Use other examination methods. There are special tests where they take blood from a vein from a child and find out that he does not have an active form of tuberculosis. In this case, nothing is injected under the skin. Or you can take an x-ray - this is also a way to prove that the child is healthy, but there are age restrictions. The doctor will advise you on the appropriate option.
— Does this also apply to preventive vaccinations?
— Preventive vaccinations are when a child is given a vaccine to prevent him from getting something dangerous: measles, tetanus or whooping cough. You can refuse such vaccinations. If a child gets sick, it will be the responsibility of the parents, not the school or kindergarten. Therefore, the requirements for these procedures are different. A preschool or school cannot refuse to admit or teach a child without a measles or tetanus vaccination. If other children are vaccinated against these diseases, then it is not they who are at risk, but the unvaccinated child. But without a Mantu test, although they will admit you to school, they may isolate you. And they usually don’t accept people into kindergartens at all, because the school provides home-based education, but there can’t be a kindergarten at home. So far it works like this.
Sometimes children without preventive vaccinations are also isolated. For example, if a child has not been vaccinated against polio, he cannot go to the same group with children who have recently received such a vaccination for two months. Because an unvaccinated child risks becoming infected himself. Usually the disconnect looks like this: “Mom, don’t take your child to kindergarten for two months, it’s dangerous for him.” In this case, mother will not be given sick leave. Where to put the child is the mother’s problem.
- What is the solution to the problem?
Go through the examination and get a certificate from a TB doctor. This certificate will confirm that the child will not infect anyone. It can be issued on the basis of other types of diagnostics, and not just the Mantoux test. Sometimes a test shows a reaction, and an x-ray confirms that there is no disease.
Present the certificate to the school or kindergarten. This does not mean that the child will definitely not be isolated, but often such confirmation is enough. The certificate does not mean permission to visit with the examined children; the health worker has the right to decide whether to isolate the child or not. So it is in the interests of parents to secure themselves with the appropriate documents.
To obtain this certificate from a TB doctor, you must provide the following documents:
- be examined by a phthisiatrician;
- provide an extract from your vaccination card;
- provide fluorography results for people over 15 years old/parents or legal representatives of the child.
A prerequisite for obtaining a certificate is the presence of a note on the vaccination card about BCG vaccination. Information about conducting a Mantoux test or an alternative test to detect the presence of tuberculosis infection in the body (Quantiferon test or T-Spot) must also be indicated.
Cost at Phoenix Medical Center:
- Quantiferon test - 4000 rubles/Shushary
- TestPot — 5800 RUR/Kolpino
- Registration of a phthisiatrician’s certificate costs 1,000 rubles when taking tests in our medical centers or 1,500 rubles if you have test results from other laboratories.
After the examination, if all the necessary marks are present on the vaccination card, the TB specialist issues a certificate, which can be provided at the place of request.
The appointment is conducted by Natalya Viktorovna Glukhova, a phthisiatrician, a general practitioner, with more than 15 years of experience. Reception is by appointment only.
You can also leave a request on the website, as well as in the UDS application.
How long does it take to check Mantoux on a child?
The reliability of the results obtained depends directly on what day the manta ray is tested. A reliable result will be detected after 72-76 hours, i.e., after three days. The correct result will be only during this period. After these hours, the size of the “button” changes and the diagnosis will be incorrect.
The doctor who checks Mantoux uses a special medical ruler to measure the size of the papule. The smaller it is, the better. The norm for a healthy child is 0-1 mm. But it is worth remembering that sometimes a tuberculin test can give a false result - positive or negative. The reason may lie in other diseases of the baby, in a procedure performed with violations, or in low-quality tuberculin. In any case, the doctor will prescribe a number of diagnostic procedures. Sometimes the result depends on the individual characteristics of the child’s body, so the sample is evaluated over time, comparing with last year’s results.
A few words about tuberculosis
“Don’t scratch or get it wet!” - after hearing this phrase, each of us instantly remembers school.
As children, we delved into the essence of what was happening little, knowing for sure that in three days people in white coats would return to classes and begin to measure the “buttons” on our forearms. As we grew up, we learned about a unique infection called “Tuberculosis.”
The causative agent of tuberculosis, entering the human body, almost always leads to infection. As doctors say, to “infection.” More often, “acquaintance” with the tuberculosis bacillus occurs in childhood and adolescence.
After the first contact with the microbe, tuberculosis rarely develops: the tuberculosis bacillus enters the lungs with inhaled air and, thanks to good immunity, the body can cope with the microbe. In this case, the inflammation goes completely unnoticed and does not lead to the development of the disease. After meeting with mycobacterium, the body develops anti-tuberculosis immunity and will be able to recognize the “enemy” in the future. Some tuberculosis bacteria remain in the body forever. They go into “sleep mode” and wait for their “finest hour”. When a person's immunity decreases, in 1-5% of cases, infected people develop tuberculosis.
Don’t forget, contracting (infection) with tuberculosis does not mean a disease!
Doctors learn that a child has been infected with tuberculosis after performing a Mantoux test.
Why is Mantu checked after 72 hours?
If you check the reaction of the child’s body earlier, the papule has not fully formed. In the first hours, the injection site resembles a mosquito bite, and there is redness around it. It is on the 4th day that the swelling subsides, and the papule acquires reliable features.
And 5 days after the tuberculin injection, the papule decreases in size, which will also distort the results. Therefore, it is necessary and possible to check mantu on day 4 - 72 hours after administration of the drug. But on the 5th day, the reaction to the administration of the drug can no longer be checked.
Most often, kindergarteners and schoolchildren are given a tuberculin test on Friday so that the reaction can be checked on Monday. If mantu was made on Monday, when to check? Doctors schedule an examination for Thursday, around the same time. If the sample was taken on Tuesday, it is checked on Friday.
Who checks Mantu at the clinic? As a rule, this is the same nurse who administered the “vaccination”. It could also be a pediatrician or phthisiatrician - a doctor involved in identifying, treating and preventing tuberculosis.
When sending your child for a tuberculin test, calculate how many days doctors check Mantoux. If it is not possible to show the child to a specialist on this day, it is better to reschedule the test to a more convenient time. It is better to temporarily postpone the “vaccination” than to torment yourself with anxious doubts and your child with the need for a repeat procedure.
Is it possible to make manta if you have allergies?
The Mantoux reaction for allergies is not recommended by doctors. Today, there are several other methods where diagnostics and tests give the same informative results as the Mantoux test. Therefore, there is no point in doing Mantu for allergies and deliberately provoking a negative reaction in the child. If a child has contraindications for testing, including an allergic reaction, he is prescribed alternative research methods:
- polymerase chain reaction;
- quantiferon test;
- Diaskin test;
- linked immunosorbent assay;
- fluorographic examination;
- sputum analysis.
Each of these diagnostic methods has its own characteristics, and the doctor will prescribe a study taking into account the individual characteristics of the patient. This will make it possible to obtain the most reliable result.
How to check the Mantoux reaction yourself in a child
If we found out how many hours later Mantoux is checked, is it possible to carry out the inspection yourself? Of course, you can see what size the “button” has become and compare the indicators with the norm on your own, before coming to the doctor. But only a doctor will give an adequate conclusion.
How to test Manta in a child’s home yourself:
- Note the size of the redness, but do not take it into account when measuring
- Pay attention to whether there is a seal inside and its size
- If desired, use a pen to circle the papule itself without touching the redness - this will make it easier to determine the size of the “button”
- Use a clear plastic ruler to measure the size of the seal.
- Take care in advance of high-quality natural or artificial lighting - the papule is tiny, a few millimeters in size
If on the 4th day, in good light, the Mantoux reaction is almost invisible, the test is considered negative, and the child does not have tuberculosis
Mantoux reaction dimensions:
- From 0 to 1 mm – negative reaction
- 2-4 mm – the reaction is considered doubtful, the child is included in the risk group
- A papule larger than 5 mm indicates that the child is highly likely to be sick. The diagnosis is not made based on the reaction to the tuberculin test alone. Conducts additional research
- Over 17 mm – the so-called hyperergic reaction, which is a serious symptom of tuberculosis
In children who have not been vaccinated with BCG or are older than 6 years, there should be no papule, or its size should be no more than 1 mm. Then the sample is considered negative. Previous vaccinations, allergic reactions, infection with parasites, colds and infectious diseases, blood transfusions, incorrectly performed procedures, and violations of the rules for caring for the injection area can lead to unreliable results. Mantoux vaccination can only be given a month after the previous vaccination or previous illness.
The size of the papule depends on the age of the child. The doctor also examines how much the current Mantoux reaction is greater than the previous one. If this difference is 6 mm or more, there is cause for concern.
If your child experiences itching in the injection area after the injection, do not allow him or her to scratch the area. An infection may get into the wound, and the test results will be unreliable. For the first few days, you should not smear Mantu with iodine, brilliant green, antipruritics, or wet it. This can also affect the result. For several days after the tuberculin test, it is advisable not to give the child allergens - chocolate, oranges, etc.
As we said, the Mantoux reaction is checked after 3 days, but in some cases the child must be shown to the doctor before the appointed time.
The child should be seen by a doctor immediately if the following symptoms appear:
- Significant increase in body temperature
- Weakness, dizziness and general poor health
- If severe inflammation or even pus appears in the injection area
Such a reaction may indicate an allergy to tuberculin. However, these phenomena are rare.
If the test shows a positive result, the doctor prescribes a set of other diagnostic procedures. They examine sputum, do chest x-ray, and examine other family members. If necessary, anti-tuberculosis therapy is prescribed.
Mantoux...explain, I'm confused...
My son was given mantu at both one and two years old, nothing appeared at the injection site, i.e. the reaction is negative. The doctor looked at me on the third day and said everything was fine!
Our furnace friends, on the contrary, developed a small inflammation, like a mosquito bite. The doctor also told them that everything was fine.
And this friend claims that not everything is so good with us, according to her, if nothing appeared after Mantu, this means that after BCG (done in the Maternity Hospital) the child did not develop immunity to tuberculosis and we will have to do it again BCG.
I read a lot of information on this topic on the Internet.
The Mantoux test is the body’s reaction to the introduction of tuberculin.
At the site of injection of the drug into the skin, specific inflammation occurs, caused by infiltration by lymphocytes - specific blood cells responsible for cellular immunity. If the body has already had a chance to “get acquainted” with the real Mycobacterium tuberculosis, then there will be more such lymphocytes, the inflammation will be more intense, and the reaction will be “positive”. By measuring the diameter of a papule (inflammatory “plaque” or “button”) with a ruler, you can assess the strength of immunity to the tuberculosis bacillus. Tuberculin does not carry the tuberculosis bacillus, as the name might suggest.
It contains only the products of its vital activity. Vaccination To prevent tuberculosis, BCG vaccination is given to newborns aged 3–7 days. Repeated BCG vaccination is given to children aged 7 years. In 90% of children, a scar forms at the site where the BCG vaccination was given. A year after BCG, the scar is measured and its character is recorded. In the absence of a scar, a repeat BCG vaccine is given only if the Mantoux test is negative and not earlier than 2 years after the primary vaccination and a year after revaccination.
Classification of Mantoux test results
The reaction is considered:
- negative
or in the complete absence of infiltration (compaction) or in the presence of a prick reaction (0-1 mm); - doubtful
- with an infiltrate (papule) measuring 2-4 mm with only hyperemia (redness) of any size without infiltration (compaction); - positive
- in the presence of a pronounced infiltrate (papule) with a diameter of 5 mm or more. Reactions with an infiltrate size of 5-9 mm in diameter are considered weakly positive; medium intensity - 10-14 mm; pronounced - 15-16 mm; - hyperergic
(i.e. too pronounced) in children and adolescents is considered a reaction with an infiltrate diameter of 17 mm or more, in adults - 21 mm or more, as well as a vesiculo-necrotic (i.e. with the formation of pustules and necrosis) reaction, regardless of the size of the infiltrate, lymphangitis, daughter dropouts, regional lymphadenitis (enlarged lymph nodes).
And now I found what a negative reaction means:
1. A negative reaction means that the child’s immunity to tuberculosis has not yet formed, therefore, the risk of the disease remains.
2. If after mantoux the result is negative (no papule). Or the injection site. This means that the child is not tubular infected, or if the papule was 4 mm before, but now it is 2 mm (for example), this means a negative reaction! But if the papule increases, then the reaction is positive.
3. The vaccine has already stopped working.
4. A negative reaction means a good result.
And what is the truth???
