How is the test
According to Dr. Komarovsky, most parents are deeply mistaken about the Mantoux test, mistaken for her inoculation, which can develop a protective reaction to the child for tuberculosis. This is not entirely true.
The Mantoux test, according to the doctor, is a reaction of the child’s body to the intradermal administration of the tuberculin drug. The reaction manifests itself local specific inflammation of the skin at the injection site. Such a reaction is caused by special blood cells responsible for cellular immunity. The injected drug stimulates this reaction by drawing blood cells (lymphocytes) from the blood vessels of the skin to itself.
The Mantoux test procedure is carried out only to find out whether the child has a tubercle bacillus and how much the child is predisposed to the disease. This assessment makes the doctor. As we see, the Mantoux test is not a vaccination, since in this situation no defensive reaction is formed.
The procedure of vaccination Mantoux includes the following steps:
- introduction under the skin of the drug. The injection site is the inner surface of the forearm. The doctor must put the needle under the skin and inject the solution. At the time of the introduction of the drug over the skin should form a bump, which is called a button;
- stage of tracking the response of the child’s immune system to the drug;
- evaluation by the doctor of the size of the skin reaction.
It is necessary to know that the technique of conducting a Mantoux test is regulated by the Ministry of Health of the Russian Federation. According to him, this vaccination sample should be conducted annually.
Start testing from 12 months of a child’s life. And they start to do, regardless of what the child had before the reaction to this vaccination.
As Dr. Komarovsky says, the Mantoux test is a diagnostic test designed to detect the presence of a tubercle bacillus in a child’s body. This is the kind of diagnostic test used today throughout the world. Of course, there are alternative methods, but they are few and they are not so informative.
Therefore, according to Dr. Komarovsky, this “vaccination” is necessary in order to detect the disease at the earliest possible stages.
Preparations for the sample
For the vaccination Mantoux use the drug tuberculin. Its exact name is alttuberculin. This is the most common solution that allows doctors to most effectively identify the onset of the disease and conduct high-quality treatment.
The drug is an extract of tuberculosis microbes that died as a result of exposure to high temperatures. The mechanism of influence of tuberculin on the human body has not been fully studied. There is no accurate scientific data. It is known that it is a complete pathogen for the lysate of bacterial proteins. Also, it does not lead to the formation of immunity. Therefore, there is no need to use it as a full vaccine. In addition, this drug can provoke a busfer effect.
Tuberculin for Mantoux test has been used for over 100 years. The very first hood used as an inoculation was not cleaned. This means that it contained residues from the nutrient medium of bacteria. Also, such a vaccine in those days had a suspension of salts and other substances. Therefore, the interpretation of the results was difficult. But in the 60s of the last century, vaccination was cleared. As a result, Purified Protein Derivate was created. Making a trial and interpreting its results is now much easier. Since that time, this drug has never been amenable to changes, and today it is very widely used in medical practice. Children with tuberculin can be tested using 0.1 ml of the drug.
According to Komarovsky, tuberculin is the most effective drug, so the Mantoux reaction is recognized by the world community as the most qualitative and effective means to fight tuberculosis.
It should be noted that today, instead of the Mantoux test, a new vaccination sample is being introduced – Diaskintest. Diaskintest gives a reaction only to the active stage of the disease. The manifestation of a positive reaction to this drug indicates a 100 percent presence of a microbe in the child’s body. Therefore, it can be done as an additional diagnostic test.
Inoculation Mantu begin to do with the year of the child’s life. This is a monthly procedure that is governed by applicable law. Until the year, the drug is not necessary for children, because due to the nature of the immune system of newborns, their bodies will not react to the manipulations.
Since the drug is an extract from dead bacteria, this test is absolutely harmless for both adults and children. The administered dose in 0.1 ml of tuberculin has no effect on the immunity of the child. There is no large-scale impact on the entire body. At the same time, it is safe for people suffering from various somatic diseases.
It is prohibited to test if there are the following contraindications:
- skin diseases;
- allergic exacerbations;
- bronchial asthma;
- acute infectious diseases;
- exacerbations of chronic diseases.
After the disappearance of the symptoms of the above diseases, a sample is allowed after one month. It is also forbidden to conduct tests simultaneously with other vaccinations, as this will have a significant impact on the final result. In this situation, you need to endure after the last vaccination for 4 weeks. This rule applies to diphtheria, tetanus and influenza vaccinations. It is necessary to withstand a break of 6 weeks after the vaccination against measles, rubella, mumps and other live vaccines.
Before the introduction of the hood is not recommended to take antiallergic drugs. It is forbidden to test during the quarantine in the children’s educational institution.
After the drug has been injected under the skin, appropriate care is needed after the button is formed so that the reaction rate really corresponds to reality.
The site of tuberculin injection itself does not require additional treatment. However, neither the child nor his parents should do the following manipulations with the “button”:
- clean, rinse with water. Please note that you can wash the child, the main thing is not to drench the “button” itself. During the shower, the injection site can be blocked by a stream of water;
- swim in open ponds;
- tape or wrap with a bandage;
- to scratch or rub the button;
- process the button with various antiseptics, as well as iodine, hydrogen peroxide or brilliant green.
Following these simple rules will allow to obtain in the final result truthful information about the presence in the body of the child of the causative agent of tuberculosis. After the doctor has evaluated the reaction, the “button” can be treated with iodine.
What can be the reaction and what does it mean
Evaluation of the Mantoux reaction is carried out 72 hours after the drug is introduced into the child’s body
Tuberculin may have the following reaction during this time:
- hyperemia or redness;
- swelling or induration.
The presence of such reactions is the norm. Deviation from the norm can be very strong redness, which occupies a large area, as well as the formation of a large swelling.
For children, the primary norm is manifested in obvious changes of the “button” – a reddish and hard seal that forms at the injection site. Usually, on the first day after the injection, the skin may redden slightly. A more noticeable reaction appears on the second day, which is an absolute norm.
The doctor does not evaluate the redness and seals. The size of the button depends on the number of infected cells. Based on her size, the doctors make a conclusion about the state of health of the child, as well as the level of his immunity. Only an experienced doctor can make an accurate assessment. He measures the injection site with a ruler on the third day and makes a conclusion.
The doctor gives an assessment not only of the buttons, but also takes into account the child’s age, as well as all the side effects that occurred to him at 72 hours after the injection.
If the button is within the normal range, then the result of the test is negative and the child is completely healthy. For children aged 2 years, the norm for the button is 5 mm. At the big sizes – test is considered positive. Such indicators are valid only for those children who, until one year of age, were vaccinated with BCG.
There is the following rating scale:
- 0-1 mm – negative reaction;
- 2-4 mm – doubtful reaction. There is only redness;
- 5 mm or more is a positive reaction.
Deviation from the norm and evidence of a positive reaction is considered to be a festering injection site. In such a situation, the “button” looks like a sore, and the injection site itself is burgundy and very dense.
But the value of the sample can be regarded by the doctor as false positive. This is allowed if the recommendations for the care of the button were violated. Dr. Komarovsky claims that only a competent doctor can give a final assessment of a diagnostic test.
As you can see, such a diagnostic test as a Mantoux test is quite an effective and informative way to assess the immune system and the health of the child. Therefore, it is necessary to do it.
Video Why do Mantoux test?
After watching the video, you will learn why it is needed, what are the warnings before and after the test. Doctor Komarovsky tells about all this.