Mantoux vaccination

Many people call the Mantoux test vaccination, but it is not a vaccination. The vaccine is given in order to create immunity to the causative agents of a disease. What then is the Mantoux test and what is it made of? The Mantoux test is not done to develop immunity to the causative agent of tuberculosis of Koch's bacillus, but in order to assess the presence of this immunity in the child. This test is known to everyone since childhood as a “button” and is completely harmless to the child, but very important in terms of diagnosis. For parents, the Mantoux test raises many questions to which we will try to find answers.

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What is the Mantoux test done for?

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As we have already said, the Mantoux test allows you to assess the presence or absence of an child’s immunity to tuberculosis pathogens. Mostly the Mantoux test is used to identify among children:

Primarily infected (those who first "picked up" tubercle bacillus);
Infected for over a year;
Carriers of tuberculosis bacillus (those who have tuberculosis pathogens in the body, but no symptoms of the disease);
Those who need revaccination against tuberculosis.

All this information is needed in order to confirm the diagnosis where it is, and to carry out prophylaxis in case the child is healthy.

Is it mandatory to put Mantoux?

Refusal of vaccinations is now not at all uncommon, so parents are often interested in whether or not to put Mantoux on. Mantoux tests are not made by force, so no one can oblige to put a “button”. If parents object to having a tuberculin test for their child, they write a refusal. However, WHO strongly recommends Mantoux testing, especially in countries where tuberculosis is very common. Russia belongs to this category of countries, so it is better for Russian parents not to neglect this breakdown.

Indications and contraindications

Scheduledly, the first Mantoux test is done in 1 year. There is no point in making this test up to a year, since the immune system of a child up to a year is still being formed, and the results will not be reliable. Starting from 12 months, a Mantoux test is done every year, and it is advisable to do it every year at about the same time.

If there is no indication for a more frequent test, Mantoux is placed once a year for prevention. If the test gives positive results or someone close to the child is sick with tuberculosis, the “button” can be done 2-3 times a year.

In some cases, the Mantoux test needs to be postponed.Contraindications for her:

Chronic and acute skin diseases;
Any infectious diseases;
Allergies of any nature;
Epilepsy;
Some somatic diseases (bronchial asthma, rheumatism).

Mantoux reaction mechanism

The Mantoux test in other words is called the tuberculin test. Tuberculin is a substance that is introduced into the body in order to assess the degree of its “acquaintance” with Koch’s wand. It is an “extract” of tuberculosis bacteria. That is, there are no living microorganisms in it.

Tuberculin is injected intradermally with a special syringe from the inside of the forearm. What then happens in the body? Particles of bacteria that have fallen under the skin begin to “attract” T-lymphocytes to their cells. However, not all T-lymphocytes react to tuberculin, but only those that have already dealt with tubercle bacillus. This process is called the “Mantoux reaction." Due to the accumulation of lymphocytes under the skin in the place where tuberculin was injected, a seal forms - a papule, or the same “button”.

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Button sizes

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The most important thing when conducting a Mantoux test is to correctly measure the result. The injection site often turns red and inflamed, swelling and hardening appear. The result of the sample in this case will be only the diameter of the seal, the size of the redness does not affect the result in any way and is an individual reaction.

The diameter of the papule is measured only using a rigid transparent ruler, and then these sizes are compared with the norms:

0-1 mm - “negative reaction”;
2-4 mm - “doubtful reaction” (the child falls into the risk group);
from 5 mm - “positive reaction” (high probability of illness, but they are not diagnosed with a single Mantoux test, additional studies are needed);
from 17 mm - “hyperergic reaction” (a serious sign of the disease).

Sometimes the Mantoux test ends in a false negative or false positive reaction. In the first case, the Mantoux reaction is negative in an infected child, in the second, on the contrary, in a healthy child, it is positive. This happens with immunodeficiencies, cancer, after hemodialysis, as well as if the test procedure itself was carried out with violations. Sometimes the reason lies in tuberculin itself, which was improperly transported or stored.

By its nature, the Mantoux reaction can be attributed to one of the types of allergic reactions, therefore, the characteristics of the body also affect the result. That is why the mantoux test is evaluated in dynamics, that is, in comparison with samples of previous years. An alarming sign is the change in papule size by more than 6 mm.

Complications after the Mantoux test

Usually, the Mantoux test is very easily tolerated by children. In rare cases, side effects occur after it: lymph nodes may increase, temperature may rise. Sometimes children complain of weakness and headache. All this happens quite rarely, but if the temperature rises after the Mantoux vaccination, don’t worry, you just need to give the child an antipyretic and monitor the condition.

Button Care

“Buttons” are measured on the third day after tuberculin administration. This means that all 3 days you need to follow some rules. The “button” does not require any special care, but there are things that are not worth doing so as not to affect the result:

no need to disinfect the injection site, smear it with “green” or peroxide;
Do not seal the place of vaccination with a band-aid;
Do not once again touch the reddened area of the skin with your hands, rub or scratch it;
Avoid contact of the vaccine with water.

What will happen if wet

The rule that Mantoux cannot be wet for 3 days, everyone knows. In this case, the parents have a reasonable question: how many days can not be wet vaccination? After all, you can’t deprive a child of water procedures for all 3 days - this is not hygienic. - It is advisable that the injection site does not fall into the water for the first 48 hours, but if you wet the Mantoux vaccine, you just need to dry it with a towel and inform the doctor about it when measuring. You can give your child something anti-allergic (Claritin, Zertek).

“You can swim, take a shower with a Mantoux test. You can not swim in open water, so as not to infect the wound. You can not rub this place with a washcloth, as well as use any liquids and solutions - brilliant green, iodine, peroxide. Do not seal the wound with a band-aid. It is necessary to ensure that the child does not comb the wound. All of this can affect the result of the sample. Don’t worry about your mistake. ”

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Food and Home Restrictions

Even if the child does not have food allergies, it is better not to eat anything potentially allergenic during the Mantoux test. What you can not eat after a Mantoux vaccination:

citruses;
chocolate;
red fruits and vegetables;

It is necessary to exclude allergens not only in nutrition, but also in everyday life. In particular, to reduce “communication” with domestic animals, to ensure that the vaccine does not touch synthetic fabrics.

Should I be afraid of a positive Mantoux reaction?

If the Mantoux reaction is positive, this does not mean that the child has tuberculosis. There can be several reasons for a positive reaction, and not all of them are related to infection. So, the reasons for the increase in Mantoux may be as follows:

the rules of behavior after the injection are not observed (allergies or severe irritation may occur instead of a real reaction);
low quality tuberculin was introduced (in this case, it is better to repeat the test in an independent laboratory);
the nurse measured the papule incorrectly;
body features are such that the test shows a positive result (sometimes a hereditary factor plays a role, sometimes dietary features, in particular, excess protein food);
there was a recent (within two years) BCG vaccination (the so-called post-vaccination immunity, while the papule has vague contours, and a pigment spot remains in its place).

If all these factors are excluded, and the reaction is positive, you need to go for further examinations. Based on the Mantoux test, it is impossible to make a diagnosis, therefore, the child will need to do a fluorography and pass the sputum for microbiological culture. Be sure to examine other family members.

Vaccinations before and after Mantoux

There is no Mantoux test in the vaccination calendar, and since it is not tied to any dates, it must be set so that other vaccinations do not affect the result.

If vaccinations are planned before Mantoux, vaccination with live vaccines should be carried out 6 weeks before the test, inactivated - 4 weeks before the Mantoux test.
No vaccinations should be given on the same day as the Mantoux test.
3 days after the test, when the result is measured, you can put any vaccinations.

Thus, the main limitations relate to vaccinations before the test, and what vaccine is given after Mantoux does not really matter.

The Mantoux test is really important for the prevention of tuberculosis, and for the child's body it is completely harmless. Knowing what the meaning of this test is and how to do it correctly, parents can really contribute to the detection of tuberculosis at an early stage and protect their child from the disease.

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