Mantoux was given to every child at least once in their life. The Mantoux test has been used in medicine for quite some time. They made it for us when we were children, and they still do it for our children. As strange as it may sound, Mantoux is not a vaccine at all, but just specific method diagnostics It is done to determine the presence of tuberculosis bacteria in the human body. Unfortunately, tuberculosis is rampant today. It affects both children and their parents equally often. Therefore, parents should not refuse to perform Mantoux on their child if they want to be sure that their child is healthy.
Local pediatrician
After Mantoux is done, parents are advised not to wet the injection site until the result is checked. However, this does not always work out. All children, without exception, love to tinker with water, but if Manta was made in the summer, then it is almost impossible not to manage to wet it. I think that every mother has encountered the fact that her child wet Mantoux and was worried about how this would affect the results. Is it possible or not to wet Mantu - a question that many parents would like to know the answer to. In order to get the correct answer, you need to know what Mantu is and how it is made.
What is Mantu and why is it made?
Today the Mantoux test is considered standard method identifying people infected with tuberculosis bacteria, which is used throughout the world.
This is a tuberculin test named after the French doctor Charles Mantoux, who proposed using it to detect tuberculosis back in 1909. Despite modern technologies and diagnostic methods, this test is still the standard of medicine for identifying carriers of tuberculosis.
Many mothers refuse to undergo Mantoux, considering it a vaccination and fearing that it will affect the immune system or infect the child with tuberculosis. This is just a myth. Mantoux is not a vaccine. This is a test for tuberculosis, which allows you to understand whether a person is infected or not. Tuberculin, which is administered during the Mantoux test, is an extract from tuberculosis bacteria. There are no living microorganisms in it, so it is impossible to become infected. However, tuberculin is an allergen that can provoke allergic reaction.
Why is Mantoux made every year? To find out if the child has been in contact with someone who has tuberculosis. And if there was contact, take timely measures to prevent the baby from getting sick.
In addition to Mantoux, Diaskintest has been used in Russia since 2008. It is used only in combination with the Mantoux test to determine whether the child is truly infected or whether this is a reaction after a tuberculosis vaccination.
How and when is the Mantoux test performed?
For a collective examination of healthy children and adolescents attending educational institutions, use the intradermal Mantoux test, as well as Diaskintest.
The purpose of mass screening for tuberculosis is:
- early (before the appearance of signs of the disease) identification of children and adolescents with tuberculosis;
- timely identification from among the examined children and adolescents of those who have an increased risk of developing tuberculosis (who have had contact with sick people);
- selection for repeated vaccination against tuberculosis.
Before performing the Mantoux test, each child must be examined by a pediatrician to obtain permission to perform it.
Mantoux is not made:
- children under one year old, if they have already been vaccinated against tuberculosis;
- if the child is sick;
- if the child has an exacerbation of allergic diseases.
Children who test negative for seven years are given a booster TB vaccine at age seven, then another seven years later if the results are negative when the child turns 14.
To make a Mantoux test, use a disposable tuberculin syringe and 0.1 ml of tuberculin, which is injected intradermally on the dorsum of the forearm, previously treated with a cotton swab soaked in alcohol solution. In the place where tuberculin was injected, a papule is formed - a whitish tubercle protruding above the surface of the skin, similar to a button, inside which tuberculin is located. That is why Mantoux is often called a button.
The Mantoux test is performed on all children and adolescents without exception who are vaccinated against tuberculosis annually after the child turns one year old, regardless of the result of previous tests. Children who do not have the tuberculosis vaccine (BCG) are given it twice a year from six months until they are vaccinated. Mantu is made by a nurse who has undergone special training. The result of each sample is recorded in medical card child.
If Mantoux is done systematically, every year the doctor can analyze the dynamics of the results and detect in time, not to miss the moment when the child’s body encounters bacteria, and also prevent the development of the disease.
It turns out that you can wet Manta. Despite doctors’ prohibitions, getting water on the injection site will not affect the result at all. Tuberculin is located inside the skin, and water can only get there the way Mantoux is made, that is, it must be injected with a syringe. And none of this normal person won't do it.
A child who has received Mantoux can wash his hands and even take a shower and bath. But only if certain conditions are met.
- Do not rub the injection site with a washcloth or comb it with your hands. It is important to constantly monitor the child, because the temptation to scratch or rub the injection site is so great.
- Do not cover the injection site with a plaster or wrap it in a bag or plastic wrap. By covering Mantu with a material that does not breathe, you create a compress effect, and it becomes damp and damp. This may cause irritation and intensify the reaction. In the end you will get positive result.
- After performing the Mantoux test, it is better to refrain from swimming in lakes, pools, or visiting baths and saunas. Why can’t you wet Mantu in a swimming pool, bathhouse or sauna? Only because under the influence of chlorine, which is used to treat the water in the pool, and steaming, irritation may occur at the test site, and the result will be incorrect. You only have to wait three days. After checking the result, swim to your health.
- Do not apply cream, iodine or other antiseptics to the injection site.
- You can't heat Mantu.
Why do doctors and nurses and everyone around say that Manta cannot be wetted? It's all about history, when our grandmothers were children, instead of the Mantoux test, they performed the Pirquet test: tuberculin was dripped onto the child's hand and incisions were made (they scratched the hand in the place where they dropped it). This sample really should not have been wetted under any circumstances. This way it was possible to wash off the tuberculin, and the result would be unreliable. Doctors are following an old habit, because even today the instructions for tuberculin write that you cannot wet it, adhering to established stereotypes.
How is the Mantoux test evaluated?
The results of the Mantoux test in a child are checked 72 hours after it is performed. To do this, measure the transverse size of the papule using a transparent ruler and record the result in the child’s chart.
4 Mantoux test results.
- Negative. This result is considered if there is only a trace of the injection on the skin, and nothing else.
- Doubtful. This is a result in which the skin has a thickening of 2-4 mm or redness of absolutely any size.
- Positive. In this case, the seal size is 5 mm or more.
- Hyperergic. This is a result in which the compaction size reaches 17 mm or more.
What will be the result of infection?
- The transition of previously negative results to positive if the positive result is not associated with vaccination against tuberculosis. This is the so-called turn tuberculin test.
- Increased tuberculin sensitivity. This is manifested by an annual increase in the size of the papules (compaction, protrusion above the surface of the skin).
- Development of a hyperergic (very strong) reaction in response to the introduction of tuberculin.
Such children and adolescents are under the supervision of a phthisiatrician (a specialist in the treatment of tuberculosis) for 1-2 years. They are undergoing examination. They take blood and urine tests, and, if necessary, take x-rays of the respiratory system. In addition, the child’s entire environment is examined to find the source of infection. For prevention, they are prescribed and given special treatment.
If the child has been in contact with tuberculosis bacteria or is already sick, the test result will be positive. Reasons that can distort the results can arise when the immune system is activated, this happens during illness, as well as during allergies.
What to do if, after the Mantoux test, you are referred to a phthisiatrician?
In this situation, you should listen to your doctor and go to an appointment. Believe that no one will “drive” you to doctors unless there is a reason for it. If after Mantoux your child is sent to a TB specialist, it means that the doctor has suspicions that tuberculosis may have recently occurred, and the risk of getting sick is quite high.
The child is in a group high risk within two years from the moment of infection. These two years he must be under the supervision of a phthisiatrician and examined if the doctor prescribes, and sometimes treated.
Tactics for negative reactions
In 1908, the French doctor Charles Mantoux proposed the use of a skin reaction test, which was named after him and which many mistakenly attribute to vaccinations.
In fact, this is a subcutaneous test designed to detect early stages such a terrible disease as tuberculosis. At the same time, a precautionary measure after tuberculin diagnosis includes a ban on intentionally or accidentally getting Mantoux wet.
Strict nurses in vaccination rooms separately emphasize to parents that after the test, the injection site should be left alone for three days.
After this time, the result is assessed, and conclusions are drawn about the presence or absence of problems in the body.
If Mantoux is wetted, the injection site may turn red and show an incorrect result. However, a short-term ingress of water should not cause significant harm.
The test is done in order to evaluate the reaction to tuberculin injected into the upper layers of the skin. The drug contains purified fragments of the tuberculosis bacillus, and depending on the size of the papule (seal at the injection site), a positive or negative reaction body.
The test begins to be carried out on the child as soon as he turns one, and in the future this is done annually until he is 15 years old. This measure makes it possible to timely identify the presence of contacts with tuberculosis pathogens, as well as the beginning development of the disease. There is no point in performing the Mantoux test if the baby is not yet one year old. A test that violates this rule often shows a false negative result.
Vaccination against tuberculosis is carried out to a child in the absence of contraindications during the first 3-7 days after birth. If for some reason the vaccine is not given, tuberculin testing is carried out from the age of six months.
Rules for caring for the injection site
The tuberculin test, or the well-known “button” test, is placed on inside hands, between the wrist and elbow. The tuberculin drug is administered intradermally, resulting in a slight swelling at the injection site. On the first day, redness may be observed at the injection site, but this should not frighten parents.
The effect is assessed on the third day, and only the size of the papule matters:
- a negative result is indicated by a papule size of 0-1 mm;
- a positive reaction is diagnosed if the papule reaches a size of 5 mm or more, and the skin around it becomes very red;
- the intermediate result is that the size of the papule is 2-4 mm, this may indicate an individual response to the drug or the presence of a disease.
On the 1st day, when the child has undergone tuberculin diagnostics, and before checking it with a doctor, it would not be a bad idea to refuse potentially allergenic products– chocolate, citrus fruits, nuts. The appearance of an allergic reaction will not allow the doctor to reliably assess the result of the test.
If the child is suffering skin diseases or does he have bronchial asthma, the “button” can, on the recommendation of a doctor, be replaced by other methods of tuberculin diagnostics.
Every mother, after her child has been diagnosed, is always interested in what to do if she accidentally wets Mantoux. The injection site does not require special care, but water ingress should be treated with caution.
If you wet the button, the result may be false positive, and this will require additional diagnostic procedures. Therefore, you should especially carefully monitor children and avoid soaking your hands for a long time.
What to do if water gets in
First of all, you should not be alarmed if your hand gets wet after the procedure. Accidental contact with a few drops of water will not cause harm. It is much worse to rub the injection site, smear it with brilliant green or iodine, wipe it with hydrogen peroxide or stick an adhesive plaster on it.
Some parents believe that if they “help” the healing of the papule in this way, the result will be better. However, these actions can only lead to additional irritation and redness of the hand.
Parents who are interested in what will happen if you wet Mantoux a little should remember the following. The ban on contact of a “button” with water goes back to the past, when the main research method was the Pirquet reaction.
It involved making a scratch on the skin, where a diagnostic drug was injected. In this case, it was indeed forbidden to wet the hand, since water getting into the wound could cause infection and inflammation, which did not contribute to the accuracy of the diagnosis.
With the advent of another type of research, getting wet with Mantoux will no longer be so dangerous.
The main thing is to avoid prolonged contact of the sample with water. Immediately pat your child's hand dry with a clean towel or napkin, without waiting until the injection site gets very wet.
Will there be consequences?
The tuberculin test can easily withstand short-term contact with liquid, especially on the second or third day after it is performed. Parents should supervise small children. It will be easier to do this during the day than at night - in a dream, the baby may unknowingly begin to scratch the injection site, but this should not be allowed.
So you can put him in a long sleeve shirt for a couple of nights until it's time to test his reaction.
It is quite possible to tell a grown-up child what will happen if he wets Mantoux while washing his hands. It should be explained that the injection site should not be touched, even if it is slightly itchy. After the injection, you are even allowed to swim, although cautious parents still prefer to avoid any contact with water.
A quick shower will not do any harm, but it is better to refrain from rubbing the reaction site with a washcloth or staying in water for a long time.
In any case, the fact that the injection site has been exposed to water should be reported to the doctor during a scheduled visit for testing. This will allow the specialist to correctly assess the result and avoid errors in its interpretation. At the same time, remember that the ingress of water is not always the cause of a positive reaction.
There is a common myth among parents that it is prohibited to wet Mantu. It is believed that water can affect the test result or even contribute to tuberculosis infection. All these myths are unfounded, since the Mantoux test is administered intradermally, and the liquid does not distort the diagnosis in any way. Therefore, a small amount of water cannot affect the effectiveness of the sample.
On the day of tuberculin injection, you can wash your hands and take a shower, but it is better to avoid bathing and visiting a sauna or steam bath. This precaution is due to the fact that an increase in temperature causes the pores to expand, through which the injected substance can be partially eliminated from the body along with sweat.
Water cannot get through the puncture and distort the results if you do not perform any actions that damage the skin: combing, rubbing the forearm with a washcloth. Only after such manipulations may the injection site turn red and increase in size. After the injection, you will need to monitor the child’s actions during bathing and explain to him the rules that should be followed after the injection.
In some cases, the sample size increases in children after visiting a pool, lake, or sea. Experts recommend not swimming in these places until final results and examination are obtained, as there may be substances that irritate and allergize the skin. Doctors are also of the opinion that after the injection you need to wait one hour until the blood clots and a drop of water gets through the puncture. Most likely, the time required for this process is spent much less, but doctors advise to play it safe.
Reasons for the appearance of the myth
Some experts still argue that it is impossible to wet the “button” for several days. This is due to the fact that Pirquet and Koch tests were carried out earlier. To detect infection, thin incisions were made on the skin, and if any contact occurred on an unhealed wound, dirty water, this could actually lead to incorrect results.
Since the substance was applied to the resulting scratches, it could also wash out, rendering the test ineffective. I had to redo the test, which was a waste of time and money. Because of this, doctors decided that the sample should not be soaked for three days. However, there is no reason to believe that contact with the liquid could lead to infection with tuberculosis.
True, such methods are already outdated, and they were carried out in the 70s. Today, the Mantoux test is administered intradermally, which ensures a correct test.
What does Dr. Komarovsky say?
According to Komarovsky, parents often confuse the Mantoux test with vaccination. And therefore they are afraid to wet the puncture site. However, swimming after the test is not contraindicated; contact with water will not affect the test in any way. The doctor only advises following a few rules so that the result is not false positive:
- Do not allow your child to scratch or rub the skin, as these actions lead to an increase in the “button”.
- Do not use iodine, ointments and other antiseptics, this causes irritation of the epidermis.
- Do not cover the puncture with a bandage or bandage.
- Do not dress warmly unless necessary to avoid greenhouse effect. Sweat and friction from clothing give erroneous results.
Komarovsky advises that if there are any changes in the sample, inform your doctor about this; sometimes the papule can sharply increase in volume, the test in this case will be uninformative.
Tuberculosis refers to dangerous infections, which have now become particularly widespread. The disease requires long-term treatment medications. To diagnose an illness in a child, an allergy test is performed. To reliably determine whether there is children's body Koch's wand, you should know whether it is possible to wet manta rays in order to exclude all circumstances that could distort the evaluation sample.
Why can't you get it wet?
It's simple - manta rays cannot be wetted for one simple reason: due to irritation, the injection site can deceptively swell, doctors will consider this fact as positive reaction for tuberculosis, but this will not be the case. You will need to spend time and nerves on additional tests.
Therefore, in order to avoid false diagnosis, do not wet the manta ray under any circumstances!
How is a tuberculin test done?
This substance is used to perform the test. Tuberculin is an extract from safe, destroyed tuberculosis bacilli. It is not capable of harming the child, but has antigenic identity to Mycobacterium tuberculosis. As a result, the immune system reacts to the test differently in healthy children and children with tuberculosis.
Using a special syringe, tuberculin is injected into the skin in the upper part of the inner forearm. In this case, an external local allergy occurs, lasting three days. After the period, the doctor assesses the volume of the compaction and the brightness of the redness at the injection site.
Parents often ask the question: why can’t we wet manta rays? To ensure the reliability of the results when introducing the antigen, it is not recommended to wet the manta ray.
How is the test scored?
- The diameter of the swelling is less than 0.5 cm – there is no protective reaction against mycobacteria. This happens in those children who maternity hospital did not do BCG vaccination or produced it incorrectly;
- The size of the bulge is greater than 5 mm, an abscess may appear at the injection site - before making a conclusion about possible availability diseases, you should consult a pediatric phthisiatrician and also do an additional examination.
Intradermal administration of tuberculin is easy to carry out, the results are obtained quickly, they are quite informative if the test is carried out correctly and all medical recommendations are followed.
However, the test also has significant drawbacks; the results are often distorted - external and internal stimuli affect the final assessment. Factors such as exposure to humid environments, internal state organisms are able to influence the outcome. Therefore, the questions - how many days should you not wet a manta ray and what will happen if you wet a manta ray - do not lose relevance for many parents.
How does water affect the sample?
The test is given to all children in kindergarten and school annually. Allergy to tuberculin manifests itself differently in different children. For the test to be accurate, moms and dads must clearly understand why manta rays should not be wetted and what to do if they accidentally wet the manta ray.
Tuberculin is located inside the skin, and water is located on the surface. Mixing them with each other has a low probability, but it is possible under some circumstances.
When does a false positive reaction occur?
- If the child overheats;
- During a long stay in a stuffy or too humid room;
- In a sauna, bathhouse, swimming pool, and other rooms where heat and moisture interact;
- Combing the injection site;
- An attempt to squeeze out the emerging papule.
Under the influence of heat, skin pores expand, moisture easily penetrates inside. It is important for parents to monitor their children and explain to them that they should not scratch the area where the injection was given.
Children need to be explained that the manta ray can be wetted after the doctor checks the sample, otherwise the outcome will be incorrect and they will have to give a second injection. This usually works on children; they stop itching.
If the test area is constantly scratched, inflammation will occur and the papule will increase for other obvious reasons. Therefore, doctors constantly tell adults how many days they should not wet manta rays. You need to be careful in the first three days. Be sure to ask your doctor what to do if you wet manta rays to avoid unwanted complications.
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Video - What happens if you wet a manta ray
Is there a danger if the injection site gets wet? Usually parents are interested in what will happen if the manta ray is accidentally wet. Each child may have a completely unexpected reaction. How many days you should not wet manta depends on characteristic features
The first time, parents are usually explained how long it takes to soak the injection, and also that the child should not be taken to the beach or allowed to swim in a river or lake. An open body of water can provoke the development of an infection; the doctor will not be able to determine for what reasons the papule grew.
If the skin around the injection site was rubbed vigorously with a washcloth or covered with an adhesive bandage so as not to get wet during bathing, the result will also be false. The child’s second test goes more calmly; the parents already know what they will have to face.
But doctors most often issue a warning not that the injection site should not be rubbed with soap or adhesive patches should be applied, but that water should not be allowed to enter the tuberculin injection site. Such discrepancies are explained by the fact that children previously underwent a cutaneous Pirquet reaction.
What should not come into contact with water?
The sixties of the last century were not so developed medically; the test for the tuberculosis bacillus was not carried out intradermally or subcutaneously, but rather cutaneously. This scarification test was named Perke after the name of the Austrian pediatrician who introduced it into medicine.
First, a tuberculin solution was dripped onto the inside of the child’s forearm, after which scratching incisions were made through the drops of liquid with a special stick or sterile needle.
The principle of evaluating the results was the same: lymphocytes recognized mycobacteria and began to attack them. In this case, the injection site turned red and swollen, and a small red swelling formed. Although the technique tuberculin reaction This has changed a long time ago; doctors, out of habit, warn moms and dads to use the test with caution.
The skin test actually lost its effectiveness under the influence of water, since the liquid washed away tuberculin from the incisions. The substance applied to the skin could simply be washed off with water, in which case the reaction test would be invalid or false negative. Modern intradermal tests are located deep under the skin and cannot be removed from there. But still, you shouldn’t put your hand in the water again; after how long you can bathe your baby and how long you can’t wet a child’s manta ray, you should find out from your doctor.
What to do if your baby does not protect the injection site and accidentally wets it with water. Parents can be advised not to panic; it is important to know what will happen if you wet manta rays for your child. Nothing terrible will happen, it will not lead to any serious consequences.
The wetted area should be carefully blotted with a sterile napkin or a clean handkerchief. This oversight does not require any other additional measures.
The redness and slight swelling that appears should not be associated with water. It could just be allergic inflammation.
Probably everyone at school has encountered an incomprehensible procedure called the Mantoux test. First, a small injection was given in the arm with instructions that under no circumstances should this area be wet or scratched. Three days later, the same doctor came into the class and asked to roll up the sleeves, and then measured with a ruler how enlarged this red spot was after the injection.
So what is the mysterious procedure - the Mantoux test? Tuberculin test, PPD test is diagnostic procedure, during which the tuberculosis pathogen antigen, also known as tuberculin, is injected under the skin. The reaction to the injection is expressed as increased redness of the skin at the injection site, if the disease occurs.
Therefore, the Mantoux test is prophylactic procedure which allows. To carry it out, a special extract made from destroyed virus microbacteria is injected under the child’s skin. In Russia this procedure carried out from 1960 to this day.
Doctor's note: the dynamics of the development of the papules with previous ones plays a big role in this type of procedure diagnostic tests, since the reaction to the hood is mostly individual. So a positive test result is not always a sign that the child is actually infected.
Increased papule size may be associated with external factors. This is how, for example, the main myth about Mantoux appeared - the injection site should never be exposed to water
Is it possible to wet Mantu?
Even if the Mantoux test site is wet, it can get wet soft cloth
There is a fairly clearly formulated rule that you cannot wet the place where the Mantoux test was performed. This statement is a misconception that arose due to the original methodology of the procedure. Previously, the tuberculin test was performed on the skin. To do this, the patient’s skin was specially damaged and tuberculin was dripped onto the wound. In this case, indeed, the ingress of liquid had a significant impact on the result, but a lot of time has passed since then, and the rule still passes from mouth to mouth.
If during bathing the injection site gets wet, then you should simply blot it with a soft cloth and you should not make a tragedy out of it. It is also not worth covering the vaccine with a band-aid or other improvised means, as this can lead to irritation and redness. The only thing that can affect the test result, and what you absolutely should not do, is rubbing or scratching the injection.
Other myths about the Mantoux reaction
There are a number of misconceptions about the tuberculin test that are not at all true:
- During the procedure, neutralized tuberculosis bacteria are injected under the child's skin, which can cause serious illness.
This sample contains only proteins, a waste product of microbes - this is a feature of tuberculin. This injection cannot cause any diseases because it does not contain a pathogen.
- There are children who by default have an allergic reaction to the Mantoux test; for this reason, you should prepare for the procedure in advance by taking antiallergic medications.
This procedure is diagnostic and consists of observing the body's reaction to the antigen. Children who are sick and not sick with tuberculosis react to the test differently. We can say that tuberculin is a substance that causes an allergic reaction only in case of illness. The specificity is that leukocytes will react to the sample only in a situation if the virus is present in the child’s body. Additional preparation for the test procedure is only necessary for those
