The Mantoux test as a diagnostic method was proposed by the French physician Charles Mantoux. Based on medical studies of the tuberculosis bacillus, he proposed subcutaneous injection of tuberculin - a test for the presence of the causative agent of a serious disease in the child’s body.
The Mantoux test, otherwise known as the tuberculin test, is a subcutaneous or percutaneous injection designed to detect the presence of specific immunity to the administration of tuberculin. It is done annually, 12 months after the birth of the baby. The procedure is performed for children vaccinated in the maternity hospital and for those whose parents refused BCG vaccination.
Mantoux is not a vaccine. This is a reaction to the presence of Koch’s bacillus in the child’s body, the main “culprit” of tuberculosis. It shows how ready the child’s immunity is to fight viruses from the outside.
The main active ingredient, tuberculin, is a mixture of dead tuberculosis bacteria that died due to thermal exposure. After the injection, a “button” - a papule - is formed at the site where the drug was administered, which will grow in the presence of the pathogen.
How is the Mantoux test performed?
The test is carried out annually at approximately the same time. You must first visit a pediatrician. He will assess the baby’s health condition and give a referral for the procedure. Most pediatricians recommend taking antiallergic drugs such as Zodak, Fenistil, and Zyrtek 3 days before and 3 days after tuberculin administration.
The procedure is quite simple: at one time, using a disposable syringe with thin short needles, a dose equal to two tuberculin units is injected under the skin in the forearm. Manta rays are only allowed in treatment rooms. The child is in a sitting position; if necessary, the mother must hold her hand tightly so that the baby cannot pull it out. Every year the arm is alternated: first the left forearm, then the right.
The manipulation is practically painless, in most cases absolutely harmless. The test can be done at a clinic or educational institution. After a certain time, the doctor measures the size of the papule that appears at the injection site. Its size depends on the presence of infection in the body.
Is it possible to give Mantu for a cough: reaction, how to vaccinate, pediatricians’ opinion, consequences
The Mantoux test is an allergy test that is done annually to every child in order to find out whether immunity against tuberculosis is present in his body.
Before carrying out the test, the specialist must examine the child and assess his state of health. The pediatrician decides to do Mantoux for illnesses or to postpone this immunological test until the child has completely recovered.
Symptoms of a cold, such as a runny nose and cough, may affect the test result.
What is Mantoux test
Children are especially sensitive to tuberculosis, so BCG is the first vaccination given to newborns in the maternity hospital. The vaccine is administered to a child in the first days of life and does not require a preliminary allergy test.
If the baby was not given BCG at birth, then after two months of age a tuberculin test must be done before vaccination, since by this time the child may already have contact with sick people and is at risk of becoming infected.
After the BCG vaccination, a tuberculosis bacillus remains in the baby’s body, which, when interacting with tuberculin, can give a positive response. Therefore, children under 12 months are not given Mantoux, since the test will not be objective.
Mantoux is not a vaccination, it is an allergy test that does not create immunity to tuberculosis. The test is carried out using tuberculin, a drug that is a mixture of protein antigens obtained after neutralizing tuberculosis bacteria.
The procedure for performing tuberculin diagnostics is as follows:
Conducting tuberculin diagnostics
- the skin on the inside of the arm above the wrist is disinfected;
- the syringe is placed parallel to the arm and the drug is injected under the skin;
- A papule, the so-called “button,” forms at the injection site.
A papule is a local reaction to tuberculin. 72 hours after administration of the drug, its diameter is assessed using a regular transparent ruler.
The Mantoux test is done to all children, even those who have a medical exemption from vaccinations. The manipulation is carried out once a year until the age of 18 in order to be able to assess the child’s health.
After reaching the age of eighteen, it is already possible to carry out a fluorographic examination, which makes it possible to exclude not only pulmonary tuberculosis, but also other pathologies of the lungs and heart.
An exception may be children prone to allergic reactions.
Is it possible to use Mantu for a cough?
Just a few decades ago, tuberculin diagnostics were performed on all children without exception for any health condition. Currently the approach is slightly different:
The decision to conduct tuberculin diagnostics is made only after examining the child by a pediatrician
- the pediatrician examines the child and decides on the advisability of conducting a tuberculin test;
- parents fill out a questionnaire in which they talk in detail about the child’s health status and past illnesses;
- permission to conduct the test must be from both the parents and the doctor.
Taking into account the health characteristics of the baby, the procedure can be postponed or carried out as planned.
Cough is a protective reaction of the body to an irritant or inflammatory process. The reasons may be:
- cold;
- bronchospasm;
- allergy;
- external irritants (dust, harmful substances);
- lung disease.
If a child has a cold and coughs, then there is an infection in the body that affects the upper respiratory tract. All protective resources of the child’s body are aimed at combating the cause of the disease. The introduction of even a small amount of the pathogen into a weakened body can cause a violent reaction and give a false positive result for a tuberculin test.
Making Mantoux when coughing is dangerous for a child’s health
It is possible that a child may have a slight cough, and the doctor may not notice it. Parents should focus on current or recent illness. Carrying out an allergy test can aggravate the situation and intensify the cough or intensify it.
It is better not to do Mantoux if the child is coughing, since there is a high probability that the consequence of the administration of tuberculin will be an exacerbation of the cough. This manifestation is not evidence of infection with Koch's bacillus. This may indicate that the body has encountered an infection against the background of a weakened immune system.
At the time of the test, the child must be completely healthy to exclude false reactions. To fully restore the body after an illness, another 10-14 days are required after recovery.
Untreated upper respiratory tract diseases and residual cough can give not only a false positive, but also a false negative result.
This is explained by a change in the body's sensitivity to tuberculin.
Mantoux for allergic cough
If a child is prone to allergies, then he may develop a specific cough, which differs from a cold in the following ways:
- the cough is dry, not accompanied by sputum production;
- manifests itself in attacks and can cause asthma attacks;
- often accompanied by a runny nose and sneezing;
- manifests itself more at night, to a lesser extent during the day.
An allergic cough can be a reaction to an external irritant: pet hair, seasonal flowering of plants, food allergens, taking medications. Any allergies can affect the Mantoux reaction and give a false result.
A child prone to allergies should be prepared in advance for Mantoux:
- do not introduce new foods into the diet 5 days before the procedure and 3 days after;
- do not visit public places and entertainment venues;
- on the day of the allergy test, take an antihistamine.
The rules for caring for the injection site are the same for all children. It is forbidden:
- wet your hand;
- cover with a plaster;
- comb;
- treat with brilliant green and other means.
You can go for walks and breathe fresh air after the Mantoux test.
Assessing the reaction - checking the result
No less relevant is the question on what day the sample is checked. Results are assessed after 72 hours. To do this, use a transparent ruler that has millimeter divisions. It is important that measurements are taken by a professional in very good lighting.
| Result | Description | Norm |
| Negative | There are no traces left at the injection site. The body either has not encountered the carrier of the disease, or itself successfully copes with the pathogen. | 0 – 0.1 mm |
| Doubtful | There is redness around the “button”, but there is no compaction. Doctors assess this result as the child’s absence of Koch’s bacillus. | 2- 4 mm |
| Positive | The papule is red; when pressed, a compaction is felt. It is likely that the infection has already occurred as a result of contact with a sick person. | 6 mm or more |
Important! The absence of an inflamed large papule does not always mean a negative result. A positive result can be not only if the child is a carrier of the disease.
Often a red, enlarged papule is the result of an incorrectly placed injection. A positive test is typical for children prone to allergies.
Proper care of the “button” is no less important. It is unacceptable to wet the injection site, rub it, smear it with brilliant green, iodine or alcohol solutions. All this will lead to the papule increasing in size, and the result will be unreliable.
Why you can’t get vaccinated if you have snot, cough, fever
Is it possible to do Mantu for a runny nose, cough, rhinitis, although these are faithful companions of colds that arise due to viral invasion? Is it possible to do Mantu for a child’s cough?
During this period, the child’s body is busy fighting a viral infection and all the resources of the immune system are mobilized, so the introduction of even a small amount of antigens causes a strong response from the body’s defenses.
Due to general weakening of health, active growth of the papule is possible, which is regarded as a positive test result. Naturally, having seen this, you and the child will be forced to visit a specialized institution for the purpose of further diagnosis, without paying attention to the fact that the result is unreliable due to the child’s illness.
Please draw the pediatrician's attention to the fact that your child is behaving unusually, feeling unwell, and not being active enough. A doctor seeing a baby for the first time may not pay attention to minor sniffles and coughing.
If the child's cough is minor, a test can be done, although the result may still not be true. After Mantoux, the cough may become more active!
Is it possible to do a mantu test when a child has a runny nose?
Are mantu and runny nose compatible? This is what worries parents when the time comes for a tuberculin test, and the child has obvious problems with the nose.
Mantoux is not recommended for a runny nose. This is due to the fact that a child who has contracted the virus begins to get sick, and therefore the load on all organs and systems increases. Doing a test with a runny nose means making this load even greater. How the body will cope with it is unknown. The immune system is strained, tuberculin can only complicate the situation.
A runny nose is one of the symptoms of the onset of a respiratory disease (ARVI). If the test is given to a baby with snot, changes in the size of the “button” will soon occur. This can often be the reason for false results and unnecessary treatment. Mantoux, in principle, does not provide 100% information about the presence of a disease, while a runny nose, as a provoking factor, negatively affects the test result. Parents who give their child a mantu test when they have a runny nose run the risk of getting some complications. As a result, they are expected to visit a phthisiatrician - a specialist involved in the diagnosis and treatment of tuberculosis.
Fever and Mantoux test
Experts note that it is not advisable to give Mantoux to an adult or child with a temperature of 37 degrees or higher. Such indicators indicate the tension of the immune system, and therefore indicate that the reaction to the introduction of tuberculin will be ambiguous.
Some patients experience a more severe skin reaction, while others experience no change in the intensity of the immune response. Therefore, to obtain the most accurate sample, the manipulation should be postponed to a later date.
Mantoux after a runny nose - how long after can you do it?
Many parents cannot decide whether to make mantu after a runny nose. The main rule here is that the child must be absolutely healthy. It is not worth taking a mantu test even with a residual runny nose. The same applies to any, even the mildest manifestation of the disease.
If the baby is healthy and the pediatrician has confirmed this, then we can talk about administering the reagent only 7-10 days after the cold. This rule does not apply to children with allergies. Serious complications may arise if the test is not performed in a timely manner. Such children should not be “vaccinated” earlier than a month after all symptoms have completely disappeared.
Is it possible to give Mantoux to a child with a cough?
If a child has a cough, then experts recommend refraining from all activities related to vaccination or other tests. However, you should clearly understand the cause of cough:
- If a child’s cough is associated with a respiratory disease, then the procedure should not be performed. At least until the symptoms of the disease disappear and the baby’s body gets stronger.
- Most specialists will not test a coughing child without special reasons.
- If the attending physician associates a child’s cough with a possible course of tuberculosis, then a test is allowed to exclude the possibility of infection and to avoid the disease becoming acute or chronic.
If the cough is associated with the development of bacterial or viral diseases, then it is better to postpone the manipulation to a later date. And perform it after complex treatment prescribed by a specialist.
Bottom line: you should not do a Mantoux test if you have a cough and there is no suspicion of tuberculosis.
Why do doctors allow Mantu to be given during a runny nose?
Many local pediatricians do not consider a runny nose a contraindication for mantu. The explanations given are quite logical: manta ray is not a vaccine, no virus is injected into the baby. The mantoux test is a reagent that will show whether there is a problem or not. Tuberculin does not have any effect on the immune system, so mantu for snot is quite acceptable. Moreover, some doctors insist on a tuberculin test even with a severe cough or sore throat.
Dr. Komarovsky is among those who do not consider a runny nose to be a serious reason for refusing a tuberculosis test. The danger of contracting a severe virus is so great that you should not neglect mantu, even if your baby has a cold. Therefore, whether to give mantu to a child with a runny nose is up to the parent to decide, after consulting with a doctor.
What is a tuberculin test?
The tuberculin test, also known as mantoux, is an immunological test that helps determine whether the child’s body has ever come into contact with tuberculosis pathogens. This test is carried out annually in educational institutions and it is highly desirable that it be done to every child who has no contraindications to the test.
The decision regarding the timing of the test must be made by the pediatrician caring for the particular child. Due to certain circumstances (which we will discuss later), this test may be delayed.
When performing a tuberculin test, an antigen obtained from Koch bacilli, the causative agent of tuberculosis, is injected subcutaneously in the area just above the wrist. After 72 hours, you can evaluate the test results:
- If the papule size is up to 5 mm, there is nothing to worry about; this size of the mark left after the introduction of the antigen indicates a negative reaction;
- A papule measuring 5 to 10 mm is an intermediate condition that may indicate possible infection with Koch's bacillus. Such children are at risk;
- If the papule size is more than 15 mm and the formation of suppuration, we can talk about a probable infection with the tuberculosis bacillus.
I would like to note that the results of the Mantoux test are not a 100% test for tuberculosis and the results of this test cannot make a diagnosis. There is also a certain number of cases in which the reaction can be positive, even if the child has not had any contact with the pathogen or patients.
Contraindications to the procedure
Some doctors convince that the test is harmless, even if you use mantu for a slight runny nose. This is not entirely true. It is harmless only for those who are absolutely healthy and do not have any serious developmental disabilities or other pathologies.
It is better to refuse the administration of tuberculin in the following cases:
- allergies in a child;
- exacerbation of chronic diseases;
- epilepsy;
- ARVI (it is unacceptable to combine mantu and snot);
- the child is in quarantine in kindergarten or school;
- Not enough time has passed since the BCG vaccination.
How it works?
Everyone is accustomed to thinking that Mantoux is a vaccine. But in reality this is a test. That is a skin test. This injection allows you to determine how the body reacts to the tuberculosis pathogen. At birth, the child is vaccinated against tuberculosis, the vaccine is called BCG. The Mantoux test is a way to detect the presence of tuberculosis infection in the body.
A positive reaction to the test means that the body is infected with Mycobacterium tuberculosis, but this does not mean that the child is sick. Such children are at risk. Therefore, careful monitoring of their health over several years is necessary.
Can it be done if you have a cold?
It is prohibited to make mantu if a child is sick or has a cold. All experts agree on this opinion. Different points of view relate to the timing of subsequent injections. Some believe that it is enough to wait two weeks, others - at least one month after recovery.
Is it possible to give an injection with a runny nose? When conducting a test, even an absolutely healthy child’s body is capable of exhibiting non-standard reactions:
- increase in body temperature to subfebrile levels;
- state of weakness and apathy;
- decreased appetite;
- dizziness;
- headache;
- unhealthy cough or runny nose - can be triggered by an exacerbation of a chronic disease or by vaccinations during the incubation period of a cold;
- allergic manifestations.
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You cannot get infected from tuberculin - dead mycobacteria are not able to come to life.
When examining a child, the doctor himself can reschedule the test - he signs a medical exemption that lasts up to two months from the moment of recovery. The total delay time will depend on the type of disease:
- for colds – 30 days;
- for pneumonia – 60 days;
- after chicken pox – six months;
- one and a half years - after measles;
- after mononucleosis – 12 months.
Is it possible to make manta when coughing?
Is it possible to make mantu for coughs and colds? The cough reflex can refer to symptomatic manifestations of certain diseases:
- acute respiratory viral infection or ARVI;
- acute respiratory infections;
- rhinitis;
- bronchitis;
- tonsillitis and other respiratory diseases;
- allergic reactions.
It is better to transfer mantu for a cold or sinusitis - there is a high percentage of false-positive samples. The procedure itself will not cause damage to the child’s health, but the result will also raise doubts.
If viral infections or allergies are suspected, a preliminary blood test is permitted. Diagnostics will reveal a latent form of the inflammatory process or an allergen present in the blood.
Most medical workers believe that the test cannot be performed when coughing, and the presence of rhinitis does not exclude tuberculin diagnostics, but casts doubt on the final results.
Is snot in a child a contraindication?
Rhinotic manifestations are present quite often in children. The main causes of their occurrence are considered to be influenza, colds or allergic reactions. Is it possible to make mantu with a runny nose? Only after a full diagnostic examination and identification of the causes of rhinitis.
Checking for a runny nose of allergic origin requires rescheduling the procedure to another time of the year. If the baby has year-round symptomatic manifestations - sneezing, rhinitis and cough, but there are no changes in body temperature, then the study is allowed.
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Mantoux for snot of infectious origin is tolerated until complete recovery and then wait for one month. Experts believe that there is no need for additional psychological trauma to the child - many children are terrified of injections. Incorrect final data will require repeat injection.
For children, the Mantoux test is performed to detect tuberculosis at the initial stages of development, when the final prognosis after therapy will be favorable.
Incorrect diagnostic data will contribute to further progression of the pathological process and spread to internal organs.
A runny nose with mantoux is a contraindication for elevated body temperature and infectious diseases. During this period, all the body’s forces are devoted to stopping the pathogenic microflora that has penetrated into it. It is necessary to wait for recovery and only then carry out diagnostics. A postponement of one month is not critical - the manipulation is carried out annually.
