Jäykkäkouristus ja kurkkumätä – Milloin sinä uusit viimeksi oman dT-rokotteesi?

Kurkkumätä-jäykkäkouristusrokotetta ja sen tärkeyttä sivusin lyhyesti jo ”Mistä tiedän, mitä rokotteita tarvitsen matkaa varten?”-postauksessa ja sainkin muutaman kysymyksen liittyen tuohon rokotteeseen, kiitos kaikista kommenteista ja kysymyksistä, ne ilahduttaa aina! Päätinkin siis ottaa tuon aiheen jo nyt heti käsittelyyn, onhan kyseessä meinaan sekä matkailijaa, että ihan ketä tahansa Suomessakin joskus ovesta ulos lähtevää ihmistä koskettava asia. Tuo dT-rokote on nimittäin ainoa rokotteista, joka perusterveen, perusohjelman rokotteet saaneen ja ilman sen kummempia reissujakaan tekemättömän perusjantterin pitää muistaa ihan itse päivittää – myös aikuisena. Puhutaan nyt kuitenkin ensin siitä, että mitä nuo taudit oikein on, joita vastaan tuo dT-rokote tarjoaa suojaa ja katsotaan sitten vielä tuota rokotusasiaa postauksen lopuksi tarkemmin! 

Mikä on jäykkäkouristus?

Jäykkäkouristus, eli toiselta nimeltään tetanus (tästä tulee se rokotteen t-kirjain) on sairaus, joka aiheuttaa lihasten jäykistymisen ja johtaa valitettavan usein hyvästä hoidosta huolimatta kuolemaan. Tautia aiheuttaa Clostridium tetani -niminen bakteeri, joka elää maaperässä ympäri maailmaa, myös Suomessa ja kestää koviakin oloja eli itiöt säilyvät maaperässä jopa Suomessa ympäri vuoden. Bakteeri päätyy haavojen kautta elimistöön ja tuottaa sitten elimistössä hermomyrkkyä, joka aiheuttaa tuon edellä kuvatun lihasten jäykistymisen ja lisäksi usein kuumeilua, kipuja ja päänsärkyä. Jäykkäkouristus ja -halvaus alkaa usein ensin kasvoista ja leviää myöhemmin koko kehoon, usein myös sydämen ja keuhkojen lihaksiin.

Jäykkäkouristus tarvitsee siis syntyäkseen haavan, maaperän likaa ja hapenpuutteen tuossa haavassa, jotta bakteeri voi lisääntyä. Ei siis kuulosta kovin vaikeilta vaatimuksilta ja pienikin haava, varsinkin pistohaava, voi riittää tartuntaan. Suomessa viimeisimmät tetanus-tartunnat ovatkin tulleet mm. ruusunpiikin pistosta, koiran puremasta ja pyörällä kaatumisen seurauksena. Kuitenkin bakteeri on Suomessa harvinainen, joten paniikkia ei kannata ottaa ja jos tetanus-rokote on kunnossa, ei pikkunaarmuista tarvitse huolehtia lainkaan! Maailmalla tuo jäykkäkouristusta aiheuttava bakteeri sen sijaa on huomattavasti yleisempi ja puutteellisten rokotussuojien takia tappaa jopa yli miljoona ihmistä vuodessa ja uhkaa erityisesti vastasyntyneitä.

Entäs sitten se kurkkumätä?

Kurkkumätä, oikeammalta nimeltään difteria (ja tästä siis sitten se d-kirjain siihen rokotteen nimeen) on jäykkäkouristuksen tapaan bakteerin levittämä, nieluun, kurkunpäähän, nenään tai iholle syntyvä tulehduksellinen sairaus. Tällä kertaa bakteeri on nimeltään Corynebacterium diphtheriae ja se leviää ihmisestä toiseen syljen kautta. Kurkkumädässä bakteeri tuottaa elimistössä myrkkyä eli toksiinia, joka aiheuttaa ensin tyypillisimmillään voimakkaita nieluoireita, kuten kurkkukipua ja peitteitä kurkkuun ja myöhemmin voi johtaa sydänlihastulehdukseen, hengityshalvaukseen ja rytmihäiriöihin. Hyvästä hoidosta huolimatta jopa 10% sairastuneista menehtyy.

Kurkkumädän keskeisin hoito on vastamyrkyn antaminen suonensisäisesti mahdollisimman pian taudin puhkeamisesta. Varmin keino suojautua taudilta on kuitenkin ehkäistä se jo etukäteen. Suomessa kurkkumätä on luokiteltu yleisvaaralliseksi tartuntataudiksi, mikä tarkoittaa sitä, että se leviää erityisen helposti tai nopeasti, joten siihen sairastunutta ihmistä voidaan hoitaa jopa pakkohoitona, jos sairastunut ei jostain syystä itse ole halukas hoitoon. Uusia kurkkumätä tapauksia esiintyy kuitenkin maailmallakaan enää kohtuullisen vähän ja suomalaisia kurkkumätään ei ole sairastunut vuosiin. Suojautuminen on silti aiheellista, koska tapauksia kuitenkin edelleen on ja jos rokotuskattavuus laskee, leviää tautikin helpommin.

Miten näiltä kahdelta nyt sitten voi suojautua?

Helposti! dT-rokotteen tarjoaa ilmaiseksi jokainen Suomen terveyskeskus ja terveysasema sitä tarvitsevalle ja rokote tarjoaa lähes 100% suojan tartunnoilta rokotteen ottaneelle ihmiselle. Rokotetta kannattaa siis kysellä joko omasta terveyskeskuksesta, opiskelu- tai työterveydestä tai aikuisneuvolasta. Rokotesuoja on syytä uusia 10 vuoden välein. Jos omasta edellisestä rokotuksesta ei ole tietoa, asiasta kannattaa kysyä omalta terveysasemalta. Lähtökohtana on kuitenkin se, että vuosien 1956-1997 välillä syntyneet ovat kaikki saaneet rokotteen koululaisina 11-13vuoden iässä ja vuoden 1997 jälkeen syntyneet 14-15-vuoden iässä. Näin ollen reilu parikymppisenä rokote on muistettava ensimmäistä kertaa uusia itse.

Tetanuksen pelossa haavoja ei tarvitse lähteä terveyskeskukseen näyttämään, jos tietää rokotussuojan olevan kunnossa. Sen sijaa tietysti isommat haavat, likaiset haavat ja eläinten puremat on hyvä käydä tietysti näyttämässä ja puhdistuttamassa ammattilaisella muiden infektioiden ehkäisemiseksi ja haavan paranemisen takaamiseksi. Difteriakin on kovin harvinainen sairaus, mutta jos joku nyt uskaltautuu matkailemaan ilman rokotussuojaa ja reissun jälkeen parin viikon sisällä iskee kova kurkkukipu, on syytä hakeutua hoitoon.

 

Mikäs sulla on tilanne siellä ruudun toisella puolella? Onko dT-suoja varmasti kunnossa vai pitäisikö soittaa terveysasemalle ja tarkistaa asia?

 

Lisää tietoa aiheesta: 

THL:n infektiotauti-info: jäykkäkouristus

THL:n infektiotauti-info: kurkkumätä

Duodecimin artikkeli jäykkäkouristuksesta

Duodecimin artikkeli kurkkumädästä

THL:n rokottamissivuston artikkeli dT-rokotteesta

232 thoughts on “Jäykkäkouristus ja kurkkumätä – Milloin sinä uusit viimeksi oman dT-rokotteesi?

  1. Kiitos! Tosi hyödyllistä tietoa kaikesta. Joskus tuntuu, että matkalle lähtevä ei välitä mistään, eikä kuvittele mitään sattuvan. Niinkin perusjutut kuin matkavakuutukset ja eurooppalainen sairaanhoitokortti saattavat puuttua.

    • Jep, se on helppo ajatella, että ei mulle tapahdu mitään, kun muille vaan, mutta todellisuudessa se vahinko voi osua kenenkä vaan kohdalle, joten just noi perusasiat ois kyllä syytä olla kaikilla kunnossa!

  2. Hyvä idea koota vinkkejä. Itsekin vasta Aasiaan lähtöön valmistautuessani huomasin, että suurin osa rokotteista pitää uusia. Ei niitä tule mietittyä, ellei tarvitse.

    • Tuo on totta. Onneksi matkalle lähtö on monille se hetki, kun tulee ne omat rokotteet tsekattua, mutta sit vähän huolettaa ne ihmiset, jotka ei pahemmin reissaa ja helposti esim tämä dT-rokote jää vahvistamatta…

  3. Hirmu hyvä kysymys ja hirmu hyvä muistutus! Oletan, että olen saanut vahvisteen noihin viimeeksi vuonna 2002, kun otin paljon rokotuksia Kaakkois-Aasian matkaa varten. Mutta vanhetunuthan tuo rokote siinä tapauksessa on eli mars mars työterveyshuoltoon ennen seuraavaa reissua.

  4. Heippa Laura! En tiedä johtuuko meidän historiasta tämä suomalaisten lähes lapsenuskoinen luottamus viranomaistietoon. Olen matkustellut laajasti Intiassa. 2007-2008 vietin nelisen kuukautta Biharin osavaltiossa. Opiskelin ja työskentelin noin 80 ihmisen kanssa, jotka tulivat 32 eri maasta. Toimiva käytännön perusasia/neuvo vatsatautiin/ripuliin on runsas nesteytys sokeria ja suoloja sisältävällä puhtaalla vedellä! En kuullut että kukaan Intiassa tapaamani Intialainen tai ulkomaalainen olisi ollut erityisen huolestunut jäykkäkouristuksesta tai kurkkumädästä, puhumattakaan poliosta tai ”rokotesuojasta”. Matkustelussa on hyvä puoli että joutuu kyseenalaistamaan omat uskomukset. Kirjoitat että että jäykkäkouristus-kurkkumätä(-hinkuyskä)-rokote tarjoaa lähes 100% suojan. On mahdollista että suoja ei todellisuudessa ole niin korkea, kun THL antaa ymmärtää. Suomessa jäykkäkouristukseen sairastui vuosien 1969 ja 1985 viisi 5-15 vuotiasta lasta. Neljä viidestä lapsesta oli rokotettuja sitä vastaan. (PMID 8335151). Menee ehkä vähän asian vierestä, mutta… THL:n mukaan 96% vuonna 2015 diagnosoiduista hinkuyskätapauksista Suomessa olivat rokotetuilla (dtap). Lähde: http://www.julkari.fi/…/THL_Raportti_%2010_2016_korjattu_WE… (s.12).

    • Moi! Tuo vatsataudin ja ripulin hoito-ohje on kyllä erittäin pätevä, tuolla minäkin lähtisin liikkeelle, jos moinen vaiva iskee reissussa tai ihan kotonakin. Tuosta intialaisten tai muiden ulkomaalaisten huolestumattomuudesta en sen sijaa omasta kokemuksestani ole ihan samaa mieltä, näin kun kansainvälisen terveyden ammattihenkilöstön piireissä opiskelujen puolesta pyörin, tuntuu rokotusohjelmat, niiden toteutuminen ja toteutumattomuus ja pelko rokottamattomien määrän kasvamisesta olevan tapetilla kaikkialla maailmassa. Erityisesti näiden tautien kohdalla toivon myös sitä, että nuo taudit eivät ole ei lääketieteen parissa pyörivien ihmisten huulilla enää juuri siksi, että tavallinen ihminen ei niihin enää niin usein menehdy ja ne eivät näy arkipäivässä. Googlailin vielä Intian suhteen asiaa ja vaikuttaisi siltä, että juuri rokotuksilla siellä on viime vuosina saatu äitiys- ja pikkulapsien difteria tartunnat kuriin ja nyt keskitytään siihen, olisiko mahdollista saada rokotusta myös muille kuin raskaana oleville aikuisille, jotta viimeisetkin tartunnat saataisiin kuriin, koska kuten jutussa sanottu, melko heikko ennuste on noille jäykkäkouristukseen sairastuneilla. Tuo THL:n linkki ei toimi mulla, joten en osaa sitä suoraan kommentoida, mutta tuon hinkuyskärokotteen teho nimenomaan hinkuyskää vastaan on huomattavasti alhaisempi kuin jäykkäkouristus-kurkkumätä rokotteiden teho noita tauteja vastaan ja lisäksi noiden tautien leviäminen tapahtuu ihan eri tavalla. Ja kyllähän tuo suoja melkoisen hyvältä kuulostaa, jos vaikn 4 rokotettua lasta on sairastunut yli 15 vuoden jaksolla, ainakin minun mielestäni. Kiinnostaa kyllä kuulla, mihin tuo väite, että suoja ei ole niin hyvä kun THL antaa ymmärtää, perustuu? Anyways, iso kiitos laajasta ja hyvästä kommentista, näistä asioista on aina mielenkiintoista kuulla muiden kokemuksia!

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