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WormsIntroduction Threadworms, or Enterobius vermicularis, are small intestinal worm parasites that infect the intestines of humans. The threadworm, sometimes called a pinworm, is the most common worm parasite infestation of children in the UK. The mature female worm can be from 8mm-13mm long, and the male worm 2mm-5mm long. The worms are white, with a blunt head and a fine, hair-like, pointed tail. The male is shorter and is rarely seen as it remains within the intestine. Adult worms live for up to six weeks. The female worm lays many tiny eggs around the anus, and around the vagina and urethra (tube that carries urine from the bladder to the outside of the body) in girls. This usually happens at night, when the infested person is asleep. Threadworm eggs are not visible to the naked eye. When laying the eggs, the female worm also secretes irritant mucus, which causes the person to scratch the itchy area. Eggs then stick under fingernails and on fingertips, and can be transferred to the mouth where they can cause re-infestation. The eggs can survive for three weeks and sometimes hatch on the skin, and re-enter the bowel. Swallowed eggs hatch in the intestine and, after a couple of weeks, the worms reach adult size and begin to reproduce. The symptoms of threadworm include itching around the anus and a lack of sleep. However, the symptoms do not always present themselves. Humans are thought to be the only host for human threadworms. Animals cannot catch or pass on human threadworms. The only way animals may be responsible for spreading human threadworms is by transporting them on their fur as a result of human contact. Symptoms Threadworms are known to cause intense itching around your anus. In girls, vaginal itching can also occur. The itching is particularly intense at night, when the female worms are active laying their eggs. This may cause you to experience a loss of sleep and make you irritable. In cases of very heavy infestation, or persistent infestations, threadworms can cause a loss of appetite, weight loss, insomnia and severe irritability. Threadworms do not always produce symptoms, which is why all members of your household must be treated, even if only one person develops the condition and experiences symptoms. Causes Threadworms are usually passed on through poor hygiene. If you have threadworms, the eggs are laid around their anus, along with the female's itchy mucus. If you scratch the affected itchy area, eggs may be transferred on to your hands. The eggs can then rub off on to other surfaces that can come into contact with people's mouths, such as children's toys, kitchen utensils, or toothbrushes. If the eggs are swallowed, the infestation cycle begins again. Threadworm is most common in small children because they are not fully aware of the importance of hygiene, and they easily forget to wash their hands. Children can also prolong their infestation by continually swallowing fresh eggs. As children regularly come into close contact with one another, and share toys, or hold hands while playing, re-infestation is often easy. Threadworms are commonly found in family groups, particularly those living in crowded conditions. Person-to-person threadworm infestation can also occur through handling contaminated clothes, or bedding, or from touching contaminated surfaces, such as furniture and carpets. Eggs can survive on such surfaces for up to two weeks. Threadworms only infest humans and cannot be caught from animals, such as dogs and cats. However, there is a small risk that threadworm can be caught from household pets if their fur becomes contaminated with eggs as a result of human contact. Only then could they continue to spread the parasite to humans by means of patting or stroking. Diagnosis Threadworms are difficult to see because of their size and colour. The best time to try and see them is at night, when the females come out to lay their eggs. Sometimes, worms can be found in stools (faeces). The worms look like small pieces of white cotton thread, hence their name. Your GP, or nurse, may take a moistened swab from around your anus to pick up eggs. The sample can then be sent to a laboratory for testing. Treatment Treatment for threadworms is aimed at getting rid of the parasites and preventing re-infestation. To successfully treat threadworm you can either follow strict hygiene methods (as outlined below), or see your GP who can prescribe medication for you. However, when taking medication, you should also ensure strict hygiene methods as well. Hygiene Sensible hygiene measures can be used to clear up a threadworm infection, but also to reduce your chances of re-infestation. The life span of the threadworms is approximately six weeks so these hygiene methods should be followed for this period. These include: keeping finger nails short, discouraging nail biting or finger sucking in particular, you should make sure that children do not suck their thumb, frequently washing hands, and scrubbing under finger nails, particularly before eating and after visiting the toilet, wearing close-fitting underwear at night, making sure to change them every morning, wearing cotton gloves at night as this may help prevent scratching during sleep, having a bath, or shower, and making sure that you clean around the anus and vagina each morning, to remove any eggs laid during the night, making sure everyone has their own face flannel and towel avoid using communal (shared) towels, not eating food in the bedroom, as eggs can be shaken off bedclothes and survive in dust, and vacuuming regularly and thoroughly. Medication Medicines can also be used to remove threadworms. The most common medications used are: Mebendazole this kills the threadworms, usually with only one dose (100mg), and is the preferred treatment for anyone over two years old. If re-infestation does occur, a repeated dose can be prescribed. Piperazine paralyses the worms until they are pushed naturally out of the bowel. Piperazine can be used in children aged from three months to two years old, but needs to be taken in two doses (2.5ml each), two weeks apart. Mebendazole and piperazine do not kill the eggs produced by threadworms, so strict hygiene measures should still be followed for two weeks after treatment. All members of your family, or household, need to be treated at the same time, to avoid re-infestation, even if only one person displays symptoms. These medications should not be used in babies who are less than three months old. If the infestation persists after using medication, see your GP who is likely to recommend that you begin a second course of medication. The whole family should be included in this treatment, and additional hygiene measures should be practised. These include: washing sleepwear, bed linen, towels, and cuddly toys this can be done at normal temperatures but make sure that the washing is well rinsed, thoroughly vacuuming and dusting the whole house paying particular attention to the bedrooms, carefully clean the bathroom by 'damp-dusting' surfaces, and washing the cloth frequently in hot water, and keeping toothbrushes in a closed cupboard, rinsing them well before use. During pregnancy Medication for threadworm is not usually suitable during pregnancy and while breastfeeding. Only in the second or third trimester (weeks 14-26 and week 27 onwards) of pregnancy can medication be used. Mebendazole is often prescribed. Mebendazole or piperazine should never be taken during the first trimester of pregnancy. See your GP if you are unsure. The best essential oils to try for worms are Bergamot, Cajeput, Eucalyptus, Fennel, Geranium, Juniper, Lavender, Melissa, Myrrh, Peppermint, Rosemary, Spearmint, Tea Tree and Thyme. Try making a diluted solution with a few drops of three or more out of this list of oils and use as a local wash. Also add a few drops to a bath each evening. |
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