Pinworm- Symptom ,Treatment, Pinworm in Child and Adult
Pinworm infection is caused by the small worm called Enterobius vermicularis. It is the most common worm infection in the United States and it most commonly affects school-age children.
The pinworm's only reservoir is humans, and the worms are transmitted from person to person by ingesting eggs (oral-fecal route), or through contact with contaminated bedding, food, or other items.
Upon ingestion of eggs, larvae eventually hatch in the small intestine and worms then mature in the colon. Female worms then migrate to the anal area, especially at night, and deposit their eggs. This may lead to itching and sometimes infection of the involved area.
The human pinworm, Enterobius vermicularis, is a parasite that lives only in the human intestine, not outside the body. Pinworm in animals does not affect humans.
People blame pinworms for such childhood problems as teeth grinding, bed wetting, stomach aches, weight loss, poor appetite, and even appendicitis, but there is no proof that pinworm is responsible for these conditions.
Infestation with these parasites begins when pinworm eggs are swallowed and lodge in the intestine, where they hatch and mature. Two to six weeks later, the adult female worm exits down the digestive tract to the skin folds of the anal region, where she deposits her eggs in a sticky substance and then dies.
The eggs sit in the anal area for as long as three weeks before hatching. After hatching, the worms move back to the lower intestine.
School-age children are most often infected. Next are preschoolers, especially those in daycare centers. The infection is so common that in some schools more than half the children may be infected.
Pinworms are more a nuisance than a serious health problem. The main complaint is that of intense anal itching, due to the irritation caused by worms migrating across the skin.
In general, the body's immune system eliminates pinworms living within the intestine within several months. However, eggs are usually dispersed in bedding material or clothing and may spread via the fingers or even through the air, making reingestion of eggs and a new cycle of infection common - not just among those who were originally affected but among other members of the household as well.
Intense itching around the anus
Difficulty sleeping due to the itching that occurs during the night, when the adult worms migrate out through the anus to lay their eggs
Irritability due to the itching and interrupted sleep at night
Vaginal irritation or discomfort in young girls (if an adult worm enters the vagina rather than the anus)
Irritated or infected skin around the anus from constant scratching
Loss of appetite and weight (uncommon but can occur in severe infections)
Causes of Pinworm
When female pinworms lay eggs in the area around your anus, the anal area usually begins to itch - sometimes severely. When you scratch the itchy area, the microscopic eggs cling to your fingers and then transfer to other surfaces, such as food, liquids or other people. Pinworm eggs can survive for several weeks on these surfaces. A new infection starts when the eggs reach another person's mouth by contaminated drink, food or hands. You can also reinfect yourself by unknowingly swallowing the eggs again.
Diagnosis of Pinworm
Stool and blood tests are not helpful in diagnosing pinworms. Seeing a worm is what determines the diagnosis. The parent must check the child's skin with a flashlight during the night and the first thing in the morning and look for white, wiggling threads. Occasionally a wiggling worm may be seen on the surface of a stool. Since pinworms are so common, children with nighttime anal itching are often treated without any lab test. The classic diagnostic tool is to apply a piece of transparent tape to the skin near the anus first thing in the morning. The health-care provider can attach it to a glass slide and then examine it under a microscope for the presence of eggs. A pinworm lab kit can usually be supplied by a provider's office if necessary.
Pinworm is generally not a serious infection and often no treatment is required other than strict cleanliness habits.
However, there are several drugs, which can help to eliminate Pinworm. The most common drugs are Mebendazole and Pyrantel pamoate. They are usually taken in a single dose or perhaps in two doses two weeks apart. The whole family must take the medication; otherwise it will not be very helpful. These drugs only kill the adult worms so attention to cleanliness is still extremely important. Petroleum jelly or anti-itch creams and ointments may be applied 2-3 times per day to reduce the itching that continues the cycle of infection.
To clear the infection, the anal area should be washed frequently with warm, soapy water to remove and kill the eggs. Underwear should be changed at least twice a day and washed in hot, soapy water. Fingernails need to be cut close and kept clean. Areas that have a lot of hand contact around the house can be cleaned frequently with soapy water where possible or cleaned with a vacuum cleaner. The toilet seat can be cleaned often as well. Eggs from fingers, fingernails, clothes, bedding, toys and even the air (after shaking bedding and clothing) can re-infect and start another round of Pinworm. Eggs can usually survive up to three weeks, but are killed by sunlight and ultraviolet light.
Special attention does not necessarily need to be given to pets in the house. Human pinworm affects only humans and is not transmitted by or to animals.
Risk factors for pinworm infection include:
Poor hygiene. Scratching the anal area directly and poor hand washing are to blame for the spread of pinworm infection.
Warm climate. Pinworms thrive in milder climates, and higher numbers of infections have been reported in the southern United States and in other countries with warm temperatures year-round.
Living with children. Pinworm infection is more common in children and is easily spread to others in the family.
Typical pinworm infections don't cause serious problems. In rare circumstances, complications can develop from a heavy infection, including:
Urinary tract infection. More common in females, urinary tract infections sometimes are caused by heavy pinworm infestation. The parasite can also migrate to the bladder, causing cystitis.
Infection of the peritoneal cavity. In women or girls, the parasite may travel from the anal area up the vagina to the uterus, fallopian tubes and the area around the pelvic organs. This can cause vaginitis, endometritis or other problems.
Weight loss. When a large number of adult pinworms are living in your intestine, they can cause enough abdominal pain and take enough nutrients that you will lose weight.
Urinary tract infection (UTI)
Prevention of Pinworm
Pinworm infections and reinfections can be diminished by the following:
Make certain children wash their hands before meals and after using the restroom.
Keep children's fingernails trimmed.
Discourage nail biting and scratching the anal area.
Have children change into a clean pair of underwear each day.
Have children bathe in the morning to reduce egg contamination.
Open bedroom blinds and curtains during the day, as eggs are sensitive to sunlight.
After each treatment, change nightclothes, underwear, and bedding and wash them.
General Home Care
Thoroughly clean your house.
Machine wash sheets, clothing, and dishes at the hottest water setting.
Change all towels.
Cut and clean the fingernails of those who are infected.
Everyone in your household--especially those who are infected--should wash hands well after using the toilet and before touching food.
At least once a day, wash the anal area. Do this under a shower, if possible.
When using public toilet seats, cover them with clean paper first.
Try to keep children from scratching the anus. Have them keep their fingers away from the nose and mouth.
Change sheets, pillowcases, towels, and nightwear often. Machine-wash them on the hottest water setting. Change underwear daily.
Have children wear snug cotton underpants.
After the treatment, stools may look like the color of the medicine used to kill the worms.
Be sure to keep any follow-up appointment the doctor may schedule.
Call The Doctor
If you have a mild case of pinworm infection, you may not experience any symptoms and may never need medical attention. Many children simply outgrow mild pinworm infections, when all female worms have traveled out of the anus so that reinfection doesn't occur.
If you have mild abdominal pain along with insomnia or irritability, or you're experiencing consistent or severe anal or vaginal itching, consult your doctor.
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