What’s covered?

What are threadworms?

Threadworm infections are common in childhood.

Threadworms, also known as pinworms (Enterobius vermicularis), are common parasites of the intestines. The exact prevalence is not precisely known, but according to NICE data, as much as 40% of children in the UK experience it at some stage.

Let me summarise some essential facts about threadworm infection.

What are threadworms?

Threadworms are internal parasites, which means they need a human body to survive and live. However, they are specific to their hosts. These worms can be seen closely and resemble small pieces of thread. Males are smaller (3-5mm in length), while females are 2-3 times larger (9-12mm in size). With a diameter of just 0.5mm, they resemble 'threads'.

The threadworm eggs are, however, much smaller and can't be seen with eyes, so a child is likely swallowing eggs without knowing. These eggs hatch inside the body to produce worms.

How do the children get these parasites?

Its life cycle is very simple and direct and is just 1.5-2 months long. However, before dying, a female lays many eggs around the anus. The female usually comes out from the rectum and lays eggs at the anal ring. The female's tail is pointed (therefore, called the pinworm), which irritates the anus.

The child will scratch around the anus, and the eggs will be trapped in the nails. These eggs will enter the mouth, reach the intestines, hatch to release the worms, and the cycle continues. It takes up to two weeks for an egg from entry into the body to hatch and convert into a fertile worm.

The eggs are likely to fall on the bedding, foods, toys and clothes and can enter the body through any route. However, poor cleanliness and hygiene practices can increase the chances of acquiring eggs.

What are the symptoms of threadworm infestation?

Mild infestations don't cause symptoms, but such a child will transfer the infection to other kids. However, a severe infestation will leave many signs. Typically signs appear after some weeks of parasitic entry as this time is taken for the hatching of eggs and maturation of parasites. The common symptoms are;

• Irritation and itching around the anus that worsens at night

• Insomnia due to sleep disturbances

• Pain in the abdomen

• Irritability

• Scratching-induced wounds and secondary bacterial infections

• Local infection can ascend upwards to cause diseases of the female reproductive organs

The symptoms will continue to worsen as the degree of parasite infestations increases. The appearance of signs in one child means the other children in contact have already engulfed the worm eggs.

How are threadworms diagnosed?

A characteristic irritation around the anus at night is enough to confirm the infection. However, the doctor will need more precise confirmation through physical examination. The testing procedures are;

Physical observation

The large size of the parasite allows observation with the naked eye, or magnifying glass can help. The doctors often examine the anal area as the child sleeps because the parasite has more pronounced activity at night.

Use of moist swab

A moist swab rubbed around the anus will take many parasites or eggs for examination. The swabs are released into a solution of normal saline for the test.

Tape test

A clear plastic cellophane tape applied around the anus at night will take many eggs and worms. It can be examined by the doctor and shipped to the laboratory.

How is a threadworm infestation treated?

The standard treatments used are anti-parasitic drugs, e.g., albendazole, mebendazole, pyrantel pamoate etc. These drugs are given once initially and a second dose 2 weeks apart to completely kill the adult worms and their eggs. These are prescription drugs and should be used according to the recommendation.

For very young children, i.e., under 2 years, the doctor will prescribe safer alternatives. If one person in a house has the issue, all the family members should receive threadworm treatment as all are likely to be infested.

How can a threadworm infestation be prevented?

Prevention requires the use of strict hygiene measures. However, the following points will help you in prevention and control.

• Regularly wash your child's sleepwear, bed linen, soft toys and towels, and don't allow your child to share these things with other children, particularly at risk, to reduce the risk of swallowing threadworm eggs.

• Wash the area around the anus to remove the eggs laid at night.

• Regularly wash the hands and keep the nails of the child adequately trimmed and clean.

• Avoid scratching the anus, and use lubricant oil to reduce the irritation at a very itchy bottom.

• Don't allow your baby to insert fingers into the mouth.

• Avoid eating food that is contaminated and has expired.

• Avoid contact with an infected person.

• Use a disinfectant or hot water to wash the floor, kitchen and bathroom surfaces.

After the treatment, strictly practice the hygiene protocols to avoid future recurrence. Once the signs are apparent, you need to seek medical help. It is also required during pregnancy, breastfeeding and for a baby less than 6 months of age. The potential complications of an untreated infestation are urinary tract infections, secondary bacterial infections at the site of scratching and appendicitis.

Our Baby and Child Health products page has many child health and well-being products. Click here to visit the page and place the order.

Bottom-line

Threadworms are common parasites that infect the anal area and cause irritation. They are called so because their pin-like tails irritate the anus. However, its control and management are relatively easy with hygiene practices and regular hand washing. The worm infestation can cause some minor complications if left untreated for a long time. The treatment options are available, and you can choose with a doctor's consultation.

At Welzo, our team of health experts is available to guide you, and our page also has many treatment options for internal parasites. Click here for consultation.

One of the complications of internal parasites is diarrhoea. We have many treatments available; click here to visit the page.