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Worms

worms; itch; pinworm; threadworm; nemetode; enterobiasis; pin; thread; ;

Most families with young children have had to deal with worms from time to time. Although parents are often embarrassed if their children have worms, they are very common and usually not difficult to treat.

The name 'Threadworm' is used throughout this text however they may also be called Pinworms.

Contents


Worms affecting people in Australia

  • Worldwide there are many worms that can affect humans, but in most parts of Australia only the threadworm, (Enterobius vermicularis) is common. 
  • Adults as well as children can get threadworms.
  • About one month after the egg of the threadworm is swallowed, the adult worm comes out of the child's bottom (anus) and lays her eggs on the skin around the opening causing very bad itching. Scratching or not washing hands after going to the toilet can result in the eggs being carried on the hands back to the mouth, when another cycle of worm production begins.
  • The eggs can also be moved onto clothing, bedding, and other surfaces, where other people can pick them up. The eggs can survive up to 2 weeks on surfaces.
  • Adult worms can live for up to 6 weeks, but people can be re-infested even while they have worms if they swallow more of the eggs.
  • Dogs or cats do not get threadworms, so pets do not cause threadworm infections in humans.
  • However children can get different worms from animals, so it is important to 'worm' animals regularly for their own health and for the health of the family.

Human infestation with other worms such as roundworms, hookworms and tapeworms (including the hydatid tapeworm) is not common in Australia.  

Signs and symptoms

  • The main sign of threadworms is an itchy bottom. Somtimes children feel 'out of sorts' and do not want to eat much.
  • Threadworms do not cause major health problems, and are usually not the cause of tummy pain.
  • Scratching of the bottom can cause a red rash around the anus, which can sometimes become infected.
  • In girls they can move into the vagina, causing itching and a vaginal discharge.
  • Occasionally adult worms can be seen on a person's poo.
  • If you look carefully at the child's bottom, around the opening (anus), you can sometimes see the worms there, especially when the child first gets up in the morning.

What parents can do
  • It is important to see your doctor if you suspect your child has worms so the doctor can be sure of what is causing the problem. 
  • One test to see if the problem is threadworms is to briefly place a piece of adhesive tape ('sticky tape') across the anus. This will pick up the pin worm eggs, and the doctor can look for these on the tape. 
  • Treatment of threadworms is safe and works well.
  • A single dose of medicine is given to all family members, not only the child. The treatments can be bought at a pharmacy without a prescription.

What to do if your child has threadworms

  • All family members should be treated at the same time.
  • Children can get worms again, even when they have been treated because the worms lay eggs around their bottoms. The area becomes very itchy, and by scratching, children can get the worm eggs under their fingernails, then carry them back to their mouths, giving themselves another bout of worms or spreading them to other people.
    • They need to be taught not touch or scratch around their bottoms where there are likely to be worm eggs.
    • Keep fingernails short and well scrubbed.
    • Ointments or creams used for nappy rashes such as zinc and castor oil, smeared around the anus at bed time and in the morning may help with itching.
    • Get children to sleep in tight fitting underpants or pyjamas so it is not easy for them to scratch - wash all their underpants in hot water.
  • Wash clothes, pyjamas, sheets and pillow cases in hot water. Do not shake the sheets when you take them off the bed.
  • Disinfect the toilet seat often with antiseptic cleaner.
  • How long treatments take to work
    • Threadworm treatments are swallowed and mostly remain within the gut, passing along with other gut contents.
    • By the time the treatment has passed fully through the gut it will have killed the worms in the gut (this usually takes from 1 to 4 days).
    • Itching around the anus will often last longer (even when there are no worms left), because the skin around the anus has been irritated by the worms. Continue using the soothing creams.
  • Treating threadworms does not prevent them coming back, so make sure that all family members are treated, and that the family are careful with hygiene practices (especially hand washing).

Stopping worms from spreading
  • Keeping a child home from child care, school or work is not needed.
  • It is most important to be careful about being clean, especially washing hands after going to the toilet and changing nappies, and before eating.

References

Department of Health, South Australia 'Worms'

and:

Centers for Disease Control and Prevention (US) Fact sheet 'Enterobiasis (also known as pinworm infection)' 
http://www.cdc.gov/parasites/pinworm/index.html 

Better Health Channel, Victoria 
http://www.betterhealth.vic.gov.au/ 

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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