INTRODUCTION.
When a person has ‘worms’ they may be infested with one of a number of worms, including threadworms (Pinworms), roundworms or hookworms. Threadworms are the only common worm affecting humans in
A ring worm is not actually a worm, but a fungal infection of the skin, caused by a similar fungi to that which causes tinea or athletes foot. Ringworm should be treated with an anti-fungal cream such as Canesten ® (Clotrimazole), whereas other worms are treated with drugs known as Anthelmintics.
THREADWORMS.
The only host of threadworms are humans, animals do not carry threadworms so people can not catch them from their family pet. They are highly contagious and frequently a whole family will be infected at the one time. The eggs are transferred from the anus of an infected person to hands, toys, food, clothing etc and infect another person by entering their mouth.
Life cycle.
- The eggs are swallowed by a person.
- They move down the gut and hatch in the small intestine.
- The larvae move into the large intestine where they grow into a mature worm in 2 to 6 weeks.
- In the large intestine the worms mate.
- The female moves to the anus at night to lay her eggs.
- The eggs are transferred from the anus and find there way to the mouth of a new host. ( eg- under the fingernails.)
Symptoms.
- Anal itching, generally at night when the worm lays eggs. The irritation is due to a sticky substance that the worm uses to stick the eggs to the anus.
- Tiredness, irritability, grinding teeth in sleep.
- Anaemia and weight loss may also occur.
Treatment.
Treatment is only recommended if there is known to be an infestation, not just as a precaution. To check for worms the anus may be examined at night, under torch light, to look for worms laying eggs. Alternatively a strip of sticky tape placed over the anus and pulled off, may remove some worms and the tape can be examined. If infestation is severe eggs or live worms may be seen in the faeces.
Pyrantel. ( Combantrin ® , Early Bird ® )
Pyrantel paralyses the worm so that it lets go of the intestinal wall. The paralysed worms are then removed with the next bowel motion. The worms are not killed.
Dose is dependent on body weight; approximately 1 tablet per 10kg. Generally a single dose is recommended, but re-treatment in 2 weeks may be necessary if the infestation is severe.
Combantrin also now comes in chocolate squares for easier administration for children.
Mebendazole. ( Vermox ® , Banworm ® New Combantrin)
Mebendazole is absorbed by the worm and starves the worm of glucose which is essential for survival. Consequently the worm starves to death and the dead worms are removed with the next bowel motion. This is an advantage over pyrantel as the worms are killed.
The Dose is one tablet, once (100mg), from two years of age to adults. The reason that the dose is the same for every one is because the drug is not actually absorbed by the person, only by the worm. Mebendazole is also now available in liquid form.
Pregnancy
- Because infestation with threadworms is not harmful or life threatening, treatment is not recommended during pregnancy.
- For children aged 6 months to 2 years, only pyrantel is approved for treatment of threadworms.
General Advice.
- The whole family may be treated, but not the family pets as they are not affected by the same kind of worms.
- Fingernails should be cut short, especially children’s.
- Encourage hygiene. ie - washing hands after the toilet and before eating or handling food.
- On the day of treatment clothes and sheets should be washed and floors should be mopped or vacuumed.
- The toilet should be disinfected every day for at least one week after treatment.
ROUNDWORMS.
Roundworms are common in warm, tropical areas and are not common in Australia. Infestations are most likely to occur in areas of poor sanitation.
The eggs are swallowed and the larvae hatch in the intestines, where they burrow through the intestinal wall and travel to the lungs via the blood and lymphatic system.
Symptoms include, fever, cough and wheeze as well as gastric symptoms such as cramps and eventually obstruction. Chronic infestation is likely to lead to malabsorption of food.
Treatment.
Pyrantel, 11mg per kg of body weight (Maximum of 1gram) as a single dose.
Mebendazole, 100mg twice a day for three days.
The only preventative is good hygiene.
HOOKWORMS.
Hookworm infestations generally only occur in areas of poor sanitation. Eggs are removed in the faeces, hatch in soil and enter a new host by burrowing through the skin and eventually penetrating the lungs.
Hookworm infestation may have no symptoms, however some symptoms include abdominal pain, rash at entry site on the skin and iron deficiency anaemia. Eggs are readily found in the stools.
Treatment.
Pyrantel, 11mg/kg daily for 3 days. (Maximum of 1 gram per day.)
Mebendazole, 100mg twice a day for 3 days.
SOLUTION PACK.
Vermox® plus Pinetarsol ® .
Pinetarsol is a tar based product that is used to relieve the irritation and itch caused by threadworms. It should be used instead of soap to wash around the anus.
Aquium gel. Used to wash hands to sanitise before eating food.
