Intestinal worms

What are intestinal worms?

Worms (also known as intestinal worms) is a very common condition that affects humans, as well as animals. Worms are parasites which means they survive by living off a host (another animal or human). It’s very common for children aged between 5 and 10 to get worms.1The most common type of worms that infect people in Australia are threadworms (also known as pinworms). They get their name from their appearance as they look like fine pieces of thread. This content will focus on threadworms. (also known as pinworms).

Other types of worms that can affect people include:

  • hookworm

  • tapeworm

  • whipworm

  • Strongyloides

Worms can spread easily from person to person, which is why it’s important to treat all family members for worms, even if only one person is infected.

Signs and symptoms of worms

Some worms don’t cause any symptoms, but typical symptoms of threadworm may include:

  • itchy bottom (around the anus) that is usually worse at night

  • redness or scratch marks around the bottom

  • redness and itching around the vaginal area (vulvovaginitis)

  • irritability

  • loss of appetite

Threadworms usually come out of the anus at night to lay their eggs which causes extreme itching. If you shine a torch on your child’s bottom, you may even see small white threads moving about. People with heavy infections may notice threadworms on the surface of their stools (poo).

How do you get threadworms?

Threadworms are highly contagious and can be caught by ingesting the eggs (either eaten or inhaled). This usually occurs:

  • directly — through contact with an infected person (i.e. touching the eggs that are on the infected person)

  • indirectly — through touching a surface (i.e. tap, door handle, linen, bedding, towel or other items) that has been contaminated with eggs by an infected person

Once the eggs have been swallowed, they travel to the small intestine where they hatch. Larvae then make their way into the large intestines where they grow into worms. Around four weeks after ingestion, adult female worms move down to the anus to lay their eggs. A female threadworm can lay as many as 16,000 eggs. After laying her eggs she dies, and the cycle begins again.

These microscopic eggs are infectious within a few hours of being laid and can survive outside the human body for as long as two weeks.8Eggs can also be present in house dust, and stick to clothes, carpets and bedding, making it possible to ingest them.

Pets do not cause threadworm infection in humans.

How do you get other types of worms?

Some other types of worms can be contracted through the skin via contaminated soil. Examples of this include9:

  • hookworms — being barefoot outdoors and coming into contact with larvae in soil or sand contaminated by poo from an infected dog

  • dog tapeworms — coming into contact with tapeworm eggs which may be present in dog poo, the dog’s coat, bedding and play areas

  • whipworm — ingesting eggs from infected soil, or eating foods grown in infected soil

  • Strongyloides (a type of roundworm) — coming into contact with soil that is infected with larvae

Risk factors for worms

Threadworms can affect anyone, although it is more common in children. This is because they are more likely to share toys and other items as well as the tendency to put fingers in their mouths. Children also forget to wash their hands, which makes the spread of threadworm more likely.

Threadworms can spread easily in families, schools, and daycare centres.

It is possible to catch some types of worms from your pet. This usually occurs when dealing with pet waste (poo), or through eggs that may be living in the soil. However, ensuring your pets are regularly treated with worming medication can prevent the likelihood of this happening. Speak to your vet about the right worming products for your pet.

How are worms diagnosed?

If you suspect you or your child has worms, it’s a good idea to see your doctor for a diagnosis. The most common test is the ‘sticky tape test’, which involves using a special sticky tape to take a sample of eggs first thing in the morning. Pressing a piece of sticky tape against the anus will cause any threadworm eggs to stick to the tape. This piece of tape is then viewed under a microscope to determine if threadworms or their eggs are present.

Diagnosing other types of worms is usually done by taking a stool (poo) sample or through blood tests.10

How are worms treated?

Fortunately, treating threadworm is relatively easy and involves taking antiparasitic medication. This can be in the form of liquids, chewable tablets or chocolate squares. Usually, medication is taken as a single dose and then repeated two weeks later.

Even if just one person in the family has worms, you should treat everyone as this will stop the spread among other family members. It’s also a good idea to wash all sheets, towels, clothes and any toys that may have eggs or worms on them, in hot water.

Complications of intestinal worms

Threadworm infections are usually harmless. However, infection from other types of worms can lead to:

  • diarrhoea

  • fatigue or weakness

  • abdominal pain

  • weight loss

  • anaemia

When to see your doctor

You should visit your doctor if you suspect you or your child has worms as treatment will depend upon the type of worm you have. You should also visit your doctor if you:

  • suspect a child under two years is infected with threadworm

  • have used an over-the-counter (OTC) medicine to treat the threadworm, but the infection persists

  • have recently had a threadworm infection and have symptoms of a re-infection

  • have recently returned from overseas, especially Africa or Asia

  • there is blood in your faeces (poo)

  • have diarrhoea

  • have lost weight quickly

  • have abdominal pain or fever

  • have severely scratched or broken skin around your anus

  • are pregnant or breastfeeding (some medications may not be suitable)

How to prevent worms

While you can’t always prevent a threadworm infection, you can reduce the risk of being infected or re-infected. You should:

  • practice good hand hygiene, especially after going to the toilet, changing nappies, before preparing food and before eating food

  • discourage your children from scratching their bottom and biting their nails

  • keep fingernails short

  • bathe or shower daily

  • change underwear daily

  • wash bed linen and towels daily for several days after treatment and then regularly wash in hot water

  • disinfect toilet seats and potties daily

  • treat the whole family with antiparasitic medication, even if only one member has worms.

Your local MediADVICE pharmacist is available to help you manage your health and we can recommend a range of worming products for the whole family to assist in the treatment of intestinal worms. Speak to your MediADVICE pharmacist about your symptoms so we can recommend products and medications that may be suitable for you.

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References:
[1] Healthdirect, Worms in humans,https://www.healthdirect.gov.au/worms-in-humans
[2] Raising Children Network, Worms,https://raisingchildren.net.au/guides/a-z-health-reference/worms
[3] Healthdirect, Worms in humans,https://www.healthdirect.gov.au/worms-in-humans
[4] Royal Children’s Hospital, Worms,https://www.rch.org.au/kidsinfo/fact_sheets/Worms/
[5] Royal Children’s Hospital, Worms,https://www.rch.org.au/kidsinfo/fact_sheets/Worms/
[6] Better Health Channel, Pinworms,https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pinworms
[7] Royal Children’s Hospital, Worms,https://www.rch.org.au/kidsinfo/fact_sheets/Worms/
[8] Healthdirect, Worms in humans,https://www.healthdirect.gov.au/worms-in-humans
[9] Healthdirect, Worms in humans,https://www.healthdirect.gov.au/worms-in-humans
[10] Healthdirect, Worms in humans,https://www.healthdirect.gov.au/worms-in-humans
[11] Healthdirect, Worms in humans,https://www.healthdirect.gov.au/worms-in-humans
[12] Royal Children’s Hospital, Worms,https://www.rch.org.au/kidsinfo/fact_sheets/Worms/
[13] Raising Children Network, Worms,https://raisingchildren.net.au/guides/a-z-health-reference/worms
[14] Better Health Channel, Pinworms,https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pinworms
[15] South Australia Health, Worms – including symptoms, treatment and prevention,https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/worms/worms+-+including+symptoms+treatment+and+prevention