What are intestinal worms?
Intestinal worms are parasites that thrive by living inside a host, whether human or animal. This condition is very widespread, especially among children aged five to ten. In Australia, the most frequently encountered species in people are threadworms, also referred to as pinworms, named for their slender, thread-like appearance. This overview will concentrate on threadworms. Other worm varieties that can infect humans include:
- Hookworm
- Tapeworm
- Whipworm
- Strongyloides
Because these worms spread easily between individuals, it’s crucial to treat the entire household if one person is diagnosed.
Signs and symptoms of worms
While some infections remain symptomless, threadworm infestations often present with:,
- Intense itching around the anus, typically worsening at night
- Redness or scratch marks near the bottom
- Vaginal itching and redness (vulvovaginitis)
- Irritability
- Reduced appetite
Female threadworms emerge from the anus at night to deposit eggs, causing the discomfort. With a flashlight, you might spot tiny white worms on your child. In heavy infections, threadworms may also appear in the stool.
How do you get threadworms?
Threadworms are highly contagious and acquired by ingesting their eggs, either by hand-to-mouth transfer or inhalation:
- Direct contact with an infected person, touching eggs on their skin
- Indirect contact via contaminated surfaces (e.g. taps, door handles, bedding, towels)
Once swallowed, the eggs hatch in the small intestine. The larvae then migrate to the large intestine to mature. About four weeks later, adult females move to the anus to release up to 16,000 eggs before dying, restarting the cycle. These microscopic eggs become infectious within hours and can remain viable on dust, clothing, carpets, and bedding for up to two weeks. Pets do not transmit threadworms to humans.
How do you get other types of worms?
Some worm species penetrate the skin through contact with infected soil, for example:
- Hookworms: stepping barefoot on larvae-contaminated ground
- Dog tapeworms: handling dog faeces or contaminated dog environments
- Whipworm: consuming produce grown in polluted soil
- Strongyloides: skin exposure to soil containing larvae
Treating and preventing these infections involves good hygiene, regular handwashing, washing bedding, and wearing footwear outdoors.
Risk Factors
Threadworms can infect anyone, but they’re particularly prevalent in children. Young kids often share toys, put their hands in their mouths and may forget to wash their hands, all of which facilitate transmission. These infections spread rapidly within families, schools and daycare centres.
Pets and Worm Transmission
Some worm species can be acquired from pets, typically through contact with animal faeces or contaminated soil. Regular deworming of pets is key to reducing this risk, consult your veterinarian for the appropriate products.
Diagnosis
To confirm a suspicion of threadworms, healthcare providers often use the “sticky tape test”, where clear adhesive tape is pressed against the anus first thing in the morning to collect eggs. The tape is then examined under a microscope for eggs or worms. Other worm infections are usually identified via stool samples or blood tests.
Treatment
Threadworm infections are treated with antiparasitic medications, available as liquids, chewable tablets, or even flavoured chocolate squares. A single dose is taken initially and repeated after two weeks. It’s important to treat all household members simultaneously and to wash bedding, towels, clothing and any contaminated toys in hot water to prevent reinfection.
Possible Complications
While threadworm infestations are generally harmless, other worm types can cause:
- Diarrhoea
- Fatigue or weakness
- Abdominal pain
- Weight loss
- Anaemia
When to See a Doctor
Seek medical advice if you or your child:
- Are under two years old with suspected threadworms
- Don’t improve after over-the-counter treatment
- Show signs of reinfection
- Have recently travelled abroad (especially to Africa or Asia)
- Experience blood in the stool, persistent diarrhoea, rapid weight loss, abdominal pain, fever, or severe itching/skin damage around the anus
- Are pregnant or breastfeeding, since not all medications are suitable
Prevention
Although you can’t guarantee avoidance of threadworms, you can greatly reduce the risk by:,
- Practising rigorous hand hygiene, especially after toilet use, nappy changes, before handling food and before eating
- Discouraging children from scratching or nail-biting
- Keeping fingernails short
- Bathing or showering daily
- Changing underwear every day
- Washing bed linen and towels daily for several days after treatment, then regularly in hot water
- Disinfecting toilet seats and potties each day
- Treating the entire household with antiparasitic medication even if only one member is infected