Worms are considered a great source of embarrassment even though the condition is common - affecting anyone of any social status.
When people refer to worms, they are usually talking about threadworms (Enterobius vermicularis), also known as pinworm, so called because they look like small pieces of white thread. The mature female worm can be about 10mm in length, while the mature male worm is about half this length.
These worms live (and hatch their eggs) in our large intestines (bowels) absorbing their nourishment from whoever is carrying them.
Threadworms are the most common type of worm infection in the UK. They are particularly common in children, infecting up to half of all children under the age of 10.
What causes threadworm?
Threadworm usually results from poor personal hygiene. When the female threadworm lays eggs around the anus or vagina she also releases a mucus that causes itching. While itching, eggs can become stuck to the fingertips and get transferred onto other surfaces, objects, or onto food or into the mouth. Anyone who touches a contaminated object and then their mouth will become infected. Once swallowed the eggs pass through the body to the bowel where they hatch.
The worms eggs can survive for up to three weeks on surfaces making contamination easy.
The condition is more common in children because they often forget to wash their hands after using the loo. Transmission between family members is then high.
How is threadworm treated?
- To successfully treat threadworms, the entire household must be treated, even if not everyone has symptoms. Treatment is two-fold - involving medication to kill the worms in the gut and good hygiene to get rid of the eggs and prevent further contamination.
- Medication can be bought from your pharmacy or obtained on prescription.
- Mebendazole is the preferred treatment option for children who are over two years of age. It can be bought over-the-counter or prescribed by a doctor, and is available as a chewable tablet or in liquid form. All members of the household should take it at the same time. One dose kills the worms. It works by preventing the threadworms from absorbing glucose, which means they die within a few days. As re-infection is very common, a second dose is often prescribed to be taken after two weeks.
- Alternatively, Piperazine can be used - suitable for anyone over three months. Two doses are required taken 14 days apart. Piperazine paralyses the threadworms until they are pushed naturally out of the bowel. It is combined with a medication called senna, which has a laxative effect to expel the worms quicker. Piperazine and senna usually come in a sachet of powder, which you mix with a small amount of milk or water before drinking.
- In conjunction with medication strict hygiene must be practiced for two weeks in order to kill off the eggs.
- Wash all sleepwear, linen, towels and soft toys, vacuum and damp-dust the entire home. Dispose of cloths after use. Every member of the household should wear close-fitting underwear in bed to prevent scratching and then immediately on waking, bathe (or wash around the anus) to get rid of eggs laid overnight.
- Underwear and nightwear should be changed and washed daily. Hands and nails should be scrubbed first thing in the morning, after going to the toilet and before preparing food.
- Children should be discouraged from thumb sucking or nail biting and towels should not be shared.
- Toothbrushes should be rinsed thoroughly before use and kept in a closed cupboard.
- Medication for threadworm is not recommended in households with babies under three months of age or if a woman is pregnant of breastfeeding. Instead the hygiene method should be followed.