Pinworms: what they are, causes, signs, how and how to treat them in adults and children

Enterobius vermicularis are small, grayish-white roundworms. Adult females are larger than males: their length is 8-13 mm, the caudal end is awl-shaped and pointed. Hence the name pinworm. Because of their jumping movements, pinworms were previously called “jumpers.” The length of males is 2-5 mm; the rear end is spirally twisted. This is necessary to capture the female.

Click on pictures to enlarge.

Drawing. Three female and two male pinworms (1), a female (2) and a male (3) pinworms.

Drawing. The anterior end of the female pinworm: the esophagus has a spherical expansion; the uterus filled with eggs is visible through the body of the female (1). The tail end of the female is awl-shaped and pointed (2). The tail end of the male is spirally twisted (3).

What are pinworms?

As already mentioned, a pinworm (pinworm) is a worm. According to the zoological classification, it belongs to the genus of nematodes (roundworms. Of the variety of nematodes, not all are parasites; there are also quite harmless species that inhabit both land and water).

Pinworms (pinworms) are a representative of worms that lead a parasitic lifestyle. Not only people suffer from it, but also great apes. They cause a disease called enterobiasis. Pinworms occur in both children (even infants) and adults (women and men).

Externally, they are an elongated cylindrical body, 0.2 to 1.5 cm long, gray-white in color, the diameter decreases closer to the ends of the body. This species is represented by heterosexual individuals. They live in the small intestine and cecum. Fertilization occurs in the ileum, after which the males die, and the female, filled with eggs, penetrates through the anus to the surface of the body, where she lays eggs and also dies. The life cycle does not exceed a month.

The main harm is caused by toxic waste products of parasites, causing disturbances in intestinal function and increased fatigue. Also, when pinworms multiply, they have a strong irritating effect on the skin in the area of ​​the anal folds and in the groin area. In advanced stages, they can cause severe diseases of the internal (including genital) organs.

What do pinworm eggs look like?

Pinworm eggs under a microscope
Pinworm parasites lay eggs that have an oblong asymmetrical shape and are covered with a thin, transparent, double-contour shell.

Their sizes vary between 0.05 mm - 0.2 mm.

Diagnosis of pinworms, which are treated by infectious disease doctors, indicates the need for urgent antiparasitic therapy.

A timely solution to the problem of helminthic infestation makes it possible to prevent the penetration of a large number of helminths into the body of patients of all age categories, severe itching and injury to the anus, the development of infections, erosions on the sphincter mucosa, and damage to the appendix.

It is useful for parents to know what pinworms are, the symptoms of enterobiasis, and treatment methods.

Causes of pinworms in the body

The main threat to others is a person infected with this type of parasite. Already after 4-6 hours after laying, pinworm eggs become infectious. When they get on surrounding objects, clothing, in water, food, or through contact with a carrier, they become dangerous to other people. It is impossible to notice them without special equipment.

The most common infection factors include:

• lack of basic hygiene (unwashed hands, unprocessed vegetables and fruits, raw water);
• the presence of egg-carrying insect parasites (flies);
• lack of sanitization of premises where infected people were located;
• repeated self-infection when scratching itchy areas of the skin.

When examining samples taken from public toilets, a huge number of pinworm eggs were found in them.

For these reasons, children are mainly susceptible to infection with enterobiasis.

Once through the mouth opening into the intestinal environment favorable for maturation, new worms begin to hatch from the eggs in a period of 3 to 6 weeks. The period of egg maturation is called incubation. Upon reaching sexual maturity, parasites begin to mate and actively reproduce.

Pinworm infection

Parasitic infection of children and adult patients with small nematodes occurs through the fecal-oral route of transmission.

Infectious disease doctors who know how to treat pinworms note the possibility of migration of emerging parasite larvae from the anus back to the rectum.

This situation leads to the diagnosis of self-infection in patients.

Among the reasons for the appearance of pinworms and the development of enterobiasis are:

• inappropriate sanitary condition of apartments, houses, preschool institutions, schools, in the premises of which helminth eggs may appear;
• consumption of unwashed foods, vegetables, fruits, berries;
• contacts with infected adults, children;
• eating with dirty hands;
• failure to comply with personal hygiene rules;
• lack of proper care for children by parents in orphanages, leading to the active proliferation of pinworm parasites;
• close contact with animals whose fur may contain roundworm eggs;
• distribution of eggs of the most famous parasites with flies, cockroaches, ants;
• infection with nematodes through handshakes, clothing, door handles, banknotes, household items, household appliances after touching them by sick people.

Symptoms of pinworm in humans

Suspicion of a person being infected with pinworms can be determined using external symptoms (see photo above):

• continuous or periodically recurring itching in the anal area in the evening and at night;
• restless sleep, especially in children (including possible teeth grinding);
• intestinal disorders;
• abdominal pain and salivation;
• increased fatigue.

Description of the disease

Damage to the human body by pinworms is called enterobiasis.
This is the most common parasitic disease in childhood. Penetrating into the body, the worms are localized in the lower parts of the small intestine, cecum and colon. Adult females who have reached sexual maturity are able to exit through the anus to lay eggs between the folds of skin around the anus. Pinworms have distinctive features of their external structure. Females have a “tail”, that is, a pointed end (hence the name of the worms - pinworms). It can injure the intestinal mucosa, causing severe itching in the perianal area. Males are smaller than females, their “tails” are bent in a spiral. The disease causes significant discomfort to the child. Constant itching (intensified in the evening and at night) makes it impossible to sleep peacefully; the waste products of pinworms poison the body, disrupting the functioning of the gastrointestinal tract. The baby loses his appetite and a sharp decrease in body weight begins.

If a child is suspected of having enterobiasis, parents should promptly consult a gastroenterologist or infectious disease specialist. Competent specialists are able to determine whether a child has pinworms and help to quickly and effectively cope with the disease.

Diagnostics

It is almost impossible to determine whether a person is infected or not at an early stage without a special examination. But, in case of symptoms and complaints in medical institutions, a smear or scraping from the perianal folds is taken using a special adhesive tape or cotton wool moistened with glycerin.

At an advanced stage of infection, pinworms can be visually seen in feces and even on bed linen.

After the signs have been confirmed by medical analysis, it is necessary to begin treatment for pinworms. It is especially important not to start the disease, but to begin treatment on the first day.

Treatment and prevention of pinworms in adults

If pinworms are diagnosed in adults, then treatment at home with medications may well be effective. There is currently no shortage of such medicines in pharmacies. Here are some tablets for pinworms in adults:

• Levamisole-decaris;
• Vermox;
• Mebex;
• Helminthox;
• Telmox;
• Nemozol is one of the most powerful anthelmintic drugs with complex effects; it is used in advanced stages of infection and helps to quickly get rid of pinworms.

It is better to consult a doctor about which medications are best to use. To increase the effectiveness of taking these drugs, you should pay attention to your diet during the period of treatment and try not to eat foods that strengthen the stool, do not overload your stomach with rich food before going to bed, it is advisable to take laxatives in the morning.

Another important factor in successful treatment will be repeated administration of the selected medications for about a couple of weeks to destroy the parasites remaining in the body, since not all medications work against pinworm larvae and eggs.

If itching is severe, you should take anti-allergenic medications ( Cetrin, Suprastin, Zlodak ). This will also help avoid scratching and prevent parasite eggs from getting on clothes and surrounding objects.

In addition to drug treatment, certain hygiene rules must be observed during this period:

• wash your hands thoroughly before eating and after using the toilet;
• cut your nails short (so that helminth eggs cannot accumulate under them);
• change your underwear several times a day;
• disinfect bed linen (washing and ironing with a hot iron);
• regular disinfection of premises, especially toilets.

Compliance with these rules will help remove pinworms from adults in the shortest possible time and reduce the possibility of re-infection to zero.

In general, subject to simple hygiene, adults are not exposed to such diseases as often as children.

Treatment of enterobiasis

With enterobiasis, self-infection occurs very easily. For successful treatment, you need to cut your nails short and change your underwear and bed linen daily. It is important to wash thoroughly with warm water and soap at night and in the morning to remove pinworm eggs. To prevent pinworms from spreading, the perianal area is generously lubricated with Vaseline. At night, after washing, you should wear clean, tight panties; In the morning you need to boil them or iron them with a hot iron to kill pinworms and their eggs. During the day, wear clean panties. It is especially important to keep your hands clean. Treatment of enterobiasis gives a good result only if all family members are treated.

Advice from experienced people: How to get rid of enterobiasis? Place toys in bags in the cold, along with carpets, blankets and pillows for 2-3 hours. We wash bed linen at 60°. Wet cleaning of the apartment. In the evening for the whole Pirantel family. Everyone should put on thick underpants at night and give them a good wash in the morning. After 10 days, repeat pyrantel. Business!!!

It is better to take medications during or after meals at 17.00-18.00, and even better before bed.

Pirantel

Pyrantel (prices for analogues - combactrin, helminthox, nemocid, see here) suspension is taken once at a dose of 10/mg per kg of body weight:

• children from 6 months to 2 years - 125 mg (1/2 teaspoon - 2.5 ml); • children 2 years - 6 years - 250 mg (1 teaspoon - 5 ml); • children 6 years old - 12 years old - 500 mg (2 teaspoons - 10 ml); • children over 12 years of age and adults weighing less than 75 kg - 750 mg (3 teaspoons - 15 ml); • adults weighing more than 75 kg - 1000 mg (4 teaspoons - 20 ml).

Albendazole

Albendazole (Nemozol) is used for 1 day, orally, after meals, the tablets are not chewed, washed down with water:

• adults and children over 14 years of age weighing more than 60 kg, 400 mg (1 tablet) 1 time per day; • adults and children over 14 years of age weighing less than 60 kg - 200 mg (1 tablet) 1 time per day; • for children under 14 years of age, the daily dose is set at the rate of 10 mg/kg body weight 1 time per day.

Albendazole acts on several parasites at once - roundworms, whipworms, pinworms, intestinal eels, trichinella, etc.

Mebendazole

Mebendazole (prices of analogues - Vermox, Vero-Mebendazole, Vormin, Mebendazole, Telmox 100, see here) is taken once: • for children under 3 years of age, 25 mg (1/4 tablet); • children aged 3 to 6 years - 50 mg (1/2 tablet); • children over 7 years old and adults - 100 mg (1 tablet).

Treatment and prevention of pinworms in children

As numerous statistical studies show, the susceptibility to pinworm infection in children under certain conditions can be 100%. Sometimes this process takes on the character of an epidemic (mainly in kindergartens). But even in children, the symptoms of pinworm infection do not always manifest themselves sharply, especially at the beginning.

If you have the slightest complaint about itching in the anus, scratching in this area, sleep disturbances and other symptoms mentioned above, you must immediately contact a medical facility for diagnosis and subsequent treatment (if the disease is confirmed).

If treatment is not started in a timely manner, the disease can progress, and poisoning of the child’s body with helminth toxins can lead to severe stomach pain and affect the mental health and general condition of the child’s body.

Note! In girls, an additional symptom may be urinary incontinence (enuresis) due to irritation of the urethra.

In the first place, of course, is disease prevention. It is clear that it is not immediately possible to teach a child to regularly observe the rules of personal hygiene, but the educational efforts made will help to avoid problems with pinworms in the future.

Important! When diagnosing, repeated tests are desirable, or rather mandatory, since pinworms do not lay eggs every night and it is not a fact that they will be in the collected analysis material.

If infection does occur and is detected, treatment should be started immediately. The selection of the necessary medications, dosage and regimen is carried out exclusively by a doctor! Self-medication should be avoided so as not to aggravate the disease and avoid re-infection.

Pharmacy drugs

The pharmacological industry offers a fairly large range of drugs for the treatment of helminths. Particularly popular are broad-spectrum medications that can be effective against several types of helminthic infestations.

The main mechanism of action of antiparasitic drugs is aimed at suppressing the vital activity of worms - parasites, as well as their death and complete release from the body naturally. Most medications are intended for a single dose, but still many doctors believe that a one-time use of a particular medication for pinworms will not cure enterobiasis or other helminthic infestations. Some drugs paralyze the nervous system of pinworms, thereby reducing their ability to reproduce and increasing their elimination in an inactive state.

The same medications can be used for children as for adults, but the only difference is the dose of the antiparasitic agent. The following medications are considered the most effective and common drugs for the treatment of enterobiasis:

1. Nemozol . An anthelmintic drug that is available in the form of a suspension or chewable tablets. Has a pronounced antiparasitic effect. The active component of the drug is albendazole, a benzimidazole derivative. It is a broad-spectrum drug, which allows it to be used for various helminthic infestations, including those caused by pinworms. For children under 2 years of age, a single dose of the drug is recommended in the amount of 10 mil suspension. After 2 years, a single dose is 20 mil. If necessary, treatment should be repeated after 2 weeks.

1. Piperazine . The most accessible antiparasitic drug for the treatment of enterobiasis. Available in tablets for internal use. Piperazine is the only drug that has no obvious contraindications, so it can be used for therapeutic or prophylactic purposes, as well as for pregnant women. The course of treatment for enterobiasis with Piperazine is 5 days. It is recommended that children under 3–4 years old crush the tablet before taking it, and older adults take it with a sufficient amount of water.

1. Pyrantel . For children it is available in the form of an oral suspension. This drug is quite effective in the treatment of enterobiasis. The dose for children is prescribed individually depending on the child’s body weight. Pyrantel is quite toxic, so its use should be agreed with your doctor. Basically, the doctor prescribes 10 mg of the drug per 1 kg of the child’s weight.
2. Albendazole . A broad-spectrum anthelmintic drug that is highly effective against adults and larvae. For children under 2 years of age, the drug is contraindicated or prescribed with extreme caution.
3. Dekaris . A common broad-spectrum antiparasitic drug that can quickly destroy pathogenic worms. Children are recommended to take Decaris 50 mg once. The treatment course must be repeated after 2 weeks. The active component of the drug is levamisole, which exhibits a high therapeutic effect in the treatment of a large number of parasites, is well tolerated by the body, and has virtually no contraindications. Taking the drug allows you to cause paralysis of the muscles of the parasites with their subsequent death. For treatment, it is enough to take 1 tablet and repeat the dose after 2 weeks.

1. Wormil . A broad-spectrum anthelmintic drug based on albendazole, which acts on both large individuals and larvae. After administration, the drug accumulates in the bodies of pinworms, where it acts for 35 days. For children, the dose is selected individually.

Any of the drugs copes quite well with helminthic infestations in children, but during their use the dosage must be strictly observed. Also, not only the child, but also all family members need to take pills. Anthelmintic tablets for pinworms for children are selected by a doctor after the results of all studies. In some cases, taking such drugs is possible for preventive purposes.

Treatment of pinworms with folk remedies at home

The most famous natural remedy, practiced since ancient times, is pumpkin seeds. They contain substances that have a detrimental effect on parasites.

However, it should be remembered that only unpeeled seeds are effective for treatment and prevention! You can take them either in pure form or in combination with other products. For example, crushed fruits with olive oil are taken on an empty stomach 3 hours before meals for three days. After a couple of days, repeat the course of treatment.

Complications that pinworms cause in humans

Most people do not experience serious complications from pinworm infections. Rarely, if parasites are not removed, they can cause urinary tract infections in women. Pinworms can also travel from the anus to the vagina, affecting the uterus, fallopian tubes, and other pelvic organs. Pinworms can also cause vaginitis, endometritis (inflammation of the uterus) or other infections in women.

Having a huge number of pinworms can cause abdominal pain.

Overgrowth of these parasites can deprive your body of essential nutrients, leading to weight loss.

Symptoms, causes of infection, spread

The body's initial signals about the presence of pinworms usually appear within half a month after the onset of helminthiasis.

They may have varying severity of symptoms. This is decided by the massive number of parasites found in the intestines, chronic illnesses ever acquired and how the patient’s body itself reacts,

The following symptoms are usually observed:

1. itching around the anal sphincter, which sharply worsens in the middle of the night (the female becomes active), but with intense infection it also worries during daylight hours;
2. with a significant number of parasites that have entered the intestines, the itching spreads between the legs, in women - in the vagina;
3. sleep incontinence;
4. cyclical abdominal pain;
5. Possible loosening of stools to a jelly-like thickness, sometimes with mucus;
6. insomnia, bad mood;
7. Women experience vaginal discharge, pain during sexual intercourse, itching of the genitals caused by tissue destruction, and wounds on them.

General information about prevention

The main factor in preventing diseases (especially in children) associated with parasites is, first of all, prevention! It consists not only in observing the rules of personal hygiene, but also in informing parents, children and other citizens about ways to prevent infection, routes of transmission of pathogens, the consequences of diseases and methods of treatment. To do this, you should use all possible media, from personal conversations and lectures to television, radio, interactive programs and the Internet. The following recommendations should also be taken into account:

• Wash your hands with warm water and soap after using the toilet. Be especially careful after bowel movements and diaper changes. Do the same before preparing food and eating. This is the BEST preventative measure.
• Keep your nails dry and clean.
• Avoid the habit of chewing your feet or opening old wounds or scratches, which can spread pinworm eggs.
• Shower daily in the morning to remove any pinworm eggs that may have been laid overnight.
• Change your underwear and clothes daily.
• Wash items in hot water in the washing machine to remove bedding, clothing and towels that contain pinworm eggs.
• The room should be well lit throughout the day because the eggs are sensitive to sunlight.

Currently, the number of diseases associated with pinworm (and other parasite) infections has decreased significantly, but periodic outbreaks still occur. They are associated primarily with non-compliance with basic hygiene standards. Eliminating these shortcomings and carrying out systematic preventive work, especially in children's educational institutions, will reduce the incidence of parasites even further.

How long do eggs live in the external environment?

Pinworm eggs can live outside the human body for about 30 days. But for their life to continue, certain conditions are needed: humidity should be 70%, and the temperature for convenience should be from 22 to 40 degrees.

Any violation of temperature and humidity can lead to the death of parasites. That is why it is advised to carefully iron bedding and underwear, and it is advisable to iron carpet paths along which infected pets and small children can run.

When identifying the disease, doctors strongly recommend disinfecting all toys or simply taking them out into the cold for a long time, where the offspring of helminths die.