It can be quite horrifying for a parent when their perfect little child tells them they have an itchy bottom and you realize they have worms. Suddenly its panic stations and everyone feels itchy. There is really no need to panic, some worms in children can be a common occurrence.
Helminths (meaning worms) are multicellular organisms with complex tissues and organs. There are several classes of worms, but the ones most common in humans are:
- nematodes (roundworms, hookworms and thread worms)
- platyhelminths (flatworms) - this group includes:
- trematodes (flukes)
- cestodes (tapeworms)
Threadworm (Enterobius vermicularis) is the most common worm to infect people living in Australia.
Intestinal Human Nematodes
Threadworm (Enterobius vermicularis)
Threadworms, also called pinworms, are about 13mm long and look like pieces of white thread. They are very common worldwide, especially in children, as they are easily transmitted from human to human. The eggs can survive for weeks and can be transferred from infected house hold products, toys and human contact.
Eggs are transferred by the hands to the mouth and after the ova are swallowed, maturity takes place in the small intestine, with adult worms mainly found in the colon. The adult female lays ova around the anus generally at night, which can cause intense anal itching – scratching can transfer eggs to fingers and from there to mouth causing reinfestation, or to other objects and bed linen etcetera. Adult worms can often be seen moving around the anus, female genitals and buttocks.
Signs and Symptoms
- Itchy bottom – may be red and irritated
- Itchy vulva/vagina in girls
- Feeling out-of-sorts
- Reduced appetite
- Sleep disturbance
Other helminths not so common include:
Hookworm (Ancylostomiasis)
These cause diseases living in the human gut. The hookworm, which come from the soil as larvae, penetrate the body and lay their eggs in the intestine, where its life cycle continues. Environmental warmth and humidity are needed for hookworm survival and in the right conditions they can survive for several weeks. Coming into contact with wet soil which is contaminated with the larvae will enable the larvae to enter through unbroken skin. This is most common in areas of poor sanitation where faeces have been found on the ground. It is important to wear protective foot wear and clothing in suspect areas to avoid contamination from the soil.
People in the tropical parts of northern Australia who walk around in contaminated wet places without shoes are very likely to become infected.
Signs and symptoms
Localised rash and itching are often the first sign of infection or there may be no symptoms of light infection but for more heavier infection symptoms of abdominal pain, diarrhea, loss of appetite, weight loss, fatigue and anemia are seen.
Roundworm (Ascaris lumbricoides)
These can be 20 -35 cm long and infect humans through contaminated food or soil containing mature ova.
The larvae hatch in the duodenum of the human intestine after ingesting. They migrate through the lungs, climb the bronchiole tree, are swallowed and mature in the small intestine.
The journey can cause some general and local reactions such as pneumonitis (inflammation of the lung tissue, eosinophilic granulomas, bronchial asthma and urticaria (itching). Intestinal roundworm can cause occasional stomach pain to much more serious malnutrition.
Roundworms are found in northern parts of Australia and tropical countries. Strongyloides stercoralis is a roundworm which causes a life-threatening disease called Strongyloidiasis.
Dwarf tapeworm
According to the Australian Govenment Department of Heath, dwarf tapeworm is the most common human tapeworm in Australia. Infestation occurs from hand to mouth contamination from contact with faeces containing egg, or from ingesting food, water or swallowing an insect containing the tapeworm egg. The parasite infects the stomach and intestine and can cause:
- diarrhoea
- stomach pain
- weight loss
- weakness
Your doctor will advice the medication needed for the eradication of tape worm.
An interesting fact
For the other side, surprisingly, having intestinal worms could have a positive effect on our health. Having intestinal worms may be normal and could live in us with out changing the status of our over-all health. The clever way they can remain undetected in our tissues has peeked investitive interest in what other positive actions we can learn from them and how they may be helping us. There is interest in using helminths to treat inflammatory human diseases due to their ability to activate immunoregulatory circuits and control immunity.
Eraditcation and preventative measures
Management of infestation
If using pharmaceutical medications, follow instructions. Treatment will often need to be repeated in 2 weeks is often recommended to control reinfestation. If infection is reoccurring in a family, all members should be treated and bed clothes, linen and toys that may have eggs on them, should be washed in hot water. Vacuuming can help remove eggs from floor, and be sure food that has fallen onto floor is thrown away. Encourage good hygiene habits washing hands regularly after toilet use and before eating, change underwear daily and trim fingernails.
Things to Remember
- Threadworms are common and easily spread
- Avoid scratching the irritation to reduce the chance of spreading infection
- Treat all members of the household, wash bedding, bed clothes and toys
- Clip fingernails short
- Wash hands regularly
- Keep household surfaces clean
- Do not eat food off the floor
- Where foot wear when outside
- Avoid areas of open sewerage
Over-the counter medication for the eradication of threadworm, round worm and hook worm and is often the easiest method for elimination, but as some intestinal parasites can become resistant to these medications or if you are looking for a natural herbal alternative there are some available.
Natural alternatives
- Wormwood leaf (Artemisia annua) kills and expels intestinal worms and parasites and is indicated by the British Herbal Pharmacopoeia for nematode infestation.
- Black walnut (Juglans nigra) is strongly indicated for intestinal parasites.
- Berberis bark/ barberry (berberis vulgaris) wormwood, barberry and black walnut have been used traditionally for eliminating parasites
- Oregon grape (Berberis aquifolium)
- Hydrastis root (hydrastis canandensis)
- Garlic (Allium sativum), including garlic in the diet may help with balancing gut flora and keep intestinal worms at bay
- Pomegranate fruit peel (Punica granatum)
- Nigella seed dry (Nigella sativa)
- Myrrh gum (Commiphora myrrh)
- Grapefruit seed (Citrus x paradisi)
Herbal medicine may reduce the load and help with the expulsion of intestinal worms from the body. When using herbs or pharmacy medications it is suggested to increase fibre intake to aid in the elimination.
Consultation with an Herbalist or Naturopath is recommended if using herbal medicine for parasitic infections. Many of the herbs used to treat intestinal parasites have toxic side effects that may interfere with medication.
Support the digestive tract with probiotics, vitamin c and zinc as a follow-up after eraditacation. If there is digestive inflammation, chamomile, slippery elm or aloe vera may help.
References
- Boon, Nicholas; Colledge, Nicki R and Walker, Brian R. 2006, Davidson’s Principals and Practices of Medicine 20th edition, Churchill Livingstone Elsevier
- https://www.mayoclinic.org/diseases-conditions/pneumonitis/symptoms-causes/syc-20352623
- https://www.healthdirect.gov.au/threadworms-pinworms
- https://www.rch.org.au/kidsinfo/fact_sheets/threadworms/
- https://www.abc.net.au/news/health/2018-02-09/intestinal-worms-parasites-how-worried-should-you-be/9404130
- http://www.health.gov.au/internet/publications/publishing.nsf/Content/ohp-enhealth-manual-atsi-cnt-l~ohp-enhealth-manual-atsi-cnt-l-ch1~ohp-enhealth-manual-atsi-cnt-l-ch1.5
- https://www.ppcherbs.com.au/herbal-medicines/medical-conditions/intestinal-worms/
- Fisher, Carole; 2009, MATERIA MEDICA OF WESTERN HERBS, Vitex Medica, New Zealand.
- Helminth Immunomodulation in Autoimmune Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5401880/
- Helminth-based therapies for rheumatoid arthritis: A systematic review and meta-analysis. https://www.ncbi.nlm.nih.gov/pubmed/30529501
- Effects of dietary intake of garlic on intestinal trematodes. https://www.ncbi.nlm.nih.gov/pubmed/28536879
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