Summary about Disease
Enterobiasis, also known as pinworm infection, is a common human parasitic disease caused by the pinworm Enterobius vermicularis. It is characterized by intense itching in the anal area, particularly at night. While generally not serious, it can be quite bothersome and lead to secondary skin infections.
Symptoms
Intense anal itching (pruritus ani): This is the most common symptom and is often worse at night when the female pinworm lays her eggs around the anus.
Difficulty sleeping: The itching can disrupt sleep.
Irritability: Sleep deprivation can lead to irritability.
Restlessness: A general feeling of being unable to relax.
Occasionally, abdominal pain or nausea: These are less common symptoms.
In females, vaginal itching or irritation: This occurs if pinworms migrate to the vaginal area.
Visible pinworms: Small, white, thread-like worms may be seen in the anal area, especially at night, or in stool.
Causes
Enterobiasis is caused by the ingestion of Enterobius vermicularis eggs. The eggs are typically transmitted via:
Fecal-oral route: This is the most common mode of transmission. Eggs are deposited around the anus, and scratching the area can transfer the eggs to the fingers. If the person then touches food, toys, or other objects, the eggs can be ingested by themselves or others.
Contaminated surfaces: Pinworm eggs can survive on surfaces like bedding, clothing, toilet seats, and toys for up to two weeks.
Airborne transmission: Although less common, eggs can occasionally become airborne, especially when shaking bedding or clothing.
Medicine Used
The most common medications used to treat enterobiasis are:
Mebendazole: A single dose, repeated in two weeks.
Pyrantel pamoate: A single dose, repeated in two weeks. Available over-the-counter in many countries.
Albendazole: A single dose, repeated in two weeks. It is important to treat all household members to prevent reinfection, even if they don't have symptoms. Consult a doctor before using these medications, especially for pregnant women and young children.
Is Communicable
Yes, enterobiasis is highly communicable. It spreads easily through the fecal-oral route, especially in environments where people are in close contact, such as households, schools, and daycare centers.
Precautions
Wash hands frequently: Wash hands thoroughly with soap and water, especially after using the toilet, before eating, and after changing diapers.
Keep fingernails short and clean: This reduces the chance of eggs getting trapped under the nails.
Avoid scratching the anal area: This helps prevent the spread of eggs.
Shower or bathe daily: This helps to remove eggs from the skin.
Change underwear and bedding daily: Wash them in hot water and dry them in a hot dryer to kill any eggs.
Clean and disinfect surfaces: Regularly clean and disinfect surfaces that may be contaminated with eggs, such as toilet seats, countertops, and toys.
Wash fruits and vegetables: Wash thoroughly before consumption.
Avoid nail-biting and thumb-sucking: These habits can facilitate the ingestion of eggs.
How long does an outbreak last?
Without treatment and proper hygiene measures, an enterobiasis infection can persist for weeks, months, or even years due to continuous reinfection. With treatment, the initial infection can be cleared in a few days, but recurrence is common if preventative measures are not followed diligently. Therefore, an "outbreak" in a household or group setting can last until all individuals are treated and hygiene practices are improved.
How is it diagnosed?
The most common diagnostic method is the "tape test." This involves using a piece of clear cellophane tape to collect eggs from around the anus, ideally first thing in the morning before showering or using the toilet. The tape is then placed on a microscope slide and examined for pinworm eggs. This test may need to be repeated several times on consecutive days to increase the chances of detection. Visual inspection of the anal area, particularly at night, may also reveal adult pinworms. Stool samples are not typically used for diagnosis as eggs are rarely found in feces.
Timeline of Symptoms
Initial Infection: After ingestion of eggs, it takes approximately 2-6 weeks for the larvae to mature into adult worms in the intestines.
Early Symptoms: The primary symptom, anal itching, typically begins after the female worms migrate to the anus to lay eggs. This usually occurs at night.
Progression: If left untreated, the itching may become more intense and frequent. Secondary skin infections may develop due to scratching.
Resolution with Treatment: After taking medication, the worms are typically killed within a few days, and the itching should subside. However, symptoms may return if reinfection occurs.
Important Considerations
Treatment of entire household: To prevent reinfection, all members of the household should be treated simultaneously, even if they are asymptomatic.
Hygiene is key: Medication alone is not enough. Strict adherence to hygiene practices is crucial to prevent reinfection and control the spread of pinworms.
Consult a doctor: It is important to consult a doctor for diagnosis and treatment, especially for pregnant women, young children, and individuals with underlying health conditions.
Recurrence is common: Even with treatment, recurrence is common if hygiene practices are not consistently followed.
Enterobiasis is not dangerous but uncomfortable: While the infection is not life-threatening, the intense itching can significantly impact quality of life.