Oxyuriasis, what it is and how to cure it

According to the Center for Disease Control and Prevention, between 11 and 20 percent of children between the ages of 5 and 10 have pinworm problems, more commonly called “worms.” It is an intestinal parasitic infection triggered by Enterobius vermicularis, the parasite responsible for the annoying symptoms of this infection.

“Intestinal parasites mainly affect children who, sometimes at home or more often in kindergarten or school, neglect the basic rules of hygiene, such as washing hands before eating and after going to the bathroom”, intervenes Susanna Esposito, Full Professor of Pediatrics at the University of Parma and President of WAidid, World Association for Infectious Diseases and Immunological Disorders. “But in addition to the lack of hygiene, the other risk factors not to be underestimated are undercooked or raw foods, especially meats, or those not washed properly as often happens with fruits and vegetables. The high contagiousness of pinworms, then, also compromises the health of the parents. For this reason, following some precise precautions is essential for the prevention of this infection and to avoid contagion once a subject within the family, or in any case of a group, has been infested”. When the eggs are ingested or inhaled, they reach the intestine, hatch and give rise to pinhaluses which in turn deposit eggs at the perianal level.

The path of pinworms

The onset of symptoms is not as rapid as you might think. On the contrary, they can spend about 1-2 months. After ingestion, in fact, the eggs descend through the digestive tract to the small intestine, where they find the ideal “nest” to reach maturity and hatch. The larvae of newborn pinworms remain in the area until development, and then move to the large intestine. Here, they become adults and begin to reproduce through fertilization by males of eggs deposited by females. At the end of this “task”, males who have a life cycle of about seven weeks, die and are eliminated through feces. The females, on the other hand, which live in the colon for about 5-13 weeks, settle well adhered to the intestinal mucosa and use the food residues that arrive in the large intestine to favor the development of the eggs. Once ready, the females move towards the area and deposit the eggs in the skin folds: each female deposits between 11 and 18 thousand. Having achieved their purpose, the females die, and the eggs begin to become pests. And here is the beginning of the symptoms.

Beware of disturbances

The main symptom is intense itching caused by eggs, which is present especially during the night hours. This triggers an extremely harmful spiral: the child rubs and the eggs are transferred to clothing, sheets and hands, starting the contagion of the family.

The child may also suffer from other disorders such as abdominal pain, diarrhea and restlessness, while the state of inflammation in the intimate areas can also extend to the urinary tract and cause nocturnal enuresis. In the most acute cases, anemia and vitamin B12 deficiency may also appear. Finally, in girls, pinworm larvae can reach the intimate parts causing vaginitis.

What to do

It is forbidden to waste time. In case of intense itching, therefore, it is good to inspect the and perianal area of the child, in the morning upon waking. This is because in the early hours of the morning it is possible to detect the presence of small white filaments in motion: they are the females of pinworms that during the night, when the body is at rest, lay eggs. It is precisely the movements made by pinworm females that cause itching. It is also necessary to inspect feces and underwear. “The presence of the infection is confirmed with the scotch test,” adds Susanna Esposito. “It is an investigation that is carried out by applying adhesive tape on the area, because in this way it is possible to collect the eggs.” In practice, a piece of adhesive tape, about two centimeters long, should be applied for a few seconds in the area of the child. By removing it, the eggs remain attached to the adhesive. The tape should then be placed on a slide and hermetically sealed in a bag, following the instructions of the pediatrician or the analysis laboratory. To be sure of the presence of the infection, the sample should be performed three times, on three separate days, always in the morning upon waking. The procedure must be performed wearing surgical mask and gloves and both must be thrown away at the end. The slide is then analyzed under a microscope in the laboratory for definitive diagnosis.

The cure

Pinworms can be eradicated well, but it takes patience. The cure involves the administration of specific drugs that are able to eliminate parasites in their vital form. They have no effect on eggs. For this reason, the therapy involves two cycles: the first at diagnosis and the second two weeks apart. It is then necessary that the child wear cotton underwear so as not to further increase the state of irritation and inflammation and apply an ad hoc ointment in the and perianal area that helps relieve itching. It is also essential to keep the situation under control with regular checks, because pinworm infection can recur. It happens, for example, when the second dose of the drug is taken late, or if the infection has been contracted by several people in the same household. Absolutely to avoid instead the so-called “grandmother’s remedies”. In fact, the risk is to waste time, to worsen the state of the child and increase the danger that the infection will also spread to other people.

Attention to hygiene

Pinworm infection is highly contagious. To keep away the risk that it spreads to the rest of the family, therefore, it is advisable that everything, including underwear and clothing of the child, are washed separately and at least 60 ° C, adding to the normal detergent also a sanitizing product. Yes also to regularly sanitize sanitary ware, counters and kitchen tables with special detergents and wash your hands often with hot water and Marseille soap. Maximum control also over the child, to prevent him from bringing the toys close to his mouth. As a matter of prudence, however, it is always better to wash all your toys with a sanitizer.

In case of pinworms, it is essential to notify the school, so that the same rules are adopted in the classroom and within families.

Prevention

Of course, the child should be taught that he should not bring his hands to his mouth, especially when playing or is in kindergarten or school, but it is not an easy advice to put into practice. For this, it is important to “raise your guard” regarding daily behaviors and follow the rules of WAidid. First of all, it is necessary to wash your hands thoroughly before handling food and during its preparation, especially if it is different foods. Before their consumption, moreover, fruits and vegetables should be washed well and it is advisable to avoid consuming undercooked meats or raw fish. Also pay attention to storage: food should not be left out of the fridge for more than two hours. Yes also to educate children to wash their hands often and always before sitting at the table and after being in the bathroom.

Hygiene is also important. Children must be taught proper intimate hygiene to be performed every morning, to take a shower once a day and not a bath and to change underwear every day. The family must also get into the habit of having personal towels and avoid the promiscuous use of personal items, such as toothbrush, but also nail files, since eggs can lurk under the nails.

Maximum hygiene also with regard to what everyone uses at home, such as the sink and toilet, for example, which must be disinfected daily.

The rules of hygiene must then become strict at school and kindergarten, where the risk of contagion becomes high. Children should make it a habit to never sit on the toilet and wash their hands carefully after being in the bathroom. The little ones should not bring their favorite soft toy, because it could turn into an instrument of contagion. When returning home, moreover, the child must be changed and the clothes must be washed.