Nematode infection can be promoted by a lack of hygienic measures. Appropriate measures are important in nematode control.
What is nematode infection?
So-called nematodes (threadworms) can cause nematode infection in humans. There are several types of nematodes; the nematodes that most commonly cause nematode infection worldwide include roundworm and pinworm. The roundworm is predominantly found in areas of Africa, East Asia and Latin America. Although parasites such as nematodes are partly responsible for most infectious diseases in humans worldwide, the number of people affected by nematode infections caused by roundworms has been decreasing in Central Europe since the mid-1950s. Symptoms that can be caused by nematode infection differ depending on the type of nematodes responsible for nematode infection. If a threadworm infection is caused by pinworms, itching may occur in the anal region due to deposited worm eggs. If a threadworm infection is caused by roundworms, for example, abdominal pain and diarrhea, but also shortness of breath may occur.
Causes
Depending on the type of nematodes involved, the causes of threadworm infection differ: threadworm infection by pinworms usually occurs through a so-called smear or dirt infection from one person to another. Since pinworms live in the large intestine of infected persons and lay their eggs there, worm eggs of the nematodes can get on the hands when scratching the anus. Worm eggs are also frequently found in the feces of people infected with threadworms. For example, shaking hands can transmit eggs of the nematodes, which can lead to nematode infection. Nematode infection from roundworms usually occurs due to ingestion of the worm eggs through unclean vegetables; worm eggs from the nematodes, for example, can get onto vegetables through fecal manure. Larvae of the nematodes ingested with food or larvae that develop from ingested eggs enter an affected person’s bloodstream through the intestines, leading to nematode infection.
Symptoms, complaints, and signs
Symptoms do not automatically occur with every nematode infection. Thus, the symptoms also depend on how many worms the affected person has been attacked by. The type of nematode and where it lodges in the body also play a significant role. Different symptoms are caused, for example, by roundworms that pass through the human organism. If they reach the lungs, this can result in coughing or fever. If they penetrate as far as the intestines, nausea or abdominal pain is common. In rare cases, roundworms block the bile duct or pancreatic duct, which in turn can lead to inflammation of the pancreas or bile stasis. Furthermore, roundworm infestation can cause severe symptoms such as cramps, appendicitis, intestinal obstruction or shock. If an infection with whipworms occurs, bleeding in the intestinal mucosa as well as anemia are considered signs of the infestation. If the worm infestation is severe, symptoms often include indigestion, diarrhea, abdominal pain, and inflammation of the colon. If the absorption of nutrients through the intestine is restricted in children, they are at risk of growth disorders. Signs of filarial infection include inflammation and swelling of the lymph nodes, severe swelling of the legs, itching, eye problems, skin nodules, and fevers. Threadworm infections with trichinae can be worrisome. Thus, these are often responsible for chills, high fever, severe muscle pain, skin rash, and edema of the eyes.
Diagnosis and course
If an affected person has symptoms that suggest a nematode infection, an attending physician will usually first ask about a patient’s medical history. The diagnosis of nematode nematode infection can then usually be made by microscopic stool examination, which can detect worm eggs. Another way to diagnose nematode infection is to swab the anal skin (this is where nematodes lay their eggs). With the help of X-rays or mirror examinations, larvae or adult nematodes may already be detected in the case of nematode infection.With appropriate medical treatment, a nematode infection can usually be successfully controlled. Complications from nematodes can occur, for example, when multiple adult worms cause intestinal obstruction or restrict the drainage of bile.
Complications
If a doctor is consulted quickly for a threadworm infection and adequate treatment is initiated, the infection usually heals without further complications. In rare cases, however, it can lead to further problems. One danger is that the threadworms can be transmitted to other people through an anal-oral route and make them ill. If not treated promptly, infection can cause massive discomfort in the digestive tract. Nausea, vomiting, colic, general malaise, weight loss and inflammation are possible consequences. In the worst case, several adult worms join together and close the intestine. A so-called ileus is the result. As a result, the intestine can rupture and the intestinal contents spread throughout the body. This condition is very critical and must be treated immediately. It can be fatal. Blockage of the intestine can also lead to serious inflammation of the peritoneum. Furthermore, blood poisoning and life-threatening shock cannot be ruled out. Possible complications may also arise due to obstruction of bile ducts. In this case, the bile can only drain inadequately, which can lead to further problems. The resulting congestion of bile can, among other things, severely damage the liver. This organ is subsequently limited in its function.
When should you go to the doctor?
If worm eggs or worm components are noticed in the stool, a doctor should be consulted immediately. A visit to the doctor is particularly urgent if bleeding from the intestine occurs, cramps and pain are added, or there is violent vomiting. Unusual stool changes, itching at the anus and other unusual symptoms also require medical clarification. If there is a yellowing of the skin and eyes, the threadworms may have already attacked the liver – at the latest then professional advice is needed. It is best to examine the whole family directly and treat them if necessary, because otherwise a new infection can occur. In general, a threadworm infection cannot be treated by oneself, as effective medications are only available on prescription. Therefore, anyone who has a concrete suspicion or notices unusual complaints in the gastrointestinal area should talk to a general practitioner. Other contacts are the gastroenterologist or – in case of serious complications – the medical emergency service. With children, the elderly and the sick, the nearest hospital should be visited if a threadworm infection is suspected.
Treatment and therapy
To successfully treat a threadworm infection, it is important, among other things, to comply with various hygienic measures. For example, nematode infection usually requires therapeutic treatment of the anal skin of affected individuals, since the anal area is infested with the eggs of the nematodes. This control of the eggs of the nematodes is usually done with medicinal ointments or tinctures. How often this treatment step is necessary for an affected person depends primarily on the extent of the nematode infection. Experts recommend a control examination after successful therapy in order to avoid a recurring threadworm infection. In parallel with medical treatment of the anal skin in the case of threadworm infection, wearing tight-fitting underwear at night, for example, can contribute to the success of the therapy; possible scratching is thus reduced and eggs of the nematodes are not distributed on the skin. To kill distributed worm eggs of nematodes, for example, used towels and bed linen can be boiled.
Outlook and prognosis
Patients of nematode infection have a good prognosis. Nowadays, the pathogens can be treated well with the available medical options in a drug treatment. Normally, a marked improvement in symptoms is achieved within a few days of starting therapy, and freedom from symptoms occurs after 1-2 weeks. The patient suffers no consequential damage and can therefore be discharged from treatment as cured.The observance of additional tips and hints for self-help, triggers a shortening of the recovery time. In addition, the healing process is more efficient. Without the use of conventional medical treatment, the existing symptoms may spread. The state of health deteriorates and the well-being decreases. In the case of a mild infestation of worms, a person with good health can experience a cure without consulting a doctor. In patients with a stable immune system, the body’s own defenses are able to kill the parasites on their own. Then they are removed from the organism and excreted. Despite the good healing prospects, a new infestation of threadworms can occur at any time during the patient’s life. The prognosis is also optimistic in case of a repeated occurrence. It should be taken into account that nematode infection is a highly contagious disease. Good hygiene supports the healing process and reduces the risk of re-infection.
Prevention
Nematode infection can be prevented primarily by following hygienic measures: It is recommended to thoroughly clean raw vegetables and lettuce. Peeling vegetables to be eaten raw can also reduce the risk of nematode infection. To avoid person-to-person transmission of nematodes, experts also recommend regular hand washing (especially after using the toilet and before handling food).
Follow-up
In most cases of threadworm infection, the affected person has few options for aftercare. In this case, the patient is primarily dependent on early recognition and treatment of the symptoms by a physician to prevent further spread. In most cases, this results in a positive course of the disease and not in a reduced life expectancy of the affected person. In case of threadworm infection, it is recommended to wash all worn clothing and also bed linen or towels at a high temperature to kill the worms completely. This procedure should be done immediately after diagnosis to prevent the worms from spreading. Treatment of threadworm infection is usually done with the help of medications or by applying creams or ointments. The patient should pay attention to the correct dosage and also to the regular and, above all, correct intake of the medication. If anything is unclear, a doctor should always be consulted or contacted. After about two weeks, the symptoms of the threadworm infection disappear and there are no further complications. Further measures of aftercare are usually not necessary in this case.
What you can do yourself
If an infection with threadworms occurs, there are a number of things the patient can do himself to prevent infecting other people or re-infecting them. First and foremost, this includes consistent hygienic measures. Regular hand washing after visiting the toilet plays an important role in threadworm infection. In addition, it is essential to clean hands thoroughly before eating. The anal area must also be cleaned consistently, with the patient rinsing it with water. In doing so, each washcloth must be used only once. For this purpose, disposable washcloths or disposable towels, which can also be made of paper, are recommended. To prevent the threadworm eggs from getting into the patient’s bed, the patient should also wear well-fitting underwear at night and while sleeping. Nightwear, like towels, can be cleaned in the washing machine on the boil cycle after use. Likewise, the sleeping quarters should be subjected to a thorough cleaning. It is also important to cut the fingernails. It is recommended to keep them as short as possible. If the infected person has a family, they must also be treated for the threadworm infection. Otherwise, there is a risk of re-infection. For the therapy to be fully effective, it is essential that the patient conscientiously takes the medication prescribed by the doctor until the end of the treatment.
