Pinworm infestation is a parasite infestation that rarely causes serious health problems. However, the re-infection rate is very high, so treatment is important.
What are pinworms?
The pinworm is a human parasite. This means that it almost exclusively affects humans (in exceptional cases, primates such as great apes can also be affected by pinworms). In humans, pinworms mostly affect children, but adults are also at high risk of infection. It is estimated that half of all children will exhibit a pinworm infestation at least once during their lifetime. In technical language, a pinworm infestation is also called oxyuriosis. In humans, pinworms settle in the large and small intestines. A pinworm infestation often causes severe itching in the area of the anus. The itching is particularly pronounced at night. In other cases, however, the pinworm infestation remains asymptomatic and thus often undetected. In the case of a pinworm infestation, the colony of pinworms that settles in the intestine can comprise several hundred parasites.
Causes
Infestation with pinworms can occur, for example, through contact with infected people. The pinworm can also be transmitted through contact with excrement. Infection usually occurs through ingestion of pinworm eggs, which develop into larvae that eventually settle in the intestine. A pinworm infestation can also result from contact with clothing or toys of infected people, as the pinworm eggs can survive here for several weeks. Other possible causes of a pinworm infestation can be eating fish or meat that has not been cooked sufficiently or eating wild berries or mushrooms that have not been washed. Finally, pinworm infestation can also be caused by consuming fruits, vegetables or lettuce that have been fertilized with feces.
Symptoms, complaints and signs
Pinworms do not initially cause any definite symptoms or discomfort. When the worms are shed, an uncomfortable itching may occur in the area of the anus, often associated with burning pain or problems with bowel movements. The itching may in turn cause secondary symptoms such as sleep disturbances, irritability and nervousness. Externally, the increasing exhaustion is manifested by pallor of the skin and dark circles under the eyes. The pinworms themselves can lay eggs, causing chronic [[Gastrointestinal disorders|Gastrointestinal disorders, hemorrhoids and other health problems. In the long term, a massive worm infestation can lead to chronic diarrhea, rectal bleeding, or signs of appendicitis. Accompanying this may be weight loss and deficiency symptoms. If pinworms are not treated, well-being continues to decline and symptoms increase in intensity. In the worst case, an infestation causes a chronic disease of the gastrointestinal tract. Symptoms of pinworm infestation usually become noticeable after one to two days. The laid eggs cause further symptoms after a few hours to days. With early and comprehensive treatment, the symptoms weaken after a few days and eventually subside. Late effects do not usually occur with an infestation of pinworms.
Diagnosis and course
Only very rarely does a pinworm infestation lead to serious health problems in an affected person. However, in the case of an infestation with pinworms, the risk of re-infection is very high: female pinworms leave the rectum during a pinworm infestation, preferably at night, to lay their eggs around the area of the anus. These eggs are ready for infection after only a few hours. A suspected diagnosis of pinworm infestation may initially be made on the basis of the typical severe itching in the anus area. This diagnosis can be confirmed, for example, by finding dead female pinworms on bedclothes or pajamas. These pinworms can be seen with the naked eye. In the case of a pinworm infestation, the eggs of the pinworms can be detected under the microscope with the help of a swab in the area of the anus.
Complications
As a rule, pinworms are not a serious disease. In most cases, it can be treated again relatively easily and quickly, so there are no particular complications in the process.However, the symptoms of this disease are very unpleasant and can lead to psychological discomfort or inferiority complexes. Especially after successful treatment, the pinworms can also reappear. The affected persons themselves suffer from a very unpleasant itching in the anus. White worms are also visible in the stool. Not infrequently, patients feel ashamed of this complaint. As a rule, the diagnosis can be made very quickly, so that an early and rapid treatment of this complaint is also possible. In most cases, the treatment of pinworms is done with the help of medications. These can kill the pinworms, so that the symptoms disappear relatively quickly. However, those affected are dependent on increased hygiene so that this complaint does not reoccur. Life expectancy is not reduced by this disease. Likewise, pinworms can also be transmitted to other people.
When should you go to the doctor?
If irregularities and abnormalities occur repeatedly when going to the toilet, a visit to the doctor is advisable. If there is itching, an uncomfortable feeling in the area of the anus or irritability, a doctor should be consulted. If open wounds occur, sterile wound care is required. If this cannot be adequately provided by the affected person, a doctor should be consulted, otherwise sepsis may occur. If there is blood in the stool or rectal bleeding, a doctor should clarify the symptoms. If there is a decrease in weight, diffuse deficiency symptoms or a general feeling of malaise, a visit to the doctor is advisable. A change in the appearance of the skin, a pallor of the skin or the formation of rings around the eyes are indications of a disease that needs to be investigated and treated. Signs such as sensory disturbances, a burning sensation of the skin or problems with bowel movements should be discussed with a doctor. If there is diarrhea, a feeling of faintness, fatigue and sleep disturbances, health complaints are present that should be examined more closely by a physician. If the affected person shows unusual behavioral abnormalities, increased nervousness or inner restlessness, a visit to the doctor is necessary. The formation of hemorrhoids and a chronic development of existing complaints are reasons for consulting a doctor.
Treatment and therapy
To treat an infestation of pinworms, a combination of medicinal and non-medicinal measures is usually required. A suitable drug treatment for pinworm infestation is often the use of a vermifuge, which is available in pharmacies, for example. In the case of pinworm infestation, the vermifuge helps to kill the pinworms or at least stop their ability to lay eggs. It is usually important that such treatment of pinworm infestation also involves the people who share a household with the infected person. Often, if a pinworm infestation is present, another worming treatment is recommended a few weeks after treatment to kill any worms that are still alive or have newly emerged. The use of a worming agent may be unsuitable for pregnant women, for example. Since a worming agent can kill the pinworms but not their eggs, it is important to observe strict hygiene measures in addition to drug treatment for a pinworm infestation: For example, bed linen and underwear should be boiled regularly. It is also advisable to clean your hands very thoroughly and to keep your fingernails short in order to remove any worm eggs that may have adhered to them. Of course, you should not put your fingers in your mouth when you have a worm infestation, because scratching your bottom often leaves pinworm eggs under your fingernails. The cycle of infection otherwise begins again from the beginning.
Outlook and prognosis
The prognosis for pinworms is generally favorable. It is not a disease that has serious or severe health consequences. Nevertheless, medical care should be sought for a cure. The affected person needs a vermifuge so that the germs can die and be transported out of the organism. Otherwise, the pinworms remain in the human body and can multiply there unhindered. The overall state of health is reduced, but in most cases no further impairments occur. Despite having achieved freedom from symptoms, the rate of re-infestation with pinworms is very high. If the affected person has been infected once, he or she belongs to the risk group for re-infection.Although the prognosis is favorable even if pinworms are present again, attention should still be paid to their further development. Contact with feces should be avoided and the consumption of food should be more strictly controlled. Fruits and vegetables should never be eaten raw. It is advisable that food be well washed or adequately cooked before it enters the mouth. Otherwise, new pinworms may develop quickly. Consumption of raw meat should not take place under any circumstances. Pregnant women in particular should pay increased attention to their food intake.
Prevention
In order to prevent a pinworm infestation, regular, thorough cleaning of the hands is particularly important. Fingers and hands should, as already mentioned, not be put in the mouth. Particular care should be taken with children to ensure that they do not suck their thumbs or nibble their fingernails. Other potential sources of infection should also be avoided: For example, fruit, vegetables and lettuce should be washed before eating, and meat or fish should be eaten thoroughly cooked. So the most important thing to prevent pinworms is to avoid contact of unwashed hands with the mouth.
Aftercare
Since pinworms are a relatively harmless and easily treated disease, it does not entail any special aftercare measures. Therefore, after the acute treatment phase, the focus is on thoroughly boiling the underwear to kill any remaining eggs. If the disease was of a more serious nature, any nutritional deficiencies and weight loss must be carefully compensated. For this purpose, a special diet is suitable, which gradually readjusts the body to the usual food intake and provides compensation for missing nutrients and vitamins.
What you can do yourself
An infection with pinworms is usually not dangerous, but highly unpleasant and annoying. Many affected people are also embarrassed by the disease. Nevertheless, a doctor should definitely be consulted promptly and the social close, especially people who live in the same household, should be informed, because pinworms are highly contagious. The affected person himself can best contribute to his recovery by observing strict hygiene. Female pinworms leave the intestine at night via the anus to lay their eggs. It is therefore extremely important to change pyjamas, underwear and bed linen regularly at short intervals and to wash them at at least 60 degrees. This measure should be observed by all members of a household as a precautionary measure. Since pinworms can also be transmitted through contact with clothing or toys of infected persons, utmost caution is required here. Often children, are the first family members to become infected. In this case, all toys must also be cleaned thoroughly on a regular basis. Soft toys and doll clothes should be washed to at least 60 degrees. For pets, provided that no primates are kept, there is no risk of infection. Medicines against pinworms are also available over-the-counter in pharmacies. Self-medication is therefore also possible for acute attacks on vacation or in other exceptional situations. Anyone traveling professionally or privately to regions with severely underdeveloped hygiene standards should add a worm cure to their first-aid kit as a precaution.
