Pinworms

Pinworms are white, parasitic worms that can live in the large intestine of humans. The adult female is 8 to 13 millimeters long, and 0.5 millimeter thick. The adult male is considerably smaller, measuring 2 to 5 millimeters long and 0.2 millimeter thick. While the infected person sleeps, female pinworms leave the intestinal tract and lay their eggs on the skin around the anus. The eggs are laid in a sticky, jelly-like substance that, along with the wriggling of the female pinworm, causes severe itching.

Pinworm is the most common worm infection in the United States. School-age children, followed by preschoolers, have the highest rates of infection. Cases of pinworm infection are seen most often at schools, daycare centers and other institutional settings.

The pinworm has a worldwide distribution and is the most common helminth (i.e., parasitic worm) infection in the United States and Western Europe. In the United States, a study by the Center of Disease Control reported an overall incidence rate of 11.4% among people of all ages. Pinworms are particularly common in children, with prevalence rates in this age group having been reported as high as 61% in India, 50% in England, 39% in Thailand, 37% in Sweden, and 29% in Denmark. Finger sucking has been shown to increase both incidence and relapse rates, and nail biting has been similarly associated. Because it spreads from host to host through contamination, pinworms are common among people living in close contact, and tends to occur in all people within a household.

The life cycle begins with eggs being ingested making their way through the intestinal tract usually without any symptoms. They emerge from the anus, and while moving on the skin near the anus, the female pinworms deposit eggs either through contracting and expelling the eggs, dying and then disintegrating, or bodily rupture due to the host scratching the worm. After depositing the eggs, the female becomes opaque and dies. The reason the female emerges from the anus is to obtain the oxygen necessary for the maturation of the eggs.

Pinworm infection may cause:
Itching around the anal area, difficulty sleeping and irritability.
If it is a severe infection, symptoms may include:
nervousness
restlessness
loss of appetite
weight loss
girls may experience vaginal itching and irritation (vaginitis), if pinworms are near the vagina.

Often, someone can have a pinworm infection without having any symptoms. When symptoms are present, the most common one is itching around the rectum and restless sleep. The itching is usually worse at night and is caused by worms migrating to the area around the rectum to lay their eggs.
If your child has a pinworm infection, you can see worms in the anal region, especially if you look about 2 or 3 hours after your child has fallen asleep. You might also see the worms in the toilet after he or she goes to the bathroom. They look like tiny pieces of white thread and are really small — about as long as a staple. You might also see them on your child's underwear in the morning.

Finding the female worm or the eggs confirms the diagnosis of pinworms. To find a female worm:
At night, the adult worms can sometimes be seen directly around the anal area or in pajamas. The worm (one-quarter to one-half inch long) is clearly visible to the naked eye. Finding a worm confirms the diagnosis.
If adult worms are not visible, conduct a tape test in the morning. Apply a piece of transparent tape against the folds of skin around the anus to pick up any eggs or worms. Seal in a plastic bag.
Take the tape to a health care provider. The eggs and worms caught on the tape can be identified under a microscope.
Pinworms are rarely spotted in stool samples. Because bathing or a bowel movement can remove the eggs, the tape test should be done as soon as the person wakes up in the morning.

Although hygiene plays a role, herbal parasite protocol is the chief treatment. If one household member spreads the eggs to another, it will be a matter of two or three weeks before those eggs become adult worms and thus amenable to treatment.

Regardless of the treatment used, reinfection is frequent. Asymptomatic infections, often in small children, can serve as reservoirs of infection, and therefore the entire household should be treated regardless of whether or not symptoms are present. Total elimination of the parasite in a household may require repeated doses of herbs for up to a year.

First: Treat the infected person/any infected family members
1. The infected person should take the herbs
2. Bathe first thing in the morning to reduce egg contamination.
3. Wash hands and under the fingernails thoroughly, after using the bathroom, before eating, and after changing diapers.
4. Discourage nail biting and scratching bare anal areas to avoid re-infection.
5. Keep fingernails trimmed very short.
6. Infection often occurs in more than one family member. Treat all infected family members at the same time.
Than: Treat the household
1. Change and wash underwear and pajamas in hot water daily.
2. Machine-wash sheets, blankets, towels, and clothing in hot water to destroy eggs. Machine-dry at high temperature.
3. Eggs are sensitive to sunlight, so open blinds in bedrooms in the daytime.
4. Since pinworm eggs are light and scatter easily, dust should be removed carefully from all surfaces in the home. Careful vacuuming, or the use of an oiled cloth (which may be boiled or destroyed later), will help prevent the eggs from scattering.

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Pinworms spread through human-to-human transmission, by ingesting (i.e., swallowing) infectious pinworm eggs. The eggs are hardy and can remain viable (i.e., infectious) in a moist environment for up to three weeks. They do not tolerate heat well, but can survive in low temperatures: two-thirds of the eggs are still viable after 18 hours at −8 degrees Celsius (18 °F).

The surface of the eggs is sticky when laid, and the eggs are readily transmitted from their initial deposit near the anus. They are spread when an infected person, most often a child, has scratched his/her bare anal area and the eggs get under his/her fingernails. Pinworms can then be spread in the following ways:
By an infected child not washing hands after using the bathroom. If the child then touches playmates or play toys, he/she may pass on the eggs.
Pinworm eggs can also be transferred to the fingers from clothing or bedding, and then spread around the home.
Eggs may be inhaled from the air or deposited onto food and swallowed.
Dust containing eggs can become airborne and widely dispersed when dislodged from surfaces, for instance when shaking out bed clothes and linen. Pinworms can survive up to two weeks on clothing, bedding or other objects, if kept at room temperature.
Household pets often carry the eggs in their fur, while not actually being infected.

To prevent infection:

• Wash hands and under fingernails frequently.
• Encourage children to avoid scratching their bare anal areas.
• Bathe daily.
• Change and wash clothing and bedding frequently.
• Wash pajamas every few days.
• Keep fingernails short and clean.