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When it comes to itching in the buttocks, it might bring back the childhood shadows for many. In the 80s and 90s, due to limited hygiene conditions, many people had experiences of being infected by pinworms.
Now that conditions have improved, it should be less likely to be infected, right? In fact, if you look at social media platforms, pinworm infections are not uncommon even today.
As one of the most common intestinal parasitic infections globally, especially prevalent among children aged 5-10.
Pinworm infections, though not fatal, can cause significant itching and discomfort, thereby affecting children’s quality of life. If left untreated, pinworms can reproduce continuously, leading to repeated infections.
So, today we are going to discuss this condition, hoping to raise awareness among parents.
What is pinworm?
Pinworm is a small, white nematode with a slender, thread-like appearance,
primarily parasitic in the human intestine, particularly in the cecum and appendix.
Pinworms can infect individuals of any age, with infection occurring through fecal-oral transmission. Female pinworms travel through the rectum to the perianal skin to lay eggs at night, causing itching and discomfort. The infected person scratches the perianal area, which leads to the eggs hiding under the fingernails, and then, the contaminated hands transfer the eggs to the mouth, leading to self-infection.
Consuming food contaminated by hands or handling contaminated clothing and bedding can lead to person-to-person transmission. Additionally, the eggs can also be transmitted through air, inhalation, and ingestion.
Due to this mode of transmission, pinworms are commonly spread among family members and can easily infect children living in communal settings.
What are the symptoms of pinworm infection?
Most pinworm infections are asymptomatic.
The most common symptom of pinworm infection is perianal itching, which is an inflammatory reaction to the adult worms and eggs on the perianal skin, mainly occurring at night, thus potentially causing sleep disturbances such as restless sleep, difficulty falling asleep, and night waking. Chronic sleep disturbances may lead to daytime fatigue and inattention.
Additionally, scratching can lead to subsequent autoinfection and/or person-to-person transmission, and if the scratches are severe, it may also result in secondary bacterial infections. In rare cases, a high worm load may also cause gastrointestinal symptoms such as abdominal pain, nausea, and vomiting. Furthermore, it may also cause extraintestinal symptoms, such as vaginitis or urinary tract infections.
How to diagnose pinworm infection?
Suspect pinworm infection if there is nocturnal anal itching, especially in school-age children. Pinworm infection can be diagnosed by any of the following methods:
1. Direct observation method
Parents can check the child’s anal area and underwear at night or in the early morning, sometimes directly observing small white worms.
Female pinworms are about 8-13mm long and resemble broken threads. If found, they can be sent for examination to confirm the diagnosis.
2. Transparent tape method
Parents can use a piece of clear tape to press on the child’s perianal skin first thing in the morning ( before bathing ) , then stick the tape onto a microscope slide. Doctors can examine the tape under a microscope to see if there are pinworm eggs.
Since pinworms mainly lay eggs at night, the morning is the best time to collect samples, and sometimes it is necessary to repeat the test for three days to increase the detection rate.
3. Samples collected from under the fingernails can be used to check for pinworm eggs
Since the bodies and eggs of pinworms generally do not appear in the feces, fecal examinations are not meaningful.
How to treat pinworm infection?
Oral anthelmintics are the primary treatment for pinworm infections. Easily accessible medications in China include albendazole and mebendazole. The usage is as follows:
Dosage and Administration
Albendazole
Less than 2 years old: Take 200mg orally in a single dose; 2 years old and above: Take 400mg orally in a single dose.
Mebendazole
Take 100mg orally in a single dose.
Doctors may suggest taking the medication again after two weeks
, as the medication only kills adult worms and not the eggs. Taking the medication again after two weeks can kill newly hatched adult worms, preventing reinfection and improving the cure rate.
Both medications are only approved for children over 2 years old in China, but the World Health Organization recommends they can be used for children over 1 year old. Therefore, if children under 2 years old are infected with pinworms, it is recommended to discuss with a doctor and weigh the pros and cons before use.
For severe itching symptoms, doctors may recommend the use of topical anti-itch medications or antihistamines to alleviate discomfort.
Additionally, for patients diagnosed with pinworm infection, due to the high transmission rate among family members, it is recommended that the entire family be treated simultaneously ( regardless of whether other family members have symptoms ) .
In addition to medication, all bedding and clothing should be thoroughly washed to prevent reinfection. Showers are preferred over baths, as pinworm eggs can contaminate the water in the bathtub.
How to prevent pinworm infection?
Developing good hand hygiene habits and avoiding contact with pinworm eggs are the most effective ways to prevent pinworm infection,
including regular nail trimming, thorough hand washing with soap or hand sanitizer before meals and after defecation, avoiding scratching the anal and intercrural areas, frequent laundry and bedding washing, etc.
Peer Review Expert Lu Jiao
Distinct Pediatrics, Child Health, Allergy Specialist
Master of Nanjing Medical University
References
Content Editor Luka
Disclaimer: The article is intended to provide general health information. For personal medical issues, please consult a doctor. For article reprinting, please contact: medicine@distinctclinic.com.
