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Pinworm Infection
  Parasite, Pinworms
 Signs, symptoms, indicators
 Conditions that suggest it
 Contributing risk factors
 Conditions suggested by it
 Treatment recommendations
 


Alternative Names: Seatworms or threadworms.

Pinworms (Enterobious vermicularis) may be the most prevalent worm parasite in the United States and Europe. It is relatively rare in the tropics. Humans are the only host, and transmission is maintained through a fecal-oral route or, uncommonly, by inhalation of the eggs. Pinworms are commonly found amongst children. School children get pinworms easily because they spend a lot of time with others who may have pinworms, which are highly contagious. Studies of caucasian children in the USA and Canada have shown incidences of infection from 30-80%, with similar levels in Europe. The eggs are so light that they can float in the air.
Causes & Development


Pinworm eggs are swallowed and hatch in the small intestine. They then move on to the large intestine where they find a warm, dark place to attach and live. After about 2-4 weeks, the female pinworms move to the end of the large intestine and then out of the body (usually at night) to lay their eggs around the anus, which causes itching. The eggs are then spread by scratching where they contaminate underwear, nightclothes, bed clothes, hands, and anything the contaminated hands may touch. At night, the adult worms can sometimes be seen directly in bedclothes or around the anal area.

Diagnosis & Tests
If pinworms are suspected, transparent adhesive tape (often called the "scotch tape test") or a pinworm paddle (supplied by your health care provider) are applied to the anal region. The eggs become glued to the sticky tape or paddle and are identified by examination under a microscope. Because bathing or having a bowel movement may remove eggs, the test should be performed first thing in the morning. Three specimens should be taken on consecutive days before pinworm infection is ruled out. Since scratching of the anal region is common, samples taken from under the fingernails may also contain eggs. Eggs are rarely found during lab examinations of stool.

Complications
Pinworm infection is unlikely to cause other conditions. There are cases where the parasite has been suspected as a cause of appendicitis, and pregnant female worms have been known to migrate up the vagina and fallopian tubes and into the peritoneal cavity, where they become encapsulated. Recurrent urinary tract infections have been attributed to ectopic pinworm infections.





Signs, symptoms & indicators of Pinworm Infection:
Symptoms - Food - General  Weak appetite
 A heavy pinworm infection can cause loss of appetite.

Symptoms - Gas-Int - General

  Anal itching at night
 Itching around the anus, especially at night, is a common symptom of pinworm infestation. Symptoms are caused by the female pinworm laying her eggs. They are usually mild, with many infected people having no symptoms at all.

Symptoms - Metabolic

  Hyperactivity
 A heavy pinworm infection can cause restlessness.

Symptoms - Sleep

  Being a light sleeper
 A heavy pinworm infection can cause difficulty in sleeping.

Conditions that suggest Pinworm Infection:
Personal Background  Current pinworm infection (confirmed)

Risk factors for Pinworm Infection:
Personal Background  Past pinworm infection

Pinworm Infection suggests the following may be present:
Parasites  Parasite Infection

Recommendations and treatments for Pinworm Infection:
Botanical  Wormwood
  Garlic
 Studies in humans support the use of garlic to treat various worms, including pinworm. [Garlic: The Science and Therapeutic Application of Allium sativum L. and Related Species. Williams & Wilkins, 1996, pp.173-4] In addition to consuming garlic, consider carefully peeling a raw garlic clove (don't scratch or nick it), then insert into rectum before bed.

Drug

  Conventional Drug Use
 Pin-X (pinworm treatment containing pyrantel pamoate) is available over-the-counter as a single dose remedy. If you have side-effects after taking pyrantel, get advice from your health care provider before you take it again, especially if a skin rash occurs.

Although the directions do state "single dose effectiveness", taking a second dose after 10 days is also recommended because of the pinworm lifecycle. After the initial treatment, pinworm eggs will almost certainly remain in your living environment and may be ingested or inhaled.

Habits

  Personal Hygiene Changes
 The following practices will help reduce the risk of continuous self-reinfection:
  • Bathe when you wake up to help reduce egg contamination.
  • Change and wash your underwear each day. Frequent changing of night clothes is recommended.
  • Change underwear, night clothes and sheets after each treatment. Because the eggs are sensitive to sunlight, open blinds or curtains in bedrooms during the day.
  • Personal hygiene should include washing hands after going to the toilet, before eating and after changing diapers.
  • Keep fingernails trimmed short.
  • Discourage nail-biting and scratching the bare anal region.


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
May do some good
Likely to help
Highly recommended


GLOSSARY

Ectopic
Located outside normal position, e.g., location of fetus in pregnancy.

Over-The-Counter (OTC, Over The Counter)
A drug or medication that can legally be bought without a doctor's prescription being required.

Parasite (Parasites, Parasitic, Parasitical)
An organism living in or on another organism.

Pinworms (Enterobiasis, Enterobious vermicularis, Oxyuriasis, Pinworm, Pinworm Infection, Seatworm, Threadworm)
Small intestinal parasitic worms that infect mainly children but which are also common in families with children. Pinworms are about 1/2 an inch (1.25cm) in length, white, thin and pointed at both ends. The most common symptom is anal itching, as the worms come out at night to lay their eggs.

Small Intestine (Small Bowel)
The small intestine lies between the stomach and the large intestine. It is about 6 meters (20 feet) long and its primary function is to digest (break down) food and absorb nutrients (vitamins, minerals, proteins, carbohydrates, and fats). The small intestine makes up more than 70% of the length and 90% of the surface area of the gastrointestinal (GI) tract.

Tropics (Tropical)
The region of the earth's surface lying between 23°27 North of the equator and 23°27 South of the equator.

Urinary Tract (UT)
The kidneys and the lower urinary tract, which includes the ureters, bladder, and urethra.




Last updated: May 26, 2008


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