What is Pinworm?

A pinworm is a small, round, white colored worm 2-13 millimeters long that infests the area around the anus and parts of the intestine. It lives only in humans and is generally not a serious condition. Pinworm is the most commonly seen intestinal parasite in a primary care practice. There are approximately 20-50 million cases of Pinworm in the U. S. each year. Typically, it affects children between the ages of 5 to 15 years old, but it may infest individuals at any age or socioeconomic group.

How do I get Pinworm?

Pinworm spreads from person to person. The lifecycle of the worm starts usually with the introduction of a microscopic egg into the mouth. The acid of the stomach softens the egg and it hatches in the small bowel. The worm travels to the appendix and large bowel. At night the female worms crawl out of the anus and leave eggs on the skin. The worms and the eggs cause itching and scratching, and the eggs are transferred to the fingers and fingernails. With eating or thumb sucking the eggs are re-introduced into the mouth and the cycle continues. Pinworm can also come from eggs that are airborne after shaking infested clothing and bed linen. Contact with toys and other handled objects can transfer eggs from one child's hands to another's. Pinworms can also hatch on the skin around the anus and then crawl back into the intestine to start another round of infection.

What are the symptoms of Pinworm?

The most frequent symptom of Pinworm is itchiness around the anus and between the legs. Girls may have vaginal itching if the worms crawl forward. The other symptoms of Pinworm are usually a result of this itching. Redness and irritation near the anal area, causes loss of sleep, discomfort, irritability, whining, bedwetting and emotional changes.

Other symptoms include loss of appetite and weight loss. There can also be an allergic reaction to the worms in a small number of cases. Even though pinworm is extremely common and rarely serious, having "worms" may cause some psychological trauma to the patient as well.

How is Pinworm diagnosed?

Pinworm can be diagnosed in several ways. All of them look for evidence of the worms or the eggs. The most common test uses a piece of clear cellophane tape. The tape is placed with sticky side down, onto the skin near the anus. The tape is then pulled off and put on a slide under a microscope to look for the eggs.

Another method is to swab the area of skin, which scrapes the eggs off. The swab can be looked at through a microscope. If these do not reveal the eggs, a smear of fecal material can be looked at on a slide.

Because the eggs crawl out at night, parents may use a flashlight to look at the anal area after the child has gone to bed. If worms are seen they can be removed and placed in vinegar or alcohol to save for the doctor to diagnose.

How is Pinworm treated?

Pinworm is generally not a serious infection and often no treatment is required other than strict cleanliness habits.

However, there are several drugs, which can help to eliminate Pinworm. The most common drugs are Mebendazole and Pyrantel pamoate. They are usually taken in a single dose or perhaps in two doses two weeks apart. The whole family must take the medication; otherwise it will not be very helpful. These drugs only kill the adult worms so attention to cleanliness is still extremely important. Petroleum jelly or anti-itch creams and ointments may be applied 2-3 times per day to reduce the itching that continues the cycle of infection.

To clear the infection, the anal area should be washed frequently with warm, soapy water to remove and kill the eggs. Underwear should be changed at least twice a day and washed in hot, soapy water. Fingernails need to be cut close and kept clean. Areas that have a lot of hand contact around the house can be cleaned frequently with soapy water where possible or cleaned with a vacuum cleaner. The toilet seat can be cleaned often as well. Eggs from fingers, fingernails, clothes, bedding, toys and even the air (after shaking bedding and clothing) can re-infect and start another round of Pinworm. Eggs can usually survive up to three weeks, but are killed by sunlight and ultraviolet light.

Special attention does not necessarily need to be given to pets in the house. Human pinworm affects only humans and is not transmitted by or to animals.

How long do the effects of Pinworm last?

Pinworm will last as long as the individual continues to be re-infected. When the infection cycle has stopped, the symptoms should subside in a few days. The symptoms are directly caused by the presence of the worms so, once the worms are gone, the symptoms will disappear too.

What can be done to prevent Pinworm?

Pinworm infection is reduced when eggs are no longer introduced into the digestive tract. The major way eggs get in is through the mouth. Because of that, limiting mouth contact with fingers and toys are an important way to prevent an infection. Fingers should be kept out of the mouth and thumb sucking or nail biting discouraged. Frequent hand washing may be helpful, particularly before meals.

Underclothes should be changed frequently and washed in hot, soapy water. Bedding and clothes should not be shaken because this makes the eggs airborne.

Usually other family members are also infected and will spread Pinworm infection even if they don't have symptoms. For this reason, measures to prevent and treat pinworm infection need to be applied to everyone in the family.

How can I take care of myself?

Simple attention to clean, healthy habits may make it more difficult for Pinworm infection to occur. Bathing frequently and washing clothes and bed linens is equally important. Understanding how Pinworm lives and multiplies will help in its prevention.

When should I call the doctor?

The doctor should be called if the symptoms of Pinworm infection are noticed. If Pinworm infection is diagnosed, the doctor may prescribe a medication to help clear the infection. A doctor should be called any time there is pain, bleeding, diarrhea, an allergic reaction, severe abdominal discomfort, convulsions or other unexpected results.



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