Itching during the night in a child's perianal area strongly suggests pinworm infection. Diagnosis is made by identifying the worm or its eggs. Worms can sometimes be seen on the skin near the anus or on underclothing, pajamas, or sheets about 2 to 3 hours after falling asleep.
Typical pinworm infections don't cause serious problems. In rare circumstances, heavy infestations can cause infection of female genitals. The parasite can travel from the anal area up the vagina to the uterus, fallopian tubes and around the pelvic organs.
If your child develops a pinworm infection, try not to worry. Pinworms don't cause any harm (just itching and restless sleep), and it won't take long to get rid of them.
Your child may be fussy and wake often at night. If your child is infected, it may take 2 to 8 weeks for symptoms to start.
How long does pinworms last? The life cycle of a pinworm is 4 to 6 weeks. Without treatment, infestation will continue as long as fresh eggs are being swallowed, unless a person develops immunity to pinworms, which is unusual before age 15.
Most pinworm infections are mild and easily treated. Your doctor may prescribe a single chewable tablet of a medicine called mebendazole. A second tablet is taken about 3 weeks later if the infection isn't cured. Or your doctor may recommend another kind of medicine called pyrantel, which is taken as a single dose.
It is especially active at night or early morning. Rarely, the pinworm is seen on the surface of a stool. The pinworm's secretions are a strong skin irritant and cause the itching.
Life cycle of a pinworm
A grown pinworm is yellowish white, slender and about one centimetre long. Around 4 weeks after ingestion, the adult female moves down the gut and exits the body via the anus to lay a batch of eggs on the surrounding skin, often at night. The worm then dies, her reproductive mission complete.
Pinworm infection is spread by the fecal-oral route, that is by the transfer of infective pinworm eggs from the anus to someone's mouth, either directly by hand or indirectly through contaminated clothing, bedding, food, or other articles.
The medications used for the treatment of pinworm are either mebendazole, pyrantel pamoate, or albendazole. Any of these drugs are given in one dose initially, and then another single dose of the same drug two weeks later. Pyrantel pamoate is available without prescription.
So many of us or our family members have experienced this relatively mild though distressing infection. Pinworm is the most common worm infection in North America with up to 50% of some groups of school aged children getting infected.
Chlorine dioxide gas inactivates pinworm eggs in a non-invasive and non-corrosive manner.
Playmates, schoolmates, close contacts outside the house, and household members should be considered. Each infected person should receive the usual two- dose treatment. In some cases it may be necessary to treat with more than two doses. One option is four to six treatments spaced 2 weeks apart.
If you are self-treating for pinworms, take the medication once only. Do not repeat the dose without talking with your doctor first. Depending on the type of worm infection you have, your doctor may direct you to take the medication only once or for several days.
The key is to break the 6-week cycle of pinworm reinfection by killing any live pinworms and preventing the ingestion of eggs. A diagnosis should be confirmed before treating with medications. Medications kill only the adult worms and have no effect on developing eggs and larvae.
Reinfection does happen with pinworm
Reinfection can happen by touching surfaces that have already been contaminated with pinworm eggs by another person. Eggs are swallowed, usually after hand-to-mouth contact, and the pinworm infection begins again.
Symptoms and Causes
Sleeplessness: Because anal itching is worse at night, people suffering from a pinworm infection can have trouble sleeping, which can lead to decreased concentration, tiredness and weight loss.
Pinworms can usually be treated completely with two doses of over-the-counter medicine called pyrantel pamoate, available in the United States under the brand names Pin-X and Reese's Pinworm Medicine. Take one dose immediately and another dose two weeks later.
The best way to diagnose this infection is to do a tape test. The best time to do this is in the morning before bathing, because pinworms lay their eggs at night. Steps for the test are: Firmly press the sticky side of a 1-inch (2.5 centimeters) strip of cellophane tape over the anal area for a few seconds.
Based on data from the current study, 4–5 seconds of exposure at 80°C appears sufficient to inactivate Ascaris eggs. At 75°C and 70°C treatment may also be effective, but exposure time should be increased to achieve the same level of inactivation.
These worms live in the intestine. The adult female worm crawls out of the infected person's anus at night and lays her eggs in the surrounding skin. This causes itching and scratching. The worms can also move to the vagina of a female child and cause itching.