Enterobiasis ( Pinworms )

A benign intestinal disease, enterobiasis has several other names, including oxyuriasis and pinworm and seatworm infection. Found worldwide, this disease is common even in temperate regions with good sanitation. More than 40 million Americans are estimated to be infected; it's especially prominent among school children.

Infection and reinfection most often occurs in children between ages 5 and 14 and in certain institutionalized groups because of poor hygiene and frequent hand-to-mouth activity. Crowded living conditions commonly enhance its spread to several members of a family.

Causes

Enterobiasis is caused by the nematode Enterobius vermicularis. Adult pinworms live in the intestine until the female worms migrate to the perianal region to deposit their ova.

Direct transmission occurs when the patient's hands transfer infective eggs from the anus to the mouth. Indirect transmission occurs when the patient comes in contact with contaminated articles, such as linens and clothing.

Signs and symptoms

The chief symptom is irritated skin and painful itching around the anus. The itching is worse at night and may keep you awake. If pinworms move to the opening of the vagina, they may cause itching, soreness, or a discharge. Other symptoms include loss of appetite and stomach pain, though this is rare. The skin may become pale and colorless.

Diagnostic tests 

Identification of Enterobius ova recovered from the perianal area with a cellophane tape swab confirms the diagnosis. A stool sample usually is ova- and worm-free because these worms deposit the ova outside the intestine and die after migration to the anus.

Treatment

Drug therapy with pyrantel pamoateor mebendazole destroys these parasites. Effective eradication requires simultaneous treatment of family members and, in facilities, other patients.

Prevention

The disease can be prevented by treating all the infected cases and thus eliminating the source of infection. Some ways to keep from catching or spreading the disease include the following recommendations:

• wash hands thoroughly before handling food and eating
• avoiding scratching the anal area
• keep finger nails short and clean
• machine wash linens in hot water and dry with heat to kill any eggs
• open the blinds or curtains since eggs are sensitive to sunlight
• take early morning showers to wash away eggs deposited overnight
• once the infection has been identified, and treatment is started, change the bed linen, night clothes, and underwear daily