As a parent, you might often feel like you're constantly administering treatments for intestinal worms that affect your children—usually in the form of chocolate or chewable tablets. One type of worm is very common and closely associated with humanity and can even overcome the most stringent hygiene standards. Young children are particularly good at transmitting these little parasites. The pinworm is an ancient species found in the fossilized feces of primitive mammals that is 230 million years old. The closest relatives of the pinworm in humans are found in our nearest relatives, the monkeys.
It is believed that our pinworms have evolved alongside us. The oldest pinworm eggs from a human host were discovered in about 10,000-year-old dried human feces found in a Colorado cave. Therefore, pinworms have adapted very well to living with humans. These worms are white, resemble threads, and the females can grow up to 13 mm long, while the males are less than half that size. They inhabit humans worldwide, mostly in children aged 4 to 11 years. Adults can also be affected, although the negative effects are usually less severe.
Pinworms have been associated with some other conditions, including types of appendicitis, vaginitis, and urinary tract infections, but these are not common outcomes. The problem typically does not lie with the adult worms living in the cecum (the pouch where the small and large intestines meet) for up to two months. When the female wriggles out of the digestive tract to lay eggs around the anus—usually in the early morning—it can cause irritation. The life cycle of the worm essentially depends on the child or adult. When eggs are scratched on hands or under nails, they can be transferred to other children in the home or at school, or to adults.
They often get transferred to the child's mouth, where they can be swallowed and start another infection, known as "autoinfection." This can cause the child to scratch so much that it results in a skin inflammation called puritis. This can become very painful and lead to sleep loss. There are many reasons a child can be tired and irritable. However, if your school-aged child is behaving this way, pinworms may be the cause.
Pinworm eggs are very small and cannot be seen individually, but females lay over 10,000 in creamy-colored clusters, which may be visible around the anus. Medication should be taken by every family member, and the dose should be repeated after two weeks to ensure control of the pinworms in the home. Contaminated clothing and bedding should be washed in hot water. Other methods to prevent infection include regular handwashing and scrubbing finger nails.
Although we are managing pinworms better in the 21st century, they are still with us, and it is unlikely we will be able to eradicate such a well-adapted and closely intertwined parasite.
