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Thread Worm - Rightangled

What is Thread Worm?

Cause

Threadworm infections are primarily caused by the ingestion of microscopic eggs (Enterobius vermicularis). These eggs can be found on contaminated surfaces, such as bed linens, clothing, toys, and bathroom fixtures. Common causes and risk factors for threadworm infections include:
Poor Hand Hygiene: Failing to wash hands thoroughly after using the toilet or before eating can lead to the transfer of threadworm eggs from contaminated surfaces to the mouth.
Close Contact: Threadworms are highly contagious, and infections can spread easily within households, schools, and childcare settings, especially when individuals share personal items or bedding.
Inhalation: In rare cases, threadworm eggs can become airborne when bedding is shaken or disturbed, and they may be inhaled.

Diagnosis

Diagnosing a threadworm infection typically involves a combination of clinical assessment and laboratory tests. Healthcare providers follow these steps to confirm the presence of threadworms:
1. Clinical Assessment
Healthcare providers evaluate symptoms reported by the patient, particularly the presence of anal itching, discomfort, or visible threadworms in the perianal area. A family history of threadworm infection may also be considered.
2. Scotch Tape Test
The most common diagnostic method involves the "Scotch tape test." During this test, a transparent adhesive tape is applied to the perianal area in the morning, before bathing or using the toilet. The tape is then carefully removed and placed on a glass slide or a piece of clear plastic. Any eggs or adult worms present on the tape are examined under a microscope.
3. Visual Inspection
In some cases, threadworms may be visible around the anal area, particularly at night when female worms emerge to lay eggs.
4. Confirmation
A positive Scotch tape test or visual identification of threadworms confirms the diagnosis.

Treatments

Effective treatment of threadworm infections aims to eliminate the parasites from the intestines and reduce the risk of reinfection. Commonly used treatments often involve the use of active ingredients that target the threadworms:
1. Anthelmintic Medications
Mebendazole: This anthelmintic medication is the most commonly prescribed treatment for threadworm infections in the UK. It works by preventing the worms from absorbing sugar, ultimately leading to their death.
Pyrantel Pamoate: Another anthelmintic, pyrantel pamoate, paralyzes the worms' muscles, making it easier for the body to eliminate them through bowel movements.
2. Dosage
Treatment typically involves a single dose of the medication, with a repeat dose after two weeks to ensure that any newly hatched eggs are also eliminated.
3. Family and Household Treatment
To prevent reinfection and the spread of the infection, it's essential that all family members and close contacts receive treatment, even if they are asymptomatic.
4. Hygiene Measures
Practicing good hand hygiene, particularly thorough handwashing after using the toilet and before meals, is crucial in preventing the spread of threadworm eggs.
5. Environmental Cleaning
Frequent laundering of bed linens, towels, and clothing in hot water can help remove threadworm eggs. Regularly vacuuming and cleaning the home, especially in areas where an infected person spends time, is also essential.

Prevention

Preventing threadworm infections involves several strategies to reduce the risk of contamination and transmission:
1. Hand Hygiene
Emphasize the importance of thorough handwashing with soap and water after using the toilet, changing diapers, and before eating.
2. Fingernail Care
Keep fingernails short and encourage children not to bite their nails. Threadworm eggs can be lodged under fingernails and easily ingested.
3. Regular Bathing
Encourage daily bathing or showering, especially in the morning, to help remove any eggs that may have been deposited around the perianal area during the night.
4. Laundering and Cleaning
Wash bed linens, towels, and clothing regularly, and vacuum and clean living spaces frequently to remove any potential sources of contamination.
5. Education
Educate children and family members about the risk factors, transmission, and prevention of threadworm infections.

Further Info

https://www.nhs.uk/conditions/threadworms/

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FAQs

Can Threadworm Infections Resolve on Their Own Without Medication?

While it's possible for a mild threadworm infection to resolve on its own, it's generally advisable to seek treatment. Medication helps eliminate the worms and reduce the risk of complications and reinfection.

Is Mebendazole Safe for Children?

Mebendazole is commonly prescribed for children to treat threadworm infections. However, the dosage should be determined by a healthcare provider based on the child's age and weight. Always follow the prescribed dosage instructions.

What Should I Do if I Suspect My Child Has a Threadworm Infection?

If you suspect your child has a threadworm infection due to symptoms like anal itching or restlessness at night, consult a healthcare provider. They can confirm the diagnosis and recommend appropriate treatment.

Can Threadworms Spread to Other Parts of the Body?

Threadworms primarily affect the intestines and the perianal area. They do not typically spread to other parts of the body. However, good hygiene practices are essential to prevent the spread of eggs and reinfection.

Medically reviewed & approved

This page was medically reviewed by Dr Sohaib Imtiaz (clinical lead) |

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