Warning: The subject of this post will make you feel creepy-crawly all over. It will also generate an intense urge to immediately scrub yourself down in the shower. Now that you’ve been warned, let’s talk about pinworms – also known as threadworms. Or, if you are the scientific type, Enterobius vermicularis.
Pinworms are small white, thin, thread-like worms that measure less than half an inch long (approximately the length of a staple). Pinworm infections are the most common worm infection in the United States. These tiny parasites infect people of every age, race, geographical region, and socioeconomic status. The most common symptom is intense itching in the rectal area.
WHO IS MOST AT RISK?
While anyone can get a pinworm infection, it is most commonly found in:
- Children who attend school or daycare
- Parents and caregivers of children
- Institutionalized individuals or those who live in close quarters
- Children who suck their thumbs
- Children and adults who bite their nails
- Children and adults who do not practice good hand-washing habits
HOW IS A PINWORM INFECTION SPREAD?
Keeping your hands clean and away from your mouth is definitely the best way to avoid becoming infected. Pinworms are HIGHLY CONTAGIOUS and one acquires the infection by unintentionally ingesting the pinworm’s eggs. This can happen a number of ways, but by far the most common way is by the “fecal-oral route”:
- The child ingests the pinworm eggs, which travel to the intestines. They hatch about one month later into worms.
- The worms then travel out of the rectum at night in order to lay their eggs around the child’s anus. (This is what generally causes the itching.)
- The child scratches and the pinworm eggs stick to the child’s fingers and get stuck under their fingernails.
- Anything the child touches afterward then becomes infected with the pinworm’s eggs: toys, food, dishes, furniture, door handles, etc.
- Once you touch something that child has touched, the eggs transfer to your hands. From there, if you touch your mouth or eat something with your hands, you in turn ingest the eggs. The cycle then repeats itself.
Please know that if your family comes down with a case of pinworms, don’t beat yourself up! You can be the most sanitary family on the block and still become infected – it is simply that contagious. In fact, pinworm eggs are so tiny that you can ingest them simply by breathing in!
WHAT ARE THE PRIMARY SYMPTOMS?
It is important to note that some individuals may not experience any symptoms at all when infected. However, the most common signs of a pinworm infection include:
- Intense and frequent itching in the anal area (and sometimes in the vaginal area in females) that generally gets worse at night
- Pain or rash around the anal area
- Restless sleep or the complete inability to sleep
- Presence of pinworms and their eggs in or around the anus
- Presence of pinworms in the stool
- A stomach ache can occur if the individual is heavily infected by the worms
MY CHILD SHOWS SYMPTOMS, BUT HOW DO I KNOW FOR SURE?
There are two ways to confirm that your child is indeed infected.
Option 1: The “scotch tape test”. In the morning, prior to your child getting out of bed, take a piece of clear scotch tape and press it against the anal area of the child. If you happen to have a microscope slide lying around, put the tape on the slide, sticky side down, for the doctor to see. If you don’t have a slide, just use another piece of clear tape and stick the two sticky sides together. Your doctor’s office may also have a special paddle that can be used which can make this process a bit easier.
Option 2: This one is a bit on the nightmare-inducing side. Once your child has been asleep for 2-3 hours, go in with a flashlight, gently spread the child’s buttocks apart and shine the light on the anal area. If your child is infected with pinworms, you will see them wiggling around. We warned you about feeling creepy crawly, right?? While this route is definitely invasive – and can be horrifying for everyone involved – it will likely give you a confirmed diagnosis without having to make a trip to the doctor.
HOW CAN I EFFECTIVELY TREAT THE INFECTION?
The good news is, pinworms are easy to treat with an over-the-counter medication containing pyrantel pamoate. (Pin-X and Reese’s Pinworm Medicine are the most well known, but CVS sells a decent tasting generic at an affordable price.) If you decide to go the doctor route, Mebendazole and Albendazole are the most common prescription medications.
The bad news is, it is easy to get re-infected and you will spend a few weeks having to maintain a very hygienic household. Because pinworms are so contagious, it is generally recommended that the entire family (and any caregivers) get treated with medication – even if no one else is showing symptoms.
After one to two weeks, everyone will need a second dose of the medication. This is to ensure all of the worms and eggs are expelled from the body – as pinworm eggs can live outside of the body for two to three weeks.
**If you are pregnant, nursing or if the infected child is under the age of 2, please contact your health care provider prior to taking pinworm medication.
WHAT OTHER PRECAUTIONS SHOULD I TAKE TO PREVENT REINFECTION?
On the day of initial treatment, it is VERY important that you clean your entire living space. It is recommended that you do the following:
- Wash all bedding, towels, washcloths and clothing in HOT water and dry using the HIGH setting in the dryer
- Wash towels and washcloths after EVERY use for the duration of treatment
- Wash bedding every third day for the duration of treatment
- Avoid shaking bedding, clothing and towels as to not spread the eggs into the air and other surfaces
- Thoroughly disinfect all surfaces that may be contaminated to include toys, door handles, toilets, appliance handles, and faucets
- Vacuum all carpet and wet mop all hard floors
- Encourage thorough hand washing – especially after using the restroom and prior to meals
- Clip and keep nails short and clean (a good nail brush is helpful too)
- Do not bathe children together as this can spread the infection
- Discourage thumb sucking and nail biting
- Discourage children from itching their bottoms – if they have to do so, they should do so through their clothing
- Those infected should shower in the morning to rid themselves of the eggs that have been deposited overnight
- Keep blinds and shades open during the daytime, as sunlight is known to kill pinworm eggs
There is no doubt that dealing with pinworms is not only gross, but a complete hassle as well. However, it is important that you follow the proper steps to remediate the problem, otherwise, you will have a very long and frustrating battle on your hands. It is possible to win the battle of the bugs – if you do things right the first time. Best of luck!