I can't get rid of threadworms any ideas?
Question:
I have tried everything recommended yet don't seem to be able eradicate them :(
Answers:
Threadworms live about 5-6 weeks in the gut, and then die. However, before they die the female worms lay tiny eggs around the anus (back passage). This tends to occur at night when you are warm and still in bed. The eggs are too small to see without a microscope, but cause itch around the anus. You then scratch around the anus to relieve the itch. You often do this without realising when you are asleep. When you scratch, eggs get onto fingers and under nails. You may then swallow some eggs if you put a finger into your mouth.
Also, threadworm eggs can survive for up to two weeks outside the body. They fall off the skin around the anus and can fall onto bedding, clothes, etc. They can then get 'wafted' in the air as you change clothes, bedding etc, and become part of the dust in a home. Some eggs may settle on food or toothbrushes. So, children may swallow some eggs at first by playing with other children who have eggs on their fingers, or from food, drink, toothbrushes, or dust that has been contaminated with threadworm eggs.
Any eggs that you swallow then hatch and grow into adult worms in the gut. So a 'cycle' of threadworm infection can go on and on.
Are threadworms harmful?
Not usually. Often, the worst thing about them is the itch and discomfort around the anus. This sometimes wakes children from sleep. Scratching may make the anus sore. Large numbers of threadworms may possibly cause mild abdominal (tummy) pains and make a child irritable. In girls, threadworms can wander forwards and lay their eggs in the vagina or urethra (the tube that passes urine). A doctor may check for threadworms in young girls with a vaginal discharge, bedwetting, or problems with passing urine. Rarely, threadworms can cause other problems.
How can I tell if my child has threadworms?
Threadworms look like thin, white, cotton threads. Sometimes you can see them in faeces (stools or motions) in the toilet. If you cannot see threadworms in the faeces, but suspect your child has threadworms (if they have an itchy bottom), try looking at the child's anus. You can do this with a torch in the late evening after the child has gone to sleep. Part the child's buttocks and look at the opening of the anus. If the child has threadworms you can often see one or two coming out of the anus. Do not be alarmed! Ask a pharmacist for advice on treatment in the next day or so.
Your doctor may ask you to do a 'sticky tape test' to confirm the presence of threadworms. To do this you press some clear see-through tape onto the skin around the anus first thing in the morning, before wiping or bathing. You then place the tape on a glass slide or put it in a specimen container. The tape is then sent to the 'lab' to be looked at under a microscope to see if any threadworm eggs are stuck to the tape.
What is the treatment for threadworms?
The common treatment is to take a medicine to kill the worms in your gut AND hygiene measures to clear eggs which may be around your anus or in your home.
Medication
You can buy the following medicines from pharmacies. You can also get them on prescription. (The medicines below are not recommended if you are pregnant or breastfeeding. Hygiene measures alone may be sufficient.)
Mebendazole is the usual treatment for people aged over two years. All household members, including adults and those without symptoms, should take a dose at the same time. This is because it is common to have worms in the gut with little or no symptoms. Just one dose kills the worms. A second dose two weeks after the first is sometimes needed if the infection has not cleared (which may occur if you swallow some eggs after taking the medication).
Piperazine is an alternative medicine, and can be used in children under two years (but over three months). You need to take two doses, 14 days apart.
Hygiene measures
Medicine will kill the worms in the gut, but not the eggs that have been laid around the anus. These can survive for up to two weeks outside the body on underwear, bedding, in the dust, etc (as described above). So, hygiene measures aim to clear any eggs from the body and the home, and to prevent any eggs from being swallowed. This will then break the cycle of 're-infection'. Every member of the household should do the following for two weeks after the first dose of medicine.
Wear underpants or knickers at night. This is so that if you scratch in your sleep, you will not touch the skin near the anus.
Keep fingernails short. Wash hands and scrub nails each morning. Wash hands before meals or snacks, before preparing food, and after going to the toilet or changing nappies.
Every morning have a bath, or wash around the anus, to get rid of any eggs laid overnight. You must do this straight away after getting up from bed.
Change and wash underwear, nightwear (and bed linen if possible) each day. Avoid shaking clothes and linen as any eggs on them may be wafted into the air and become part of the dust.
Keep toothbrushes in a closed cupboard. Rinse well before use.
Also, on the day when you take the medicine, it is best to have a 'blitz' around the home which aims to clear any eggs which may be part of the dust. This should include:
Vacuum and dust all household carpets, particularly those where children play.
Damp-dust smooth surfaces with a cloth rinsed in hot water. Again, particularly in places where children play, and in bedrooms and the bathroom. Throw out the cloth after use.
After an initial thorough cleaning blitz, some people suggest that you vacuum and damp-dust every day for 14 days.
However, it may not be your home which is a main source of threadworm eggs. Your children may come into contact with eggs in schools or nurseries, particularly in the toilets if they are not cleaned properly. If your child has recurring threadworms, it may be worth checking that toilet facilities at schools, nurseries, etc, are regularly cleaned in a way that will remove any threadworm eggs which may be reoccuring.
They come out at night to lay eggs just outside the bunghole, so one remedy is to put vasoline on the . . . um . . . rectum.
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