Counterculture 43: Threadworms
"I am looking to see if threadworm comes in epidemics," Cate replies.
"Why do you want to know that?" says Bea.
"There seems to be a lot of it about at the moment. Just today I've had several customers ask me about threadworms. Some of the problems they've asked about have been very tricky and I've had to pass them on to Amanda or Dee."*
"What sort of problems?" asks Bea.
"One woman said that her 15-month-old son had threadworm that she thought he could have caught from his older brother, who also had it recently. But the product the older brother had used wasn't suitable for the baby, and she wanted to know if there was anything else available.
"Another woman said that her six-year-old son kept on getting threadworm every couple of months, even though she was very careful with his hygiene. She couldn't understand where he kept catching it from.
"And another mother said her 13-year-old daughter had had threadworm for the past eight months and they had been to their GP three times. Each time he had prescribed mebendazole tablets and they had also bought them OTC several times. The girl had taken them according to the instructions and was scrupulous about hygiene, but the worms kept on coming back. So, is there a threadworm epidemic at the moment, Bea?"
*Amanda is senior medicines counter assistant and Dee is the pharmacist.
Question
1 Does threadworm occur in epidemics?
2 Is there a treatment suitable for a 15-month-old baby?
3 What could be the causes of the recurring or apparently continuous threadworm infections in the queries that Cate has had, and how can they be kept to a minimum?
Answer
1 No, but it is very common – up to 20 per cent of all children are thought to be infected at any one time. It is most common between the ages of five and nine years, but anyone can
be affected.
2 Yes, piperazine (Pripsen Piperazine) can be sold for babies over one year and, on medical advice, from age three months. For everyone two years and over the standard treatment is mebendazole (Ovex, Pripsen Mebendazole), with the same single tablet or 5ml dose of suspension for all ages.
3 The problems could be due to self re-infection or re-infection from family members or friends. Self re-infection occurs because worm eggs are recycled – they are laid overnight around the anus, causing intense itching which the infected person scratches to relieve, picking up eggs on their fingers.
If fingers are then put to the mouth the eggs are swallowed and re-infection occurs. Infection can often be passed on by small children who do not wash their hands after going to the toilet and then touch food that is eaten by others. Scrupulous hygiene by all family members and keeping all eating utensils and surfaces clean is necessary to reduce the chances of re-infection.
When should you involve the pharmacist?
Roundworm infestations are definitely one to refer to the pharmacist as they are, potentially, very serious in humans.
The OTC Pharmacy's Dee was recently asked for advice about roundworm infection. The customer involved said that she had just got a six-week-old puppy from an animal shelter, and she was worried that it might have roundworm. She feared for her two young children, as her friend had told her that children can pick up the infection and, as a result, could be severely affected and even go blind.
The friend also said that even if they got rid of the worms themselves, their eggs could already be all over the house and garden, and could still cause problems. The customer wondered if Dee could offer her any advice.
Dee explained that roundworm infection, though common in cats and dogs, is extremely rare in humans; fortunately, direct contact with roundworm-infected dogs has a very low risk for infection. However, if contracted roundworm is, potentially, very serious in humans and can cause the problems the friend described.
Roundworm eggs are shed only in the faeces and very few will be found in areas where there are no dog faeces. It takes two weeks for eggs to become infective after being shed, so even when there is a roundworm-infected dog in the home there will be very few, if any, infective roundworm eggs around.
To keep risk to a minimum, owners can be advised to regularly clean areas where the puppy has been, and ensure there is good hygiene and regular hand washing after handling either the animal or its faeces. Regular worming should also ensure the puppy stays worm-free.
