Dear Readers,

Rema, from Montego Bay, writes that her daughter, three, was scratching her vagina, and when she visited a clinic, she was told that the child had pinworms in her bottom, which caused her to get a vaginal discharge and itching. Rema says the baby's vagina was so red and inflamed that she thought the child had been sexually abused! But the doctor said no to this. Rema asks Lifeline how worms in the bottom could make the vagina so sick. She is worried although the worm medicine and creams to rub on the area did work eventually to clear the condition.

Pinworm (Enterobius Vermicularis) infections occur commonly and most often in the five to 10 age group who attend school and share the same bathroom facilities. Pinworm spread is favoured by close crowded living conditions as occurs in some yards where several families live on the one compound or as in schools. Spread among family members is common. Animals do not host the pinworm.

Pinworms live in the digestive tract of humans and migrate to the rectum and anus. Adult pinworms are about half inch and seem like moving pieces of white thread. They are visible, but the pinworm eggs are smaller and require a microscope to view them.

While the infected person sleeps, the female pinworm can lay thousands of eggs in the small skin folds surrounding the anus, which can cause itching of the anus and restless sleep but sometimes causes no symptoms at all.

The worm is very easily spread from child to child where one child scratches his bottom and gets the worm egg under his fingernails. Any other child he plays with or holds on to, and any surface e.g. a desk or table top he puts his hands on, becomes either directly infected or a source of infection to someone else. Infected dust, clothing, and bed linen easily spread this worm egg when someone else touches the infected object.

The hand enters the mouth and the pinworms are swallowed, and as they pass down the gut, they hatch into worms and mature. At maturation, female pinworms become pregnant and continue migration to the rectum and anus. The female worm leaves her eggs at the anus in the skin folds.

This female worm can live for three months in the person. Eggs can live for three weeks outside the human host in cool moist conditions and on surfaces. Pinworms are active at night and can often be seen on the child's bare bottom while he is sleeping or on the surface of his stools.

SYMPTOMS

Itching in the rectum

Itching of the anus

Itching of the vulva and vagina (female genitalia)

Insomnia

Irritability and restlessness

Mild abdominal pain and nausea.

Some individuals have no symptoms at all. Itching occurs when the rectum and anus become inflamed as the female pinworm lays her eggs. The infection is annoying but rarely causes any serious health problems. As the female genitalia lie near the anus and this area is often moist, pinworms can also migrate to the female vulva and vaginal tissues and even to the urinary tract, where the worms can cause intense itching, with inflammation. Germs and bacteria can now cause a secondary infection to occur in the worm-infested tissues, which process seems to have occurred with Rema's child.

infections

The pinworm has even been known to travel up the vagina and infect the womb! When a large number of pinworms are located in the intestines, as can occur in immune-compromised individuals, the person may experience abdominal pain, but "tummy" pain rarely occurs with pinworm infestation. With heavy worm infestation weight loss can occur.

Pinworm infection is effectively treated with anti-helminthic preparations such as Vermox (mebendazole) and Zentel, which are readily available at all pharmacies. Bed clothes, underwear, and bath towels, even toys, should be washed thoroughly and often for at least two weeks to prevent reinfection. Truly, for best results, the entire family and all who reside under the same roof should be treated. Sometimes two doses of medications are needed to ensure full treatment of the condition.

To prevent spread or reinfection of the pinworm, after treatment:

The individual should practise proper hygiene by washing his hands after using the bathroom and before eating.

He should bathe in the mornings and wash the "bottom" and anal areas to remove as many eggs as possible from the skin surface.

He should have his bed linen changed daily for several weeks and wash the clothing and bed linen in hot water to kill the eggs.

Avoid scratching the anal region and getting the eggs under the fingernails.

Clean the toilet seat daily to remove eggs.

Write to:

Lifeline,

PO Box 1731,

KGN 8