Enterobiasis in children

A common parasitic infection that many children suffer from is enterobiasis. It is brought on by pinworms, which are microscopic worms that proliferate quickly in settings like daycare centers and schools. Although these worms might not seem dangerous at first, they can really aggravate kids and cause them a great deal of discomfort.

Strong itching is a common symptom of enterobiasis in children, especially at night, which can make it difficult for them to fall asleep. Given how easily this infection can spread through contact with contaminated surfaces or objects, it is critical that parents identify the symptoms early on and take appropriate action to stop the infection from spreading.

Thankfully, medication and good hygiene practices can effectively manage and cure enterobiasis. We’ll look at the symptoms, causes, and preventative measures in this post to help shield your family and child from this infection.

What is it?

One of the helminthic illnesses is enterobiasis. It appears as intestinal inflammation and is accompanied by a host of negative symptoms that are brought on by parasites living in the gastrointestinal system. The world is overrun with this pathology. Enterobiasis can affect anyone, although it primarily affects children.

In those geographic settlements with higher population densities, incidence rates are higher. The rate at which an infection spreads from a sick child to a healthy one depends on factors such as population size and dense residential concentration.

Numerous studies have been conducted, and the results have shown that the incidence of enterobiasis in children is not significantly influenced by a state’s level of social development. This helminthic disease can infect people in both economically developed and developing nations. Typically, enterobiasis accounts for 75% of all helminth-caused diseases. Every year, this value is altered. But for many years, there hasn’t been a discernible drop in the incidence. In organized children’s groups, enterobiasis cases are significantly higher. Youngsters enrolled in kindergarten or other preschool programs are susceptible to illness.

Causes

A parasitic worm is the disease’s cause. These biological entities are referred to as helminths in medicine, and their entrance into the body is considered an invasion. The Enterobius vermicularis or pinworms are the cause of this helminthic pathology. The end of the 18th century saw the discovery of these pathogens. The helminth’s name is composed of two words that literally translate to "inner life." One cannot call this name by accident. It represents the fundamental structure of the helminth.

In appearance, these worms resemble a spindle. Their body shape is streamlined. Usually they are white or milky in color. The outer or cuticular shell of the worm has pronounced transverse striations. The length of the body of this “guest” can be different. Usually it depends on the sex of the helminth. A sexually mature female, capable of producing offspring, usually reaches one centimeter in size. The length of the body of the male, as a rule, does not exceed 4-5 mm. You can distinguish different individuals not only by size, but also by the structural features of the tail end of the body. Females have a sharp “tail,” while males have a blunt and slightly rounded one. On each side of the body, the helminth has special grooves. They run along the entire body of the intestinal parasite, and form two head vesicles towards the head. The main anatomical feature of this helminth is the structure of the digestive system. It includes an oral opening with several lips, a long esophagus, which expands in the area of ​​the tail end and forms an anus. Anatomical formations located at the head end of the body form a special suction apparatus. It is with its help that the helminth perfectly attaches to the walls of the human intestine.

The organization of the internal structure of helminths is quite complex. Another feature is the structure of the reproductive system. Females and males have organs that are responsible for further reproduction. This feature of helminths causes their fairly rapid development and active formation of eggs. Females lay a larger number of eggs. Pinworm eggs usually do not exceed 50 mm in size. They can be somewhat oblong or asymmetrical in shape. They are covered on top with a fairly dense two-layer contour shell, which protects them from various adverse environmental effects. During their life, female pinworms lay a large number of eggs. This physiological feature of their life cycle affects the specifics of prescribing therapy in the future.

The upper and lower sections of the large and small intestines are pinworms’ preferred habitats. Pinworms typically reside in the cecum and appendix regions of the body.

Typically, women reside there. Males are typically expelled from the intestines with feces following reproduction. Helminths are said to feed on the contents of the intestines by parasitologists.

The number of parasites living in the intestines can be huge. On average – from several hundred to a thousand individuals. A clinical case has been officially registered in which doctors found more than 2,500 pinworms in a child. Usually, such a huge number of helminths appears with repeated self-infection. A person can become infected by swallowing worm eggs. Usually, they contain sexually mature larvae. Helminths that have entered a child"s body easily reach the organs of the gastrointestinal tract and settle in the intestines. As a result of digestion, a huge number of different types of enzymes are released. They have a damaging effect on the outer shells of pinworms, freeing them for life. Then the helminths undergo several molts and become fully sexually mature. It should be noted that the release of eggs occurs in the lower parts of the large intestine. For this, the females descend down – along the intestines. The release of eggs and their active growth to larvae occurs already in the rectum.

A sexually mature female requires oxygen in order to release eggs. It enters the human anus through its perianal folds after crawling out of it.

This usually happens at night, when the human body is more relaxed. There are cases when pinworms move throughout the anogenital area. This leads to the fact that they can crawl into neighboring anatomical areas. Single cases of detection of helminths – in the peritoneum. After the completion of the life cycle of the female, she dies and turns into a small light lump. A feature of the development of pinworms is also that they do not need any specific living conditions for active growth. They can cause infection both in people living in northern countries and cities, and in southerners. The worse the hygiene knowledge, the more often people get sick. Severe cases of the disease are largely associated with self-infection. To treat enterobiasis, it is very important to follow all the rules of personal hygiene.

The immune system of a child is weakened as a result of helminth infections.

Children who have long-term (even mild) helminthiasis are more likely to exhibit immunodeficiency symptoms. Children with helminthic pathology are more vulnerable to infections in general and are at a higher risk of developing long-term gastrointestinal disorders. Enterobiasis typically affects children 3–4 times more frequently than it does adults. Their stay in structured groups and inadequate hygiene education are the main causes of this.

Helminthiasis is rightly considered a disease of "dirty hands". Usually self-infection occurs when a child scratches the anal area. Itching in this area is increased by mature female pinworms, which reach the anogenital area during the laying of eggs. The child scratches damaged areas of the skin, which leads to eggs getting under the nails. Little children usually put their hands in their mouths, which contributes to multiple autoinfection. Helminthiasis can be spread by contact and household means. Sick children attending kindergarten become sources of infection for healthy peers. Violation of personal hygiene rules contributes to the fact that worm eggs end up on various toys, furniture, and also on common items. Enterobiasis in children"s organized groups, where children spend a lot of time, is quite common.

It is significant to remember that pinworm eggs can survive for a considerable amount of time. They can typically live for a month at +20 degrees. Their damage is only caused by unfavorable external conditions. In less than an hour, parasites die when temperatures drop to -20 degrees. Pinworm eggs die in a matter of seconds when heated to between 50 and 60 degrees.

Symptoms

Clinical manifestations of enterobiasis can be very different. There are common symptoms that all babies have. However, there may be individual characteristics. Usually they occur in children who are prone to developing allergic reactions. The severity of adverse symptoms of the disease depends on the initial condition of the child, it can vary in intensity. The incubation period of the first infection with pinworms is usually a couple of days. This time is quite enough for parasites to begin the life cycle. The acute phase of enterobiasis is usually 5-6 days. The chronic phase depends directly on the life cycle of the parasites and the number of cases of self-infection. Most often – from one to two months.

• Itching. It can vary in intensity and even be quite unbearable. This leads to the fact that sick children begin to actively scratch the anal area. Usually the itching intensifies at night, which is due to the peculiarity of the vital activity of helminths. This contributes to sleep disturbances and frequent trips to the toilet.
• Abdominal pain. Usually, babies feel pulling or tingling pain. Some children develop tenesmus – a false urge to go to the toilet. The pain is usually localized in the area of ​​the right half of the abdomen, which imitates a similar symptom in appendicitis. Some small patients do not experience any pain in the abdominal cavity with enterobiasis.
• Neurological symptoms. The toxic effect of the waste products of helminths has a pronounced adverse effect on many internal organs, including the nervous system. A sick child develops a headache, weakness increases, concentration decreases, nervousness appears. Schoolchildren with signs of enterobiasis begin to study worse at school, lag behind the school curriculum.

• Limitation of social contacts. A sick child wants to limit his personal space from strangers. This manifests itself in the fact that he becomes more withdrawn and silent. Often staying at home and limiting social interactions brings the baby an improvement in his well-being.
• Intestinal dysfunction. Long-term enterobiasis leads to the fact that the child shows signs of functional disorders of the small or large intestine. As a rule, they manifest themselves as flatulence and various problems with the elimination of feces. They can be expressed in the form of constipation or diarrhea.
• Mood changes. Babies become more whiny and capricious. Even a minor reason can cause them to display violent emotions. Babies may refuse breastfeeding.
• Skin rashes. Usually, their appearance is due to the toxic effects of the waste products of helminths. Getting into the systemic bloodstream, these substances cause numerous allergic reactions in the child. If the baby is prone to allergies, then the severity of adverse changes is very significant. The most common skin symptoms of enterobiasis include various dermatoses, dermatitis and eczema.
• Decreased immunity. Usually this is manifested by the baby"s strong susceptibility to various infectious pathologies. If we look at statistics, we can note that children with persistent enterobiasis and multiple cases of self-infection suffer from colds and respiratory diseases much more often than their peers.

Signs in infants

Infant enterobiasis progresses in a manner largely similar to that of older children. Newborns are susceptible to infection as well. Immunodeficiency manifests in infants early in life, when the illness advances rapidly and the side effects are severe. Mothers themselves typically discover the illness while practicing hygiene.

Infants with enterobiasis are diagnosed in the same way as older kids.

Treatment option is a feature. Individual treatment plans are chosen for very young patients, and dosages of medications to eradicate worms from the body are lowered while taking the child’s age and body weight into consideration.

Diagnostics

Enterobiasis is frequently quite simple to diagnose at home. Typically, worms are discovered by parents while practicing hygiene. Children who are older can actually see the helminth. It’s usually not difficult to diagnose the illness.

It takes a number of additional laboratory tests to properly make a diagnosis. They enable you to confirm whether the child’s body contains pinworms. The general blood test shows leukocytosis (an increase in leukocyte count), and the ESR accelerates noticeably. Different perianal scrapings are required in order to identify pinworms.

Taking material and examination

There are multiple efficient methods to identify the illness, including scraping and imprinting. Three times, one week apart, the Graham method (sticky tape imprint) is executed.

Biological material is typically gathered prior to the morning procedures. This technique has a 95% efficacy rate.

Using a specialized spatula or a swab dipped in a glycerin or soda solution, you can gather material for scraping. Then, helminth eggs and, in certain situations, the remains of mature worms are found during a laboratory examination. Additionally, the result’s accuracy is fairly high.

Complications

Although there are some exceptions, the disease typically progresses without showing any negative effects. Weakened infants and kids with severe immunodeficiency states and concurrent chronic internal organ diseases may experience complications. These consist of dermatoses, allergic eczema, helminthic appendicitis, chronic colitis, and different proctitis and paraproctitis.

Treatment

Preventing any instances of reinfection is one of the primary requirements for the cure of enterobiasis. Even for the youngest patients, fairly stringent preventive measures are necessary. In the event of an epidemiological outbreak of infection, it is crucial to remember that everyone in the vicinity of sick children should also abide by the rules.

Certain medical professionals advise treating every member of the family with anthelmintic medication.

Experts surmise that this plays a major role in the marked decline in the incidence of intra-family helminthic disease outbreaks.

Side effects are another possibility with enterobiasis medications. In order to lessen these symptoms, a treatment plan is carefully customized for each child, taking into consideration factors like age, weight, and the existence of coexisting conditions.

The illness is treated with the following measures:

• Observance of hygiene rules. All sick children must wash their hands frequently – especially after active games outside and going to public places, before and after eating and visiting the toilet. Parents must ensure that these important hygiene rules are observed.
• Wearing closed underwear. Children"s panties must be washed in hot water (using detergents), before wearing they should be ironed with a very hot iron. Baby"s bed linen should be treated in the same way.

Remember to iron things! Eggs laid by pinworms can only be destroyed by extremely high temperatures.

• Mandatory daily washing. The anogenital area should be washed twice a day – using baby soap. It should not contain any aggressive chemical fragrances that can only increase allergic reactions on the delicate skin of a child.
• Daily change of bed linen and underwear. During all periods of the disease, it is very important to follow this rule. This will help prevent possible cases of re-infection. If there are several children in the family, then only individual sets of linen should be used for each child. Using other people"s things (even ironed) is prohibited.
• Drug therapy. Usually, the following drugs are used to eliminate pinworms: "Pirantel", "Vermox", "Piperazine", "Medamin" and others. The dosage and treatment regimen depend on the age of the child and are determined taking into account his body weight. To prevent pinworms from spreading throughout the anogenital area, you can use a cotton swab soaked in petroleum jelly. For girls, this simple measure helps to cope with pinworms crawling into the vagina.

Cause of Enterobiasis	Pinworms, small white worms, cause this infection. Children get it from swallowing their eggs, often through contact with contaminated surfaces.
Symptoms	Itching around the anus, trouble sleeping, irritability, and sometimes stomach pain are common signs of enterobiasis in children.
Treatment	Doctors usually prescribe antiparasitic medication. It"s also important to wash hands frequently and clean household items to prevent reinfection.
Prevention	Regular handwashing, keeping nails short, and avoiding scratching the anal area can help reduce the risk of spreading the infection.

Although enterobiasis is a common infection in children, it is treatable with proper hygiene and care. Parents can significantly lower their child’s risk of illness by learning how the infection spreads and implementing easy preventive measures.

Important actions to prevent the spread of pinworms include cleaning surfaces in the home, maintaining regular nail trims, and practicing good hand hygiene. If an infection does occur, it’s critical to consult a doctor for appropriate care to eliminate symptoms as soon as possible.

By taking preventative measures, enterobiasis can be avoided, guaranteeing your child’s continued wellbeing. Recall that maintaining good hygiene is essential to preventing these infections.

Tiny worms cause enterobiasis, commonly referred to as a pinworm infection, which is a common intestinal infection in children that can cause itching and discomfort, especially at night. It frequently affects children in group settings like schools or daycare centers and is easily spread through contact with contaminated hands or surfaces. Fortunately, medication is available to treat enterobiasis, and maintaining short nails and practicing good hygiene go a long way toward prevention.

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Patients of the Langepas polyclinic can independently take materials for analysis