Ascaris in children: symptoms of ascariasis and treatment
Parasitic diseases in childhood are common. And one of the leading places among all of these ailments is ascariasis - a disease caused by ascaris. The disease is not characterized by some bright symptoms, and therefore for quite some time it may go unnoticed. At the same time, the success of treatment and much more depends on when the child began to provide assistance. Therefore, the task of any self-respecting and loving parent baby is to learn to recognize ascariasis as early as possible.
About the disease
Ascariasis refers to pathologies, referred to as "children", because it most often affects children. A special risk group - kids up to 5 years. Ascarids in adolescent children are diagnosed much less frequently than in young children. The parasite, which belongs to helminths, causes the disease (therefore, the disease itself is de jure and de facto considered to be helminthiasis).
This parasite has plenty of opportunities to penetrate the human body. And then the body begins to experience great difficulties due to the fact that the helminths live inside - many processes are grossly disturbed. These "tenants" can live not only in the intestines, like pinworms, but also in other internal organs, and therefore the disease is considered dangerous.
Guessing that the child has parasites, mothers can independently on a set of symptoms, baby’s behavior, well-being, but to establish what kind of parasite has settled in the child’s body, the doctor should, it’s impossible to do it yourself at home.
About the pathogen
Ascariasis causes a parasite that is called human ascaris or Ascaris lumbricoides. It is called human not because of its humanity and humanity, but for the simple reason that it can only live in the human body. Neither the dog’s body, nor the cat, cow or horse ascaris horses will survive.
Ascaris refers to roundworms. It, in general, does not have a single organ or process with which it could attach to organs, and therefore, unlike many other worms, does not choose its habitat in the child’s body, but constantly travels and moves towards the food masses. The ascaris sense organs are almost deprived, there is only touch, small bumps are responsible for it around the mouth of the worm.
Ascaris lives in the lumen of the small intestine. In size, these are very impressive parasites: the adult female can be up to 40 centimeters in length, and the male - 25 centimeters. Sexually reproduces parasites and every day the fertilized female is able to lay up to a quarter of a million eggs, that go out with the contents of the intestines.
Nature took care of the offspring of ascaris - the eggs are “equipped” with shells that have 5 layers, they make them almost invulnerable to the external environment. Neither cold, nor chlorine, nor other disinfectants threaten them.
Ascaris eggs are afraid only of agents that dissolve fats, such as alcohol, gasoline, and hot water, and the direct rays of the sun also do not like.
Before finding a new carrier, eggs mature in the ground. The warmer the climate in the region, the faster the eggs ripen.There are cases when they remained alive and potentially dangerous even after 12 years in the ground.
Ascaris remain “faithful” to their wearer, they do not change it throughout their lives. As soon as unfertilized eggs penetrate into the child’s body from the soil with dirty vegetables or fruits, being transferred by flies and other unpleasant insects, larvae leave the gut, which are able to get into the blood vessels through the intestinal wall, from there to the liver, into the right atrium light The child begins to cough, and the larvae with mucus move into the pharynx, swallow again, again in the small intestine, where they mate and lay eggs. This is a complete life cycle.
The migration phase from the intestine to the lungs takes up to two weeks through the bloodstream. Sometimes young larvae can overcome all the way in 8 days. The subsequent intestinal stage after secondary ingestion is the longest. It can last about a year, the first “fresh” eggs start appearing in the baby’s fecal masses a couple of months after infection.
What feeds on ascaris, science knows in some detail: at first it is blood serum, but as it grows up, serum becomes small, and the individual begins to consume red blood cells - red blood cells. The choice is not accidental - roundworms also need oxygen, and it is these cells that carry it. The older the ascaris becomes, the more oxygen it needs, which is why individuals who are deprived of reason intuitively tend to where the most oxygen is in the lungs.
Deceit ascaris lies in the fact that they do not always clearly follow the phases of the life cycle envisioned by nature. Individuals can linger in the liver or lungs, causing serious pathological processes there. Over time, they are distributed throughout the body; they can affect the pancreas, gallbladder and biliary tract, heart, brain.
It is noteworthy that there is also a benefit from ascaris. Their phenomenal property to increase the fertility of women was discovered by researchers from California. They found that the presence of ascaris in the body of a woman increases the chances of conceiving and carrying a child.
It is believed that this is due to the "distraction" of the immune system to the parasites, which is more favorable for the occurrence of pregnancy and its carrying.
Ways of infection and disease progression
Since there is no way to survive in the external environment and give birth to the roundworm, she is looking for a human carrier. You can become infected by swallowing eggs that are already ripe enough. And in a few hours the migration phase will begin. As the number of parasites grows, more new foci of inflammation and hemorrhages will form in the body.
A sick person is contagious because it releases into the environment a huge number of unfertilized immature eggs. In this way, children are infected from each other in children's groups — kindergartens, schools, health camps, and sections.
But a child can get ascariasis without having direct contact with a sick person. A fecal-oral route is considered to be a very common transmission route for parasites when ascaris eggs enter the baby’s body. with eaten fruit, a vegetable that was previously poorly washed. Ascariasis is especially common in countries and regions where it is customary to fertilize the soil with fecal fertilizers.
Ascaris eggs can get out of the ground into the hands of a child, bypassing the "middlemen", while playing with sand, earth. If after this the child does not wash his hands and pulls them into his mouth or starts to eat something, then the probability of infection will be very high.
At the same time, you should know that a child can become infected, even picking his nose with dirty hands - it is much easier for eggs to get into the lungs, into the mouth through the nasal passages.
The habit of drinking unboiled water can also be dangerous. Do not rely on the total chlorination of water from the tap, against ascarid chlorine is powerless.
There are cases of infection through contaminated banknotes, coins, door handles, handrails in a trolleybus, tram, bus. Bringing parasites can pets on their own wool from the street. Among the insects that spread ascaris, we can mention flies, cockroaches and ants.
Based on the foregoing, it is clear why the peak of infection usually occurs in the summer and the beginning of autumn. At this particular time, children walk a lot, have close contact with grass, earth, sand, animals, insects, eat a lot of fruit.
Symptoms and signs
Features of ascariasis depend on how large the number of parasites in the child’s body. In addition, there is intestinal ascariasis, in which the predominant habitat of roundworms is concentrated in the lumen of the small intestine, and extraintestinal ascariasis, when parasites settle in the brain or in the organs of vision.
After the child swallowed the eggs of ascaris, there is no point in waiting for any symptoms of infection right away. The migration phase is usually not accompanied by symptoms, and the disease is latent, latent. If there are few parasites, then there will be no signs at all.
In most cases, the first clinical manifestations of ascariasis can occur. only a week and a half after infection (in infants a little earlier, in children older than 3 years later). As long as the larvae go through the migration phase and with blood they move from the intestine to the lungs to get back into the intestine, the child may experience an increase in body temperature (above 37.0, and sometimes up to 38.0 degrees). The child looks tired, lethargic, weak. With the ingress of larvae into the lungs, a strong dry cough appears that is difficult to relieve.
Sputum departs in small quantities, and sometimes does not depart, in general, you can notice small bloody streaks in it, although they might not be as good. It is noteworthy that with the appearance of cough, many children simultaneously start a rash. This is usually urticaria - an acute allergic reaction (antibodies in the child’s body try to fight the parasite, but sensitization peaks, and histamine is released).
Allergic rashes are most common when infected with ascaris visible on the hands, feet. It happens that the urticaria, even after curing ascariasis does not pass for some time, becomes chronic.
A child with ascariasis in the migration stage increases lymph nodes, an increase in spleen, liver in size can be observed.
When the intestinal phase begins, that is, the larvae return to the small intestine, having traveled through the blood vessels and lungs to mature and multiply, the signs become different. The child gets tired quickly, gets tired even after insignificant physical exertion, his appetite suffers (or decreases so that parents cannot feed the child with almost anything, or increases to such an extent that the child becomes literally voracious).
Toxins that secrete individuals of parasites in the course of their existence, lead to vomiting, diarrhea, damage to the intestinal wall - to pain in the abdomen. It is noteworthy that the child complains mainly of pain in the navel. Diarrhea and constipation may occur. After constipation can be profuse diarrhea and vice versa.
In general, the child becomes irritable, distracted, he forgets everything, ceases to focus attention normally. Sleep is often disturbed, there may be bouts of dizziness. Body weight is reduced.
Because adults eat red blood cells, a child may have anemia. Immunity decreases, the baby starts to hurt more often. The defeat of individual organs with ascaris may have its own symptoms.
- Amazed organs of sight - children's eyes become especially painfully sensitive to bright light, the pupils look dilated, while the right pupil may be more or less than the left and vice versa.
- Liver and digestive tract organs affected - obstructive jaundice may appear, there are bouts of nausea, vomiting, intolerance to certain foods, general loss of appetite, diarrhea with blood in the stool, abdominal pain, rapid weight loss, excessive salivation.
- Astonished heart - usually roundworm located in the right part of the body, more precisely, in the right ventricle. The child complains of shortness of breath, pain in the region of the heart, small and medium hemorrhages may occur.
- Affected lungs - symptoms are similar to a normal viral infection with a dry and unproductive cough, there are dry rales on inspiration, shortness of breath, fever. This form of the disease can quickly become chronic, and worsen each season change. In this case, the child faces a rapid probable development of bronchial asthma.
- Affected brain - this condition is very dangerous, and the degree of its danger depends on where the parasites “settle down”. The defeat of the outer shells of the brain causes meningoencephalitis with severe migraine. The defeat of the deeper structures of the brain causes the formation of local seals, which manifest as organ tumors - seizures like epileptic, convulsions, episodes of loss of consciousness, increased blood pressure, neuroses, mental disorders, severe forms of depression.
Affection of individual centers and nerves causes its symptoms, for example, the location of the parasites near the auditory nerve leads to a decrease in hearing, and the occupation of the optic nerve can cause a decrease in vision or blindness.
At any stage of the life cycle of ascaris, the child is contagious. This should not be forgotten.
Danger and complications
The danger of the disease lies not so much in the presence of parasites in the body, but in what damage they can cause. The walls of blood vessels and internal organs suffer from purely mechanical damage by the larvae, small or significant hemorrhages can occur. Not excluded local inflammatory processes, the formation of infiltrates, necrotic foci, ulcers.
The metabolic products of worms are toxic to humans. They cause allergies, urticaria, and for children with special allergies, it is dangerous to cause acute allergic reactions of the first type - angioedema, for example, suffocation.
In most cases, intestinal ascariasis leads to intestinal dysbiosis, the child’s immune system suffers, which is very dangerous for children with low immunity. The fact of influence on the immune system makes the child poorly protected against various infections, viruses, bacteria. Given this effect on immunity, it is believed that vaccinations during the period of illness with ascariasis are ineffective, since antibodies to dangerous diseases are not produced or are produced in small quantities.
With a large number of parasites, complications such as the development of intestinal blockage and obstruction of the bile ducts are not excluded. Against the background of the presence of ascaris often develops acute appendicitis, inflammation of the pancreas, cholecystitis.
In infants with severe ascariasis in the pulmonary form, severe pneumonia with a fatal outcome can develop.
If you suspect ascariasis in a child, you need to contact a pediatrician or pediatric gastroenterologist. There are also doctors of narrow specialization - parasitologists and infectious disease specialists, but they should be sent to them after the tests for roundworm gave a positive result. The symptoms of the disease appear most clearly after 2.5-3 months from the moment of infection, and this period is considered, according to clinical recommendations, optimal in order to detect signs of the disease within the framework of diagnosis.
At the first visit to a pediatrician, the doctor measures the temperature, feels the baby's lymph nodes, palpates the tummy, examines the condition of the skin for a rash, and also talks to the parents. Laboratory tests are assigned to the child:
- general blood analysis;
- feces analysis;
- microscopic examination of sputum samples;
- blood chemistry;
- serological tests for antibodies to ascaris.
It is also recommended to make an X-ray of the lungs, irrigoscopy, ultrasound of the abdominal organs. In some cases, there is a need for MRI or computed tomogram, for example, if the parasites suspect the brain membranes or its deeper structures.
In the blood of a child with ascariasis, it is usually possible to reveal a characteristic picture of leukocytosis simultaneously with eosinophilia. In the smear of sputum and feces may be detected larvae or particles. It is this analysis that will help to establish the parasite accurately, because a child can have lamblia and pinworms.
In the intestinal phase of the life cycle of Ascaris, diagnosis is usually more accurate, since in the child's body there are mature individuals that are already breeding, and in this case, Ascaris eggs are already detected in the feces.
Sometimes the detection of ascaris is, in general, a pure coincidence. For example, a child undergoes a physical examination, and only on fluorography the doctor draws attention to strange blackouts (infiltrates), or the eggs of parasites are found in the stool masses quite accidentally.
How to treat?
Treatment is prescribed only after diagnostic measures give a positive result. No preventive (just in case) treatment of drugs from worms can not be practiced. When the diagnosis is confirmed, special means that have a directed action against the parasites help to cure the child. Dosage and treatment regimen individually prescribed by a doctor.
Gone are the days when treatment for parasites required a long-term medication with a lot of side effects, parasites can now be removed quickly, the treatment regimen will not include a long medication. Some funds, in general, can get rid of the "invaders" of the child's body in literally 1 day.
If ascariasis is detected at an early migration stage, then drugs are recommended to reduce sensitization, as well as anthelmintic drugs, which are popularly called simply “worms tablets”. It is important to choose the means with a wide range of effects on the parasites. For dry cough and pulmonary symptoms of the disease, bronchodilators are recommended, and sometimes corticosteroid hormones.
When identifying the disease at a later, intestinal stage, anthelmintic drugs are recommended.
Thus, it helps to excrete parasites:
- in the early migration stage - “Levamisol”, “Nemozol”, “Vermox”, “Vermacar” (suspension), “Termox”, “Mebex”, “Mintezol”, “Tiabendazol”. Additionally - antihistamines "Suprastin", "Loratadin", expectorant - "Mukaltin";
- late intestinal stage - Helmintox, Pirantel (once accepted), Nemocid, Mebendazole, Mebex.
At any stage can be recommended enterosorbents, immunomodulators and additional intake of vitamins. The effectiveness of treatment is close to 100%.
It is important after the end of treatment about a month later to re-do tests to prevent re-self-infection.
The treatment takes place at home. Hospitalization requires only children with severe complications to treat, in fact, the complications themselves, as well as helminthiasis.
Recommended during the treatment sparing diet, excluding the abundance of sweet, fatty and spicy.
Predictions for ascariasis are quite favorable, if there are no complications, That cure occurs completely without consequences for the body.If there are complications and damage to organs, then the predictions no longer depend on ascariasis itself, but on the severity of one or another complication.
Ascaris has one peculiarity - if, in general, the child is not treated, he, in the absence of self-infection, will recover himself in about a year. As soon as the individuals complete their life cycle, they will die and come out. The same individuals do not live twice in the same organism.
Another question is how reasonable this way is, for in a year parasites can cause significant harm to a child’s body, the consequences of which will be much more difficult to treat.
Folk remedies - is it possible or not?
Many parents are interested in whether it is possible to treat a child for ascariasis with folk remedies at home. For the full and unconditional surrender of Ascaris, traditional medicine recommends garlic, duet with milk, garlic in enemas, pumpkin seeds, carrot juice and sesame oil.
Doctors doubt the necessity and effectiveness of the treatment of ascariasis by folk methods, because such treatment has a lesser effect, and sometimes it does not have it, in general. Garlic will take a long time, and pumpkin seeds are not so safe.
Is it worth it to torment and torment a child if there are drugs that can help solve the problem once and for all in just one step.
For diseased, temporary isolation from the children's team is important. After taking antihelminthic drugs, the child is non-infectious. To protect your baby from parasitic illness, it is important to adhere to preventive measures.
- Vegetables and fruits should not just be washed, but washed in warm water with a special brush. Do not allow your child to eat dirty fruits or vegetables.
- It is important every time, returning from a walk, to wash the hands, especially if the child was playing with sand, earth, stroking animals, taking door handles and handrails in a shopping center or public transport.
- Teach your child not to bite his nails. Even washing hands after a walk does not guarantee that ascaris eggs do not fall under the nails, and from there, with appropriate actions, they can easily migrate into the body through the mouth.
- Try to ensure your child plays in the sand or on the playground from the sunny side. In open sunlight, Ascaris eggs die or lose their ability to evolve into a larva.
- Do not water the child with water from dubious sources - wells and springs, without boiling water in advance. Ascaris eggs penetrate this water very often.
Opinion of Dr. Komarovsky
The famous pediatrician Yevgeny Komarovsky argues that helminthiasis is a common problem, but parents, unfortunately, have very little truthful information about worms and a lot of speculation, many of which “inherited” from their grandmothers. According to the doctor, there are several common myths about helminths. I would very much like modern parents to reconsider their attitude towards them.
- Worms are the cause of atomic dermatitis. It's a delusion. If the child has a genetic predisposition to allergies, the worms have nothing to do with this issue. And if there is no such predisposition, then atopy cannot occur.
- The child feels the parasites move inside the body. This is what some mothers are trying to explain the restless behavior of the child. Feel the parasites can not. That is why attempts to explain the restless children's crying that he has worms is a position far from science and common sense.
- The presence of parasites shows a blood test. Some paid medical centers with a dubious reputation offer to make a blood test for a certain amount of parent money, which will surely show the presence of parasites and determine what they are called. This is an attempt to mislead people, according to Komarovsky. The ELISA method is not the most informative in the diagnosis of ascariasis. You should not give him that kind of money.
- If the child bought a dog, the whole family needs to drink medicines for worms. Some go so far as to systematically do it with the whole family, reading the instructions for use and drawing knowledge from there. Dogs and ascariasis have nothing in common, they do not live ascarids.
- For prophylaxis, the child should be given worms pills once a year. In Nicaragua - yes, there the prevalence of parasites due to climate is higher. And in Russia there is no such need, because in our climate ascariasis and other parasitic diseases do not have the character of an epidemic or pandemic. Medicines must be given for the disease, and not for its prevention.
- About the presence of ascaris can say tooth gnashing at night. This phenomenon is called bruxism, and it has nothing to do with parasites.
- Supplements are also effective against parasites. This is not true. Supplements from ascariasis does not exist. And if someone advertises such a tool as anthelmintic, then it violates the law, giving you incorrect information and misleading you. And even more so from the parasites of effective and reliable folk remedies. But there is anthelmintic drugs. They need to treat the child from ascaris.
For the symptoms and treatment of ascariasis, see the following video.