Dr. Komarovsky about pinworms and other parasites
Parasites can start in the body of any person - both an adult and a child. Parasitic diseases are diverse, because they cause a variety of creatures, parasitic in man. In children, pinworms, roundworms and other worm infestations are most common.
Dr. Komarovsky tells how to recognize a parasitosis in a child and how to get rid of it.
Who is affected?
In childhood, the most common parasites of pinworms. The disease they cause is called enterobiasis. Small white worms ranging in length from 5 to 10 mm are attached to the intestinal wall with a sucker on the head. The child cannot get pinworms from cats and dogs, and therefore the assertion of the grandmothers that "the cat will have worms" is fundamentally untrue. Pinworms live only in humans and are transmitted only to humans.
Enterobiasis is very contagious. And because in the risk group all, without exception, children, and those who attend kindergarten or school, and those who are still brought up at home, although the first group of children have a much better chance of infection.
Pinworms reproduce and spread by eggs, which females lay not in the intestine, where they live, but at the exit, since there is air there, in the area of the anus. Thus, the eggs of parasites fall on linen, on clothes, on the hands of a child, because he always tries to scratch his ass. Itching is caused by isovaleric acid, which females secrete when laying eggs.
Spreading very fast eggs worm can live anywhere, even in the house dust and be quite active, causing more and more new infections.
Most often enterobiasis sick children aged 5 to 10 years. Up to 2 years, they are quite rare.
About the parasite
The most comfortable habitat for pinworms in the human body is the walls of the small intestine. Worm eggs get into the digestive tract always by oral route - through the mouth. They do not kill even aggressive gastric juice. As a result, the eggs enter the small intestine, where they hatch.
After individuals stick their mouths to the intestinal wall, they begin to actively feed on the contents of the intestines and swallow blood from the blood vessels of the membrane of the intestinal wall damaged by them.
Having reached puberty, pinworms mate, the males then die. They no longer have a biological need. Females with eggs are sent in a month to the rectum, where conditions are more adequate for the survival of the offspring. They usually crawl out only at night, each female can lay up to 20 thousand eggs for laying, after which she dies.
Eggs develop quickly - sometimes several hours are enough for them to reach the stages of the larvae.
Eggs are not afraid of either antibiotics or chlorine, and the only thing that affects them is the direct sunlight.
Most likely, this explains the low prevalence of enterobiosis in countries with hot and sunny climates.
Helminthiasis in children
As already mentioned, the parasites are different. All of them are united by the term "helminthiasis" or "helminthic invasions". In addition to pinworms, a roundworm can hit the child, and then the disease will be called ascariasis. To refer to certain parasitic diseases, depending on the type of parasite, there are other names - hookworm, trichuriasis, toxocarosis.
In total, there are about 250 parasites that can infect humans, but only 50 of them are common. These are roundworms - nematodes, and flat flukes, and tapeworms, and scratchers, and annelid parasites. It is the latter that are considered the most “childish” - these are pinworms, roundworms, trichinella.
Some are transmitted with soil, vegetables and fruits grown on it, some must change two or three owners (for example, live in the body of fish or cattle, pigs). Some, like pinworms, are transmitted only by contact.
It follows that a child can get infected with water, when eating poorly washed vegetables and fruits, not well thermally cooked meat or fish, as well as violating the rules of hygiene, which often require washing hands.
According to the official medical statistics of the Ministry of Health of Russia, helminth infections occur in approximately 2% of the country's population, with the majority of those infected being children.
Signs and symptoms
Manifestations of various parasitic ailments may be different. But it should be understood that all the symptoms are non-characteristic, there is no specific clinical picture.
Signs of helminthic invasions are the reaction of a child’s immunity to the presence of a parasite in the body. This is usually a toxic-allergic reaction, as well as a deficiency of vitamins and nutrients.
In other words, if a child suddenly began to lose weight inexplicably, complain of weakness and poor health, if he suddenly had no idea what was allergic in any form, it is a reason to visit a doctor and diagnose the presence of parasites in the children's body.
In severe cases, the child increases the liver and spleen, there is a fever and pain in mice, often hurts stomach, there are intestinal disorders, you may experience a dry allergic cough, not caused by a cold or a viral infection.
The child becomes apathetic, he quickly gets tired, complains of a headache. Often he has iron deficiency anemia, which has become possible due to a violation of the processes of absorption in the small intestine.
If a child has parasites, then the effectiveness of vaccinations decreases, immunity remains weak.
If the baby gets sick with something else, then helminthic invasions can worsen his condition.
The first and most true sign of pinworm infection is considered unbearable itching in the anus. At night it will intensify, by day it will subside somewhat. If the child combs the anus, it is possible the addition of a bacterial infection. Girls may experience frequent vaginitis. In the baby’s feces, the mother can, looking closer, notice white worms - the dead and still living females. The dead have already laid eggs. Alive - not yet.
If the disease is already running and there are a lot of individuals, the child may feel sick, his stomach often hurts, sleep is disturbed, babies become irritable, tearful. But the night creak of teeth in a dream (bruxism) has nothing to do with worms, Komarovsky says, despite the fact that the older generation stubbornly asserts that once a baby squeaks with teeth at night, he must have worm infestations.
Yevgeny Komarovsky claims that the only reliable method for determining helminthic invasions in a child is to give feces to the eggs of the worm. Such an analysis is carried out in any urban, rural and even village hospital. Pediatricians usually do not have any difficulties with the definition of enterobiosis and without laboratory diagnosis, since they are the only parasites with more or less vivid clinical symptoms.
At the same time, worm eggs may not be observed in the scraping of eggs, but in the fecal masses they will be found in any case if the child is infected.
And because parents should give preference in favor of the analysis of feces, and not express scraping.
With the diagnosis of other parasal diseases, such modern laboratory methods as serological ELISA, RIF, and histological coprology help. The search area can be large-scale, especially if the parasite is not too common - take scrapings from the skin, study the composition of vomit, sputum, urine and blood.
Sometimes an allergist helps a doctor who, with the help of skin tests, can find out which helminth antigen the child has a reaction to. If there is a suspicion that the worms have already caused the child harm, and some internal organs are damaged, ultrasound of the abdominal organs, FGDS, colonoscopy and other examination methods are carried out, which will help to establish the location and nature of injuries.
Treatment and Prevention
Despite the fact that the yard is the twenty-first century, many parents prefer to treat nterobiosis and other worm infestations with folk remedies of vegetable type. Yevgeny Komarovsky argues that such methods are significantly inferior in their effectiveness to pharmaceutical drugs with antihelminthic action. Also, folk remedies do not focus on different types of parasites, which generally can exclude any effectiveness.
Komarovsky does not advise parents to self-medicate. The doctor will help you choose the right tool based on the age of the child, his health and the severity of the worm infestation. For the treatment is usually used the same means as for adults, but in lower dosages.
Modern drugs do not require long-term treatment, sometimes 1-3 tablets are enough. But nevertheless, the doctor advises to repeat the course in a couple of weeks in order to “finish off” the individuals and larvae that could not be destroyed in the first course. Often, parents ask if they can give such preventive drugs to the child. To do this is inappropriate, says Komarovsky.
If there is no problem, no pills are needed. If there are no complaints, “just in case” such means do not give.
The problem, according to the doctor, is that mothers often do not have enough free time to visit a doctor when they suspect parasites and have a stool test, and therefore it is easier for them to give the child a couple of pills and forget about their worries. This approach is incorrect, since it is necessary to establish not only the fact, but also the name of the parasite.
In the next video, Dr. Komarovsky dispels all the myths about worms.