Oxyuriasis

Fabian Dupont is a freelance writer in the medical department. The human medicine specialist is already doing scientific work in Belgium, Spain, Rwanda, the USA, Great Britain, South Africa, New Zealand and Switzerland, among others. The focus of his doctoral thesis was tropical neurology, but his special interest is international public health and the comprehensible communication of medical facts.

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The pinworm (Enterobius vermicularis) is the causative agent of oxyuriasis, which occurs around the world. This intestinal parasite infection is also a frequent diagnosis in Germany. Oxyuriasis is particularly common in young children. It is transmitted from person to person, mainly through poor hygiene. Those affected usually do not even know that they have become infected with pinworms. Oxyuriasis can be treated easily. Here you can read everything you need to know about oxyuriasis.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. B80

Oxyuriasis: description

Oxyuriasis is caused by an infection with the pinworm. Some doctors also call the infection with the intestinal parasites enterobiosis (in English: enterobiasis). The name is based on the Latin name of the worm: Enterobius vermicularis.

Parasitic diseases are usually a rarity in Germany and often a souvenir from the tropics. An exception is oxyuriasis, which is also common in developed countries such as Germany. Around 400 million people around the world are infected with pinworms.

Oxyuriasis: symptoms

The pinworms (Enterobius vermicularis) often go unnoticed for a long time, as there are no symptoms. The most common and specific symptom of oxyuriasis is itching of the anus and vagina. Since the female worms usually emerge from the anus at night to distribute their eggs in the folds of the surrounding skin, the itching is particularly annoying at night. Small worms are sometimes discovered when inspecting the chair or underpants. The patient usually see a doctor for these two reasons.

A behavioral or developmental disorder can be noticed in young children. Because of the itching, sleep disorders sometimes occur indirectly. In girls and women, there is a risk that the worm will infect the female genitals and trigger an inflammatory reaction there. If the infestation is very severe, inflammatory processes rarely occur in the intestinal wall. Such processes can result in appendicitis or a perforated (burst) bowel. If you do not react quickly in such situations, the patient's life is in acute danger. As a rule, enterobiosis / oxyuriasis is a harmless disease and complications are very rare.

Oxyuriasis: causes and risk factors

Pinworms are more common in babies and children, but sometimes also in adults. Women are generally more affected than men. Pinworms are small, thread-like parasites that belong to the group of nematodes (roundworms).

As parasites, they belong to those living beings that live in another organism (for example in humans) and feed themselves at the expense of them. The pinworm only affects humans. The adult worms live in the large intestine, where they develop from larvae into adult worms.

The male is about half a millimeter, the female up to 1.5 centimeters tall. After fertilization, the female migrates to the anus and preferably lays up to 10,000 eggs in the folds of skin directly around the anus at night. This creates an itchiness through which the eggs quickly reach the hands and fingernails of the infected person. If the contaminated fingers are put in the mouth, self-infection is possible.

In addition, the eggs are transferred to objects during the preparation of food or through hand contact. Since the eggs remain infectious for up to three weeks in a moist environment, re-infection from remaining eggs is possible even after successful treatment. At body temperature, the worms begin their larval development in the freshly laid eggs after just a few hours. After five to six weeks, the worms are sexually mature and start producing eggs.

Oxyuriasis is transmitted particularly through hand contact. An important risk factor is therefore poor hygiene and careless hand washing. Since the infection mainly occurs in young children, the risk of oxyuriasis infection is higher in day-care centers or crèches than at home. The parasite can also be transmitted during sexual intercourse. Anal-oral practices in particular make infection possible.

Oxyuriasis: examinations and diagnosis

For the doctor, anal itching is often the first sign that indicates a possible oxyuriasis infection. The first point of contact is usually your family doctor. He will first question the patient in detail. He could ask questions like:

• When does itching mainly occur?
• Have you seen white worms in the feces or anus?

A blood test can provide further evidence of a pinworm infestation. There are an increasing number of immune cells that specifically fight against parasites, so-called eosinophils. If their number is increased, one speaks of eosinophilia.

The best method, however, is microscopic detection of the eggs early in the morning, before cleaning or defecating. This is usually done with a clear adhesive film that is stuck to the skin around the anus. The adhesive strip is carefully peeled off and placed on a slide. The eggs can be detected directly using a microscope.

In some cases, especially with severe infestation, the small white worms can already be seen on the chair. If the worms get to the outside world, they die quickly. In the excreted chair, however, you can sometimes still see them in a living form. The females in particular stay near the anus.They can be recognized by their white, thread-like shape and their whip-like movements.

Oxyuriasis: treatment

If an infestation with pinworms has been detected, or if an infection is suspected, a few points should be observed in order to get rid of the parasite infestation as quickly as possible. In order to avoid an immediate reinfection, it is necessary to take some hygiene measures. At the same time, drugs are given to kill the worms in the intestines.

Hygiene measures for oxyuriasis (enterobiasis)

To avoid further spread and reinfection, the following information should be observed. In particular, cell phone hygiene must be observed.

• Wash your hands thoroughly after using the toilet and before coming into contact with food
• Only disinfectants containing chlorhexidine kill the eggs effectively. However, thorough hand washing is usually sufficient.
• Wash underwear, pajamas and bed linen with whites.
• Change underwear every night.
• Tight underpants prevent unconscious scratching during the night.
• For anal itching, apply cream before going to bed: (e.g .: Skinsept mucosa)
• Cleaning toys and possibly contaminated objects with hot water
• Keep fingernails short.
• Cleaning agents containing biguanides and phenols are suitable for cleaning surfaces.
• Household vacuum cleaners only distribute the eggs.

Medication for oxyuriasis (enterobiasis)

Treatment for oxyuriasis is very simple. A single tablet is usually enough to kill the pinworms in the intestine. Since reinfections are common, the therapy should be repeated after 14 days. All infected persons should start drug therapy at the same time in order to avoid repeated, mutual infection. People close to you, such as family members, are often treated as a precautionary measure. There are several drugs that successfully kill pinworms. This group of substances is called anti-helmintics. The two most commonly used drugs are:

• Mebendazole
• Pyrantel

Oxyuriasis: disease course and prognosis

Oxyuriasis is usually harmless. Complications rarely occur. Especially in children it often happens that they re-infect themselves in the same night. By finger / thumb sucking, the eggs get directly from the anus to the mouth.

The therapy is very well tolerated and there are only very few side effects. Complications are also rare. So the worm eggs can get into the vagina and develop there. This triggers an inflammatory reaction, which can be associated with pain and possibly discharge. If the infection is severe, bowel function can be restricted and inflammation or perforation can occur. These potentially life-threatening courses are very rare and are associated with stool retention or abdominal / abdominal pain. Oxyuriasis is a very common, easily treatable children's disease, but it does not pose a great risk to the child's health.

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