Worms (intestinal worms)

Worms are parasitic worms that live in the bodies of humans and animals. They are difficult to recognize as they mask many other diseases and conditions. Symptoms of helminthic infection range from mild malaise to fainting, with severe intoxication. We will tell you where you can get infected with worms and how to get rid of them.

What is that

Worms are considered to be the most common parasites in humans. Today, science knows about 300 worms. The most common intestinal worm diseases are enterobiasis and ascariasis, which affect more than 2 billion people.

The size of worms in the body varies from a few millimeters to several meters. For example, the length of pinworms causing enterobiasis does not exceed 1 cm, with some tapeworms (e. g. , the broad tapeworm) reaching 12-15 meters.

Causes of helminthiasis

Helmintiasis is a disease in which infections of worms occur. The worms enter the human body and remain there. These parasites live not only in the intestines but also in other organs and tissues.

According to the World Health Organization, one in four people on Earth is infected with worms. However, WHO experts note that the actual number of infected is at least 50%. This is especially true for countries with a low health culture (these are some countries in Africa and Southeast Asia). In other countries, more than 1. 5 million helminth infections are registered each year. Most of them are children.

How to get infected with worms?

There are 4 ways to get infected:

1. Through the ground. Such diseases are called geohelminthiasis. Unwashed fruits can carry tens of thousands of parasites. Therefore, it is very important to wash vegetables, fruits and hands thoroughly before meals. Walking pets are another source of terrestrial parasites.
2. In contact with an infected person. Parasitic worms are incredibly fertile. In one day, the female pinworm can lay up to 5, 000 eggs in the human body. Eggs and adults can be passed on to other people with bedding and other household items. After that, it is enough if the infected person does not wash their hands and the worms penetrate inside.
3. When consuming contaminated food. Such helminthic diseases are called biohelminthiasis. You can catch the parasite by insufficient heat treatment of meat, poultry or fish.
4. Through insect bites. This type of transmission is rare. In general, very small parasites can spread through insect bites.

Consider the risk factors that increase the likelihood of worm infection in adults and children:

• Ignoring the rules of hygiene - if you do not wash your hands after the street, in the toilet or before eating.
• The habit of biting nails - there is a lot of dirt beneath them with microbes and parasites. This includes the habit of taking pens, pencils and other objects in your mouth.
• Poor pet care, especially for those who go outside.
• Consumption of unwashed vegetables and fruits.
• Use of water from dubious sources.
• Poor cleaning of living spaces.
• Passion for food of animal origin that has not undergone proper culinary processing.

Who is in danger

No one is free of worm infection. It is enough to give looseness in hygiene issues and the parasite larvae can "break through" into the body. The following categories of people are particularly susceptible to helminthiasis:

• Small children. Helminthic invasions are most commonly seen in children. This is due to the child ignoring the rules of hygiene. Young children put objects in their mouths and often dig mud in the streets. In groups, children tend to interact more closely than adults, which also increases the likelihood of infection.
• Families with pets. Eggs and larvae of parasites that have been moved from the street to their homes with pets can be everywhere. It is often the case that owners of dogs, cats and other animals are not even aware of the problem and for other reasons find out about the presence of worms by contacting a veterinarian.
• Foods. Lovers of exotic cuisine such as sushi, raw meat or fish are also at risk.
• I travel. This is especially true for people who travel to countries with poor hygiene.
• Summer residents, agricultural workers. Persons working in orchards, orchards or simply living in the countryside.
• People who come across raw fish or meat in the course of their work. For example, vendors or chefs - in the processing, cutting and preparation of food.

Myth 1: There are no parasites in marine fish.

Many people mistakenly believe that worms are only found in river fish and are not in the sea because of the salt water. Indeed, marine fish are predominantly affected by parasites that are not dangerous to humans. In this respect, raw river fish is more dangerous than raw sea fish. However, this does not mean that sea fish is completely safe: it is always recommended to process any fish - fry it thoroughly, boil it or freeze it for 3 days.

Classification of helminthiasis

There are several classifications of parasitic worms. According to localization, worms:

• Intestinal system - lives in the small intestine or colon. These include ascaris, eels, whipworms, bovine tapeworms and others.
• Lungs - live in the tissues of the bronchopulmonary system. Most often it is pneumonia.
• Tissue - parasites on various tissues of the body. Tissue worms include schistosomes, trichinella, and toxocar.
• Parasites of the liver and gallbladder. These are liver silk, liver giant fly and clonorch (Chinese fluke).

Depending on the pathogen, there are four types of helminthic diseases:

• Nematodes - caused by roundworms. These include ascariasis, enterobiasis, trichinosis, trichocephalosis, toxocariasis, ankylostomiasis and others.
• Cestodoses - the pathogens of the tapeworm. Such pathologies include hymenolepiasis, teniasis, teniarinchiasis, diphyllobothriasis, and cystcerciasis.
• Dystomiases are diseases caused by flatworms. These are fascioliasis, opisthorchiasis, dicroceliosis.
• Protozoa - pathogens are protozoa such as lamblia, toxoplasma or amoeba.

More than 70 species of parasitic worms are spread. The most common are the following helminthic diseases (see table).

Helminth invasions

Disease	The pathogen and its characteristics	Transmission method
Ascariasis	It's called Ascaris. These are roundworms that live in the gut. They can grow up to 30-40 cm. Roundworms feed on almost all nutrients. During vital activity, worms damage the intestinal walls to the point of perforation	Most often, ascaris eggs are transmitted by the fecal-oral route. They persist for a long time in the soil and on the surface of vegetables, fruits, herbs and berries
Enterobiasis	It develops when pinworms enter the body. These are small round worms that have a size of 0, 5-1 cm. The main danger of enterobiasis is the toxic waste of worms.	Contact with an infected person. Pinworm eggs stay on different surfaces for a while.
Giardiasis	It is caused by microscopic parasites - lamblia. Pathogens produce toxic substances and damage tissues	Giardia is spread through the stool-oral route as well as contaminated food and water
Opisthorchiasis	Pathogens are small worms up to 2 cm in size, most commonly parasitizing the liver and bile ducts. In opisthorchiasis, poisoning of toxic substances and mechanical damage to tissues occur	The pathogens of opisthorchiasis are spread by raw fish
Echinococcosis	This is caused by echinococcus - tapeworms that do not exceed 5 cm in size. Pathogens cause severe disorders in the functioning of organs and body systems. In some cases, they can trigger a malignant tumor process.	They spread with dirty hands and contaminated food. Echinococcus carriers can also be dogs and rodents.
Diphyllobothriasis	Pathogens - large tapeworms that reach 10-15 meters. Tapeworms live in the small intestine and cause serious damage to the host. Worms produce toxic substances and significantly impair the functioning of the digestive system	They are transmitted by consuming raw fish
Trichocephalosis	It is called a whip worm, a round worm that resembles a hair. Vlasoglava can reach 5-6 meters. The worms live in the intestines, penetrating the layer under the mucosa. Causes poisoning, inflammation and acute anemia	The invasion is carried out by swallowing the parasite's eggs

Worm infections can also be classified into sections:

• Acute helminthiases - occur 2-4 weeks after infection. In this case, the symptoms of the worms can be observed for 1 week to several months. If you do not take therapy, the disease becomes chronic.
• Chronic helminthiasis - manifestations depend on the type of parasite. For example, if these are parasites that cause larvae to reproduce, prolonged allergic reactions will follow. Other chronic worm diseases may be asymptomatic or may be associated with pain, malaise, fatigue, and other symptoms.

Complications of helminthiasis

If left untreated, helminthia can lead to serious complications, sometimes life-threatening:

• Anemia - anemia, an insufficient number of red blood cells and hemoglobin in the blood. This condition is due to the fact that the worms consume some of the nutrients needed for normal hematopoietic function.
• Destruction of tissues and organs. Worms live not only in the lumen of the gastrointestinal tract, but also in the thickness of tissues such as liver, lungs, and muscles. Tissues are most affected during the migration of worms as they move from one department (or organ) to another — foci of ulcers and permanent inflammation form. In light of this, there is an increased risk of developing infections and malignancies.
• Diseases of the nervous system. This is due to the toxic waste products of worms that poison the body. Nerve tissues are the most sensitive to toxins. This can lead to irritability, headaches, insomnia and other signs of nervous system damage.
• Allergic reactions. Toxic substances excreted by worms can also act as allergens. Human immunity may not respond adequately to these substances. This leads to typical allergic symptoms - rash, redness, itching, sometimes nausea and vomiting.

The presence of worms in the body also leads to a lack of the following minerals:

• Zinc. In the absence of zinc, immunity is reduced, people often catch a cold and suffer from other infectious diseases. There is an increased likelihood of developing prostatitis and infertility, as this trace element is extremely important for the health of the reproductive system.
• Selenium. It lowers immunity and also increases the risk of malignancies.
• Iodine. Iodine deficiency in children leads to slowing growth and development (physical and mental). In adults, the work of the thyroid gland deteriorates, and metabolic processes slow down.
• Manganese. Due to manganese deficiency, the bones become brittle. People lose weight fast, often bothered by cramps and dermatitis.
• Chromium. The absence of this element leads to delayed development and impaired carbohydrate metabolism.

Worms and immunity

Worms are often accompanied by other parasites, such as toxoplasma and chlamydia. The reason for this is the suppression of immunity. A healthy body is able to resist intruders, but in helminthiasis, protection is weakened. Toxoplasmosis is particularly dangerous during pregnancy as it can lead to fetal death.

Symptoms of helminthiasis

The signs of worms are varied in adults and children. The most common symptoms are:

• itching of the anus is the most common symptom of intestinal worms;
• gnashing of teeth in a dream - due to toxins released by worms;
• drooling in sleep and morning;
• nausea if you brush your teeth in the morning;
• peeling of the skin of the hands and feet;
• allergic skin rashes;
• strong feeling of hunger, even to fainting;
• swelling (often allergic);
• itchy skin;
• chronic fatigue;
• headache and dizziness;
• mental disorders of unknown cause (stress, neuroses, depression);
• bloating;
• symptoms of intestinal diseases;
• weight change (both overweight and lean);
• the simultaneous course of several diseases (or the successive progression of one disease);
• cramps or pulling pain in the abdomen;
• anemia;
• delaying the physical and mental development of children;
• pediatric hyperactivity or lethargy;
• enlarged lymph nodes (often in the acute stage of helminthiasis).

When to see a doctor

A therapist or infectious disease specialist deals with the treatment of parasitic diseases. You should contact your doctor if you experience one or more of the above symptoms. Because of the rather sophisticated system of covering worms, the doctor must explain the symptoms as accurately as possible and also talk about his lifestyle: what foods he prefers, whether and where he has recently traveled, whether there are pets, and so on.

Diagnosis of the disease

If the doctor suspects a helminthic invasion, it is not difficult to identify. The following diagnostic procedures are used:

• Stool examination. The stool sample is handed over to the laboratory. They may contain eggs or larvae of parasites living in the intestines.
• Scraping for enterobiasis. We take a cotton swab from the anus. With this analysis, pinworms can be identified. Scraping should be done early in the morning before going to the toilet.
• Blood test for antibodies. This is a fairly informative test to identify a number of parasites. However, even with a positive result, there is no 100% guarantee that the parasites are still in the patient’s body because the antibodies remain even after elimination.
• Instrumental diagnostics. Application of radiography, MRI and CT using contrast agents. These diagnostic methods allow the identification of certain pathological lesions in tissues caused by both large worms and helminthic invasion.

Generally, your doctor will prescribe various tests to increase the reliability of the data you receive. Sometimes the patient needs to be examined several times for an accurate diagnosis.

Important!When confirmation of helminthiasis, other close family members should be notified. The test is also recommended for them. If the test is positive, it is important that all infected family members receive treatment. Otherwise, the eggs of the parasites will re-enter the body of the recovered person and everything will have to be repeated from the beginning.

Treatment of intestinal worms in children and adults

Although there are plenty of antiparasitic drugs in pharmacies, you cannot take them. Prescribing comprehensive treatment, the doctor strives not only to remove the parasites, but also to eliminate the consequences of their vital activity.

As a general rule, in addition to anthelmintic drugs, the patient also prescribes vitamins and other medications that eliminate the symptoms of the disease. The doctor selects medications for each patient individually because the symptoms are different for everyone.

Medications for the treatment of helminthiasis

In case of helminthic invasion, patients prescribe a complex of the following drugs:

• Anthelmintic drugs. These are anthelmintic drugs that either remove or kill worms. These goals are achieved by disrupting the metabolism of parasites or paralyzing their muscles. In the latter case, they lose their ability to remain in the gut and are excreted.
• Antihistamines. If the patient is allergic to parasites, doctors will prescribe antiallergic medications during treatment. This is extremely important because the mass death of worms releases a large number of allergens, which can trigger a strong allergic reaction. Antihistamines inhibit the production of histamine, which is a major mediator of the allergic reaction.
• Enterosorbents. These are drugs that are able to bind substances in the gastrointestinal tract. In the treatment of worms, enterosorbents are used to bind and remove toxins excreted by the worms.
• Vitamins and minerals. Vitamins B (folic acid and B12) and iron preparations are most commonly prescribed. This is necessary to treat anemia.
• Hepatoprotectors. These are drugs that protect the liver from toxic substances. These include preparations based on essential phospholipids or plant substances (milk thistle, artichoke, licorice, St. John's wort and other plants).
• Probiotics and prebiotics. It is prescribed to restore the intestinal microflora. Probiotics are living cultures of beneficial bacteria. Prebiotics are indigestible food ingredients (such as fiber) that are fermented only by the gut flora.

Surgery

In most cases, it is sufficient to drink a complex drug. Sometimes, however, doctors are still forced to resort to surgery. For example, a large accumulation of roundworms can cause intestinal obstruction. This is an urgent condition that requires surgery.

Worms can accumulate in the bile duct, which causes obstructive jaundice and even liver abscess. The same situation can occur in the pancreas, leading to acute pancreatitis. When worms enter the appendix, appendicitis develops. All of these conditions require urgent surgery.

They often resort to surgery when the echinococcus damages the organs. These parasites accumulate and form echinococcal plugs in the liver, lungs, bones, kidneys, and even the brain. The danger of such a plug is that it may dust and explode.

Folk remedies against worms

Folk remedies for worms are not as effective as anthelmintics. This is just an additional method - the main treatment is prescribed by a doctor.

Folk remedies include pumpkin seeds, which contain cucurbitin, an anthelmintic substance.

Myth 2: Garlic enema gets rid of worms

Worms really don't like garlic because it contains phytoncides - antibacterial and antiparasitic substances. However, garlic enema is not required for helminthiasis. There are very few worms in the colon where the contents of the enema are injected. Most parasites live in the small intestine, so this procedure is useless. In addition, such an enema can cause severe irritation to the mucous membranes.

Prevention and precautions

In most cases, the prognosis for the treatment of helminthiasis is favorable. A timely visit to the doctor avoids many of the complications caused by worms.

Worm prevention is limited to the following recommendations:

• Wash hands with soap and water before eating, after returning from the street, using the toilet, or after contact with animals.
• Vegetables, fruits and herbs are washed thoroughly. It is better to pour boiling water over them.
• Do not use other people's hygiene items or others' utensils.
• He gives up bad habits (smoking, alcohol).
• Avoid stress, it will have a beneficial effect on immunity.
• Show your pet to the vet regularly, vaccinate in time.
• Perform a comprehensive preventive examination each year, including examination for worm eggs.
• Cook meat, poultry, fish and eggs properly.

Myth 3: Parasites die in frozen meat.

This is only true for certain worms. For example, the bovine tapeworm actually dies when the meat is deep-frozen (minus 12 and below). And, for example, Trichinella larvae can only be removed after 2-3 hours of cooking.

Conclusion

The main cause of helminthic invasions is inadequate hygiene. Improving hygiene and proper cooking of food of animal origin significantly reduces the likelihood of helminthiasis. In most cases, worms do not pose a threat to human health if detected in a timely manner. However, lack of treatment can lead to serious consequences - anemia, damage to the nervous system and other infections.