Threadworms (Enterobius) are like little strands of white cotton – hence the name. They are less than 1.5 cm long and can be seen wriggling in the faeces. Horrible as they sound, they are a very common problem, particularly in children. It is estimated that up to 40% of children below the age of ten are infected with threadworms, though many may not show the ‘itching’ symptoms generally associated with them.

Threadworms produce large numbers of tiny eggs that cannot be seen with the naked eye. The eggs are present in house dust, they stick to clothing, carpets, towels and bed linen and can also be picked up in garden soil or on unwashed vegetables and salads. They are spread by eating contaminated food or by hand contact. If another person should touch an infected person’s hands when eggs are present and subsequently put his or her hands into the mouth, then he or she will also become infected as a result of swallowing the eggs. The eggs then hatch in the lower bowel and at night a female worm starts to lay her eggs just outside the anus. She can lay up to 10,000 eggs, which can cause severe itching.

The wriggling of threadworms irritates the anus and their presence slightly inflames it. This normally makes the sufferer scratch and so pick up eggs on the hands and under the fingernails. The most common sign of threadworms is scratching of the bottom, particularly at night and first thing in the morning. When the scratching takes place solely during the night, as sometimes happens, it may just cause a disturbance of sleep and hence daytime irritability – the itching itself may not be apparent. Some sufferers show no signs of infection, in which case it is a question of spotting the worms in the motions in order to detect their presence.

Threadworms are very common and appear even in the cleanest households, so there’s no need to feel embarrassed about consulting your doctor. They only affect humans, never pets. And although they can be uncomfortable, they are generally harmless and do not usually cause any long-term damage.

You can buy a remedy from the chemist containing mebendazole, which kills threadworms, or piperazine, which is one of a number of substances that paralyse the worms so they can then be passed out in the faeces. These treatments are usually effective, but you should follow the instructions on the packet exactly. If the problem recurs, then everyone in your household should take a course of the medicine at the same time (your pharmacist will advise you on the correct dosage for each individual), as they may be harbouring worms themselves without necessarily having any symptoms. If this is the case, the worms can, in a variety of ways, be continually passed from person to person. So if, after treatment, your symptoms return, gather your courage and bring up the subject with everyone sharing your home – you may find they’ve been suffering silently, too.

Make sure that everyone scrubs their fingers and nails with a brush after each visit to the toilet and before each meal. Disinfect – by washing thoroughly – the toilet seat, toilet handle or chain and door handle regularly, as well as making sure you dust and vacuum bedrooms thoroughly.

Roundworms can also be treated by piperazine. These worms are one of the largest parasites – they can be 10-30 cm long, look like earthworms and can block the intestine. They’re transmitted by eggs found in contami-nated raw food or in soil. Fortunately, they’re rare. The sufferer may inexplicably lose weight or suffer other symptoms – a cough is not uncommon. When the doctor takes a blood test, the results should strongly suggest the diagnosis. Occasionally, an adult worm, not unlike an earthworm, may be passed in the faeces or even vomited up. But don’t be alarmed – as I said, it’s rare, thank goodness.

The roundworm is usually eradicated by a single dose of a medicine containing piperazine, whereas threadworms may need several days’ treatment, as instructed, and phases of treatment may sometimes be separated by a week or more.

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