Ascaris in children: symptoms of ascariasis and treatment

Parasitic diseases are common in childhood. And one of the dominant places among all such ailments is ascariasis - a disease caused by ascaris. The disease is not characterized by any vivid symptoms, and therefore it can go unnoticed for a long time. At the same time, the success of treatment and much more depends on when the child began to receive help. Therefore, the task of any parent who respects himself and loves his baby is to learn to recognize ascariasis as early as possible.

About the disease

Ascariasis is referred to as a pathology called "children's", since most often it affects children. A special risk group is babies under 5 years old. Ascaris in adolescent children is diagnosed much less often than in young children. The disease is caused by a parasite that belongs to helminths (therefore, the disease itself is de jure and de facto considered helminthiasis).

This parasite has many opportunities to penetrate the human body. And then the body begins to experience great difficulties due to the fact that 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.

To guess that the child has parasites, mothers can independently on the basis of the totality of symptoms, the behavior of the baby, well-being, but the doctor must establish what kind of parasite has settled in the child's body, it is impossible to do this at home on his own.

About the pathogen

Ascariasis is caused by a parasite called human roundworm or Ascaris lumbricoides. He is called human not because of his humanity and humanity, but for the simple reason that he can live exclusively in the human body. Neither in the body of a dog, nor in the body of a cat, cow or horse, the roundworm will not survive.

Ascaris refers to round worms. She, in general, does not have a single organ or process that could attach to the organs, and therefore, unlike many other worms, she does not choose her habitat in the child's body, but constantly travels, moves towards the food masses. Ascaris is almost devoid of sense organs, there is only touch, small tubercles around the mouth of the worm are responsible for it.

Ascaris lives in the lumen of the small intestine... These are very impressive parasites in size: an adult female can reach 40 centimeters in length, and a male - 25 centimeters. Parasites reproduce sexually, and every day a fertilized female is able to lay up to a quarter of a million eggs, which go out with the contents of the intestine.

Nature has taken good care of the offspring of Ascaris - eggs are "equipped" with shells that have 5 layers, it is they that 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 - alcohol, gasoline and hot water; they also "dislike" direct directed rays of the sun.

Before finding a new host, the 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 after 12 years in the ground.

Ascaris remain "faithful" to their host, they do not change it throughout their life. As soon as unfertilized eggs enter the child's body from the soil with dirty vegetables or fruits, being carried by flies and other unpleasant insects, larvae emerge from them in the intestines, which are capable of entering the blood vessels through the intestinal wall, from there into the liver, into the right atrium , lungs. The child begins to cough, and the larvae with mucus move into the pharynx, are swallowed again, again end up 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 through the bloodstream takes up to two weeks. Sometimes young larvae manage to cover the entire path in 8 days. The subsequent intestinal stage after secondary ingestion is the longest. It can last about a year, the first "fresh" eggs begin to appear in the child's feces within a couple of months after infection.

What the ascaris eats is known to science in some detail: at first it is blood serum, but as it grows, serum becomes scarce, and the individual begins to consume red blood cells - erythrocytes. 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 devoid of reason intuitively tend to where the oxygen is most - to the lungs.

The insidiousness of the roundworm lies in the fact that they do not always clearly follow the phases of the life cycle provided by nature. Individuals can linger in the liver or lungs, causing serious pathological processes there. They are distributed over time throughout the body, can affect the pancreas, gallbladder and biliary tract, heart, brain.

It is noteworthy that ascaris also has benefits. Their phenomenal property to increase the fertility of women was discovered by researchers from California. They found that the presence of ascaris in a woman's body increases the chances of conceiving and bearing a child.

It is believed that this is due to the "distraction" of the immune system to parasites, which is more favorable for the onset of pregnancy and its bearing.

Ways of infection and development of the disease

Since the roundworm has no opportunity to survive in the external environment and give offspring, it is looking for a human carrier. You can get 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 in the body, more and more foci of inflammation and hemorrhages will form.

A sick person is contagious, since he releases into the environment a huge number of unfertilized immature eggs. This is how children in children's groups become infected from each other - kindergartens, schools, health camps, sections.

But a child can get sick with ascariasis without having direct contact with a sick person. A very common way of transmission of parasites is the fecal-oral route, when ascaris eggs enter the baby's body with eaten fruit, vegetable, which 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 fall from the ground into the hands of a child, bypassing the "intermediaries", 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 by picking his nose with dirty hands - it is much easier for eggs to get into the lungs and mouth through the nasal passages.

The habit of drinking unboiled water can be dangerous too. Do not rely on the general chlorination of tap water, chlorine is powerless against ascaris.

There are known cases of infection through contaminated banknotes, coins, doorknobs, handrails on a trolleybus, tram, and bus. Pets on their own fur from the street can bring parasites. Among the insects that spread roundworm are flies, cockroaches and ants.

Based on the foregoing, it is understandable why the peak of infection usually occurs in the summer and early fall. It is at this time that children walk a lot, have close contact with grass, earth, sand, animals, insects, and eat a lot of fruits.

Symptoms and signs

Features of the course of ascariasis depend on how large the number of parasites is in the child's body. In addition, there is intestinal ascariasis, in which the primary 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 has swallowed the ascaris eggs, 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 proceeds latently. If there are few parasites, then there will be no signs at all.

In most cases, the first clinical manifestations of ascariasis may appear only a week and a half after infection (in infants a little earlier, in children over 3 years old a little later). While the larvae go through the migration phase and move from the intestines to the lungs with blood, in order to get back into the intestines, 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. When the larvae enter the lungs, a strong dry cough appears, which is difficult to relieve.

The phlegm leaves in a small amount, and sometimes does not leave, in general, you can notice small bloody brownish streaks in it, although they may just as well not be there. It is noteworthy that with the appearance of a cough, a rash starts at the same time in many children. Usually this is urticaria - an acute allergic reaction (antibodies in the child's body are trying to fight the parasite, but sensitization reaches a peak, and histamine is released).

An allergic rash is most often seen when infected with roundworms on the hands and feet. It happens that urticaria, even after recovery from ascariasis, does not go away for some time, it becomes chronic.

In a child with ascariasis in the migration stage, lymph nodes increase, an increase in the spleen and liver in size may be observed.

When the intestinal phase begins, meaning the larvae return to the small intestine after traveling through the blood vessels and lungs to mature and reproduce, the symptoms change. The child quickly gets tired, gets tired even after a slight physical exertion, his appetite suffers (either decreases so that the parents cannot feed the child with almost nothing, or increases to such an extent that the child becomes literally gluttonous).

The toxins that parasites release during their existence lead to vomiting, diarrhea, damage to the intestinal wall - to abdominal pain. It is noteworthy that the child complains mainly of pain in the navel. Diarrhea and constipation may occur. After constipation, there may be profuse diarrhea and vice versa.

In general, the child becomes irritable, absent-minded, he forgets everything, ceases to concentrate attention normally. Sleep is often disturbed, there may be attacks of dizziness. Decreases body weight.

Since adults feed on red blood cells, the child may have anemia. Immunity decreases, the baby starts to get sick more often. The defeat of individual organs with ascaris can have its own symptoms.

The organs of vision are affected - children's eyes become especially painfully sensitive to bright light, the pupils look dilated, while the right pupil may be larger or smaller than the left, and vice versa.
Liver and gastrointestinal tract affected - obstructive jaundice may appear, there are attacks of nausea, vomiting, intolerance to certain foods, a general loss of appetite, diarrhea with bloody impurities in the feces, abdominal pain, rapid weight loss, profuse salivation.
Heartbroken - usually roundworms are located on the right side of the organ, 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 appear.
Lungs affected - the symptoms are similar to a common viral infection with a dry and unproductive cough, there are dry wheezing on inspiration, shortness of breath, fever. This form of the disease can quickly become chronic, and exacerbate every change of seasons. In this case, the child is threatened with the rapid likely development of bronchial asthma.
Brain affected - this condition is very dangerous, and the degree of its danger depends on where exactly the parasites will "settle". Damage to the outer lining 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 themselves as organ tumors - seizures similar to epileptic seizures, episodes of loss of consciousness, increased blood pressure, neuroses, mental disorders, and severe forms of depression.

The defeat of individual centers and nerves causes its own symptoms, for example, the location of parasites near the auditory nerve leads to hearing loss, and the occupation of the optic nerve can cause decreased vision or blindness.

At any stage of the life cycle of the roundworm, the child is contagious. This must not be forgotten.

Dangers and complications

The danger of the disease lies not so much in the presence of parasites in the body, but in what kind of destruction they can cause. The walls of blood vessels and internal organs suffer from purely mechanical damage by the larvae, small or significant hemorrhages may occur. Local inflammatory processes, the formation of infiltrates, necrotic foci, ulcers are not excluded.

Metabolic products of worms are toxic to humans. It is they that cause allergies, urticaria, and for children with a special allergic status, this is dangerous due to the occurrence of acute allergic reactions of the first type - Quincke's edema, 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 very fact of the effect on immunity makes the child weakly protected against various infections, viruses, bacteria. Given this effect on immunity, it is believed that vaccinations during the period of ascariasis are ineffective, since antibodies to dangerous diseases are not produced or produced in insignificant quantities.

With a large number of parasites, complications such as the development of intestinal blockage, obstruction of the bile ducts are not excluded. Against the background of the presence of ascaris, acute appendicitis, inflammation of the pancreas, and cholecystitis often develop.

In infants with severe pulmonary ascariasis, severe pneumonia with a fatal outcome can develop.

Diagnostics

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 you should go to them after the tests for roundworm have given a positive result. The symptoms of the disease appear most clearly in 2.5-3 months from the moment of infection, and this period is considered, according to clinical guidelines, to be optimal in order to detect signs of the disease as part of the diagnosis.

At the first visit to the pediatrician, the doctor measures the temperature, feels the child's lymph nodes, palpates the tummy, examines the condition of the skin for a rash, and also talks with the parents. The child is assigned laboratory tests:

general blood analysis;
stool 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 an MRI or computed tomogram, for example, if there is a suspicion of parasite damage to the membranes of the brain or 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 a smear of sputum and feces, larvae or their particles can be found. It is this analysis that will help to accurately identify the parasite, because a child may have both lamblia and pinworms.

In the intestinal phase of the ascaris life cycle, the diagnosis is usually more accurate, since there are mature individuals in the child's body that are already multiplying, and in this case, ascaris eggs are already found in the feces.

Sometimes the discovery of ascaris is generally a pure accident. For example, a child undergoes a physical examination, and only on fluorography does the doctor pay attention to strange darkening (infiltrates), or, quite by accident, parasite eggs are found in the feces.

How to treat?

Treatment is prescribed only after the diagnostic measures are positive. You cannot practice any preventive (just in case) treatment with drugs for worms. When the diagnosis is confirmed, special remedies that have a directed action against parasites help to cure the child. The dosage and treatment regimen is individually prescribed by the doctor.

Gone are the days when treatment for parasites required long-term administration of drugs with a mass of side effects, parasites can now be removed quickly, the treatment regimen will not include long-term medication. Some means, in general, allow you to get rid of the "occupants" of the child's body in just 1 day.

If ascariasis is detected at an early migratory stage, then drugs are recommended to reduce sensitization, as well as anthelmintic drugs, which are popularly called simply "pills for worms". It is important to choose products with a wide range of effects on parasites. For dry cough and pulmonary symptoms, bronchodilators and sometimes corticosteroid hormones are recommended.

If the disease is detected at a later, intestinal stage, anthelmintic drugs are recommended.

Thus, help to remove parasites from the body:

at an early stage of migration - "Levamisole", "Nemozol", "Vermox", "Vermacar" (suspension), "Termox", "Mebex", "Mintezol", "Tiabendazole". Additionally - antihistamines "Suprastin", "Loratadin", expectorants - "Mukaltin";
in the late intestinal stage - "Helmintox", "Pirantel" (taken once), "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 after about a month to do the tests again in order to exclude repeated self-infection.

Treatment takes place at home. Hospitalization is required only for children with severe complications for treatment, in fact, the complications themselves, and at the same time helminthiasis.

During treatment, the child is recommended sparing diet, excluding the abundance of sweet, fatty and spicy.

The prognosis for ascariasis is quite favorable, if there are no complications, then the cure occurs completely without consequences for the body. If there are complications and damage to organs, then the predictions no longer depend on the ascariasis itself, but on the severity of one or another complication.

Ascaris has one feature - if, at all, the child is not treated, he, in the absence of self-infection, will recover on his own in about a year. As soon as 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 path is, because in a year parasites can cause significant harm to the 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 complete and unconditional surrender of Ascaris, traditional medicine recommends garlic, garlic in a duet with milk, garlic in enemas, pumpkin seeds, carrot juice and sesame oil.

Doctors doubt the necessity and effectiveness of treatment of ascariasis with folk methods, after all, such treatment has less effect, and sometimes does not have it at all. It will take a long time to take garlic, and pumpkin seeds are by no means so safe.

Is it worth it to suffer and torment a child if there are drugs that literally in one step will help solve the problem once and for all.

Prevention

For those sick, temporary isolation from the children's team is important. After taking anthelmintic drugs, the child is not contagious. To protect your baby from a parasitic illness, it is important to adhere to preventive measures.

Vegetables and fruits need not only be washed, but washed in warm water with a special brush. Prevent your child from eating dirty fruits or vegetables.
It is important every time, returning from a walk, to wash the handles, especially if the child played with sand, earth, stroked animals, took hold of doorknobs and handrails in a shopping center or public transport.
Teach your child not to bite their nails. Even washing your hands after a walk does not guarantee that ascaris eggs do not get under the nails, and from there, with appropriate actions, they may well migrate into the body through the mouth.
Try to ensure that your child plays in the sand or on a sunny playground. In open sunlight, roundworm eggs die or lose the ability to evolve into a larva.
Do not give your child water from questionable sources - wells and springs without first boiling the water. Ascaris eggs penetrate into such water from the soil very often.

The opinion of Dr. Komarovsky

The well-known pediatrician Yevgeny Komarovsky claims that helminthiasis is a common problem, but, unfortunately, parents have very little truthful information about the worms and a lot of conjectures, many of which "inherited" from their grandmothers. There are, according to the doctor, 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 a child has a genetic predisposition to allergies, worms have nothing to do with this issue. And if there is no such predisposition, then atopy cannot arise.

The child feels how the parasites move inside the body. This is how some mothers try to explain the child's restless behavior. You can't feel the parasites. And therefore, attempts to explain the restless crying of children for the presence of worms in him is a position far from science and common sense.

The presence of parasites is shown by a blood test. Some paid medical centers with a dubious reputation offer a certain amount of parental money to make a child's blood test, which will definitely show the presence of parasites and determine what they are called. These are attempts to mislead people, says Komarovsky. The ELISA method is not the most informative in the diagnosis of ascariasis. You shouldn't give that kind of money for it.

If a dog is bought for a child, the whole family needs to drink medicine for worms. Some even 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, roundworms do not live with them.

For prevention, the child should be given pills for worms once a year. In Nicaragua, yes, the prevalence of parasites there is higher due to the climate. 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 a pandemic. Medicines should be given for illness, not to prevent it.

The presence of ascaris can be indicated by grinding teeth at night. This phenomenon is called bruxism and has nothing to do with parasites.

Supplements are also effective against parasites. This is not true. There are no dietary supplements for ascariasis. And if someone advertises a drug such as an anthelminthic drug, then they are breaking the law by providing you with incorrect information and misleading you. And even more so, there are no effective and reliable folk remedies from parasites. But there are anthelmintic drugs. They also need to treat the child from ascaris.