Worm diseases are very common in children's practice. Every day, district pediatricians consult hundreds of babies who get to see them with this problem. Many parents have to think about how to cope with enterobiasis in children.
What it is?
Enterobiasis is one of the helminthic diseases. It manifests itself as inflammation in the intestines, and is also accompanied by numerous adverse symptoms caused by the habitation of parasites in the gastrointestinal tract. This pathology is widespread throughout the world. Anyone can become infected with enterobiasis, but children are more likely to get sick.
The incidence rates are higher in those geographic settlements where more people live. A large population and dense concentration of residence affect the rate of transmission of infection from a sick child to a healthy one.
Scientists conducted numerous studies and came to the conclusion that the level of social development of the state does not greatly affect the incidence of enterobiasis in children. Cases of infection with this helminthic disease are found both in economically developed countries and in developing countries.
Usually, among all diseases caused by helminths, the share of enterobiasis is 75%. This value changes every year. However, there has been no significant reduction in the incidence for many decades. In organized children's groups, there are much more cases of infection with enterobiasis. Toddlers attending kindergarten or other preschool institutions can get sick quite easily.
Causes
The cause of this disease is a parasitic worm. In medicine, such biological individuals are called helminths, their entry into the body is an invasion. This helminthic pathology is caused by pinworms or Enterobius vermicularis. These pathogens were discovered at the end of the 18th century.
The name of the helminth is built from two words, which, when literally translated, mean "inner life". This name cannot be called accidental. It denotes the essence of the vital organization of the helminth.
In appearance, these worms resemble a spindle. Their body shape is streamlined. They are usually white or milky in color. The outer or cuticular membrane of the worm has a pronounced transverse striation.
The body length of this "guest" can be different. It usually depends on the sex of the helminth. A sexually mature female, capable of breeding, usually reaches one centimeter in size. The body length of the male, as a rule, does not exceed 4-5 mm. It is possible to distinguish between different individuals not only by size, but also by the structural features of the tail end of the body. In females, the “tail” is sharp, while in males it is blunt and slightly rounded.
On each side of the body, the helminth has special grooves. They run along the entire body of the intestinal parasite, and form two head vesicles to the head.
The main anatomical feature of this helminth is the structure of the digestive system. It includes a mouth opening with several lips, a long esophagus, which expands in the region of the tail end and forms the anus. Anatomical structures located at the head end of the body form a special suction apparatus. It is with its help that the helminth is perfectly attached to the walls of the human intestine.
The organization of the internal structure of helminths is rather complicated. Another feature is the structure of the reproductive system. Females and males have organs that are responsible for further reproduction. This feature of helminths determines their rather rapid development and active formation of eggs. Females lay more eggs.
Pinworm eggs usually do not exceed 50 mm in size. They can be somewhat oblong or asymmetrical in shape. From above, they are covered with a sufficiently dense two-layer contoured shell, which protects them from various adverse environmental influences. In the course of their life, female pinworms lay a large number of eggs. This physiological feature of their life cycle affects the feature of the appointment of therapy in the future.
The favorite habitats of pinworms are the lower part of the small intestine and the upper part of the large intestine. Typically, pinworms live in the appendix region as well as in the caecum region.
Usually females live there. After breeding, males are most often excreted from the intestines along with feces. Parasitologists say that helminths feed on the contents of the intestines.
The number of parasites living in the intestines can be overwhelming. On average, from several hundred to a thousand individuals. A clinical case was officially registered when doctors found more than 2500 pinworms in a child. Usually, such a huge number of helminths appear with repeated self-infection.
A person can become infected by swallowing the eggs of worms. They usually contain sexually mature larvae inside. Helminths that have entered the child's body easily reach the organs of the gastrointestinal tract and settle in the intestines.
As a result of digestion, a huge number of different types of enzymes are released. They have a damaging effect on the outer shells of pinworms, freeing them for life. Then the helminths go through several molts and become quite sexually mature.
It should be noted that the release of eggs occurs in the lower sections of the large intestine. For this, the females go down - along the intestines. The release of eggs and their active growth to larvae are carried out already in the rectum.
To release eggs, a sexually mature female needs oxygen. It crawls out of the man's anal passage and enters his perianal folds.
This usually happens at night when the human body is more relaxed. There are cases when pinworms move throughout the anogenital zone. This leads to the fact that they can crawl into adjacent anatomical sites. Isolated cases of detection of helminths - in the peritoneal region. After the end of the female's life cycle, she dies and turns into a small light lump.
The peculiarity of the development of pinworms is also that they do not need any specific conditions of existence for active growth. They can cause infection both in people living in northern countries and cities, and in southerners. The worse with hygiene knowledge, the more often people get sick. Severe cases of the disease are largely associated with self-infection. For the treatment of enterobiasis, it is very important to follow all the rules of personal hygiene.
The main effect of helminths on the child's body is to weaken the immune defense.
Long-term (even mild) helminthiasis contributes to the appearance of signs of immunodeficiency in a child. Babies with helminthic pathology are susceptible to any infection and have a high risk of acquiring chronic diseases of the gastrointestinal tract. Children usually develop enterobiasis 3-4 more often than adults. This is largely due to being in organized teams and low hygienic education.
Helminthiases are rightfully considered diseases of "dirty hands". Self-infection usually occurs when a child scratches the anal area. Sexually mature female pinworms, which reach the anogenital zone during oviposition, contribute to itching in this place. The child scratches the damaged areas of the skin, which leads to the ingress of eggs under the nails. Young children usually pull their hands into their mouths, which contributes to repeated autoinfection.
The spread of helminthiasis can be carried out by a contact-household method. Sick kids, attending kindergarten, become sources of infection for healthy peers. Violation of the rules of personal hygiene contributes to the fact that the eggs of the worms end up on various toys, furniture, and also on common items. Enterobiasis in children's organized groups, where kids spend a lot of time, are quite common.
It is important to note that pinworm eggs can remain viable for a long time. At a temperature of +20 degrees, they usually persist for a month. Only unfavorable external conditions lead to their damage. Cooling down to -20 degrees leads to the death of parasites within one hour. Heating up to 50-60 degrees contributes to the death of pinworm eggs in a few seconds.
Symptoms
The clinical manifestations of enterobiasis are very different. There are common symptoms that all babies have. However, there may be individual characteristics. They are usually found in children with a tendency to develop allergic reactions. The severity of the adverse symptoms of the disease depends on the initial state of the child, it can be different in intensity.
The incubation period for the first pinworm infection is usually a couple of days. This time is quite enough for parasites to start the life cycle. The acute phase of enterobiasis is usually 5-6 days. The chronic phase depends directly on the life cycle of the parasites and the number of cases of self-infection. Most often - from one to two months.
Clinical manifestations of enterobiasis in children are:
- Itching. It can be of different intensity and even quite unbearable. This leads to the fact that sick babies begin to actively comb the anal area. Usually itching intensifies at night, due to the peculiarity of the vital activity of helminths. This contributes to sleep disturbance and frequent trips to the toilet.
- Stomach ache... Usually, babies feel pulling or tingling pains. Some children develop tenesmus - a false urge to go to the toilet. Soreness is usually localized in the right side of the abdomen, which mimics a similar symptom in appendicitis. In some young patients, no pain syndrome in the abdominal cavity occurs during enterobiasis.
- Neurological symptoms. The toxic effect of the waste products of helminths has a pronounced adverse effect on many internal organs, including the nervous system. A sick child develops a headache, weakness increases, concentration of attention decreases, and nervousness appears. Schoolchildren with signs of enterobiasis begin to study worse at school, lag behind the school curriculum.
- Limiting social contacts... A sick child wants to limit his personal space from strangers. This is manifested by the fact that he becomes more withdrawn and silent. Often times, staying at home and limiting social interactions will make your baby feel better.
- Disruption of bowel function. Prolonged enterobiasis leads to the fact that the child has signs of functional disorders of the small or large intestine. As a rule, they are manifested by flatulence and various problems with the excretion of feces. They can be expressed as constipation or diarrhea.
- Change in mood... Kids become more whiny and moody. Even an insignificant occasion can cause them to show violent emotions. Babies may refuse to breastfeed.
- Skin rashes. Usually, their appearance is due to the toxic effects of the waste products of helminths. Once in the systemic circulation, these substances cause numerous allergic manifestations in the child. If the baby has a tendency to allergies, then the severity of adverse changes is very significant. The most common skin symptoms of enterobiasis include various dermatoses, dermatitis and eczema.
- Decreased immunity... This is usually manifested by the baby's strong susceptibility to various infectious pathologies. If you focus on statistics, it can be noted that children with persistent enterobiasis and multiple cases of self-infection suffer from colds and respiratory diseases much more often than their peers.
Signs in a baby
Enterobiasis in infants proceeds in almost the same way as in older children. Newborn babies can also become infected. If the baby has signs of immunodeficiency, then the disease proceeds quite brightly, and the adverse symptoms manifest themselves extremely strongly. Usually, the disease is detected by mothers on their own - during hygiene procedures.
Diagnosis of enterobiasis in infants is the same as in older babies.
Feature - the choice of treatment. For very young patients, individual therapy regimens are selected, and the dosage of drugs to eliminate worms from the body is reduced - taking into account the age and body weight of the child.
Diagnostics
It is often very simple to identify enterobiasis at home. Usually, parents notice worms during hygiene procedures. Older children can see the helminth on their own. Diagnosis of the disease usually does not cause difficulties.
For an accurate diagnosis, several additional laboratory tests are performed. They allow you to verify the presence of pinworms in the child's body. In the general analysis of blood, leukocytosis appears (the number of leukocytes increases) and ESR is significantly accelerated. To identify pinworms, various scrapings from the perianal zone are needed.
Sampling and examination
There are several effective ways to identify the disease - with the help of an imprint and by scraping. The Graham method (an imprint on adhesive tape) is carried out three times - with an interval of a week.
Usually biological material is collected before the morning procedures. The effectiveness of this method is up to 95%.
You can collect material for scraping with a special spatula or swab on a match dipped in a solution of glycerin or soda. Then an examination is carried out in the laboratory, eggs of helminths are revealed, and in some cases even the remains of sexually mature individuals of worms. The accuracy of the result is also quite high.
Complications
Usually the disease proceeds without the appearance of negative consequences, but there are exceptions. Weakened babies and children with pronounced immunodeficiency states and concomitant chronic diseases of internal organs may experience complications. These include various proctitis and paraproctitis, chronic colitis, helminthic appendicitis, allergic eczema and dermatoses.
Treatment
One of the main conditions for curing enterobiasis is to prevent any cases of re-infection. This requires quite strict preventive methods, which are mandatory even for the smallest patients. It is important to note that the rules should be followed not only for sick babies, but also for everyone who is with them - in the conditions of an epidemiological focus of infection.
Some doctors argue that all family members should be treated with anthelmintic drugs.
Experts believe this is contributing to a significant decrease in the number of cases of intrafamilial outbreaks of helminthic disease.
Medicines for enterobiasis can also cause side reactions. To reduce such manifestations, the selection of the treatment regimen is carried out strictly individually - taking into account the child's age, weight, and the presence of concomitant diseases.
The following measures are used to treat the disease:
- Compliance with the rules of hygiene... All sick babies should definitely wash their hands often - especially after active games on the street and going to public places, before and after eating and visiting the toilet. Parents must ensure that these important hygiene practices are followed.
- Wearing closed underwear... Children's panties must be washed in hot water (using detergents) and should be ironed with a very hot iron before wearing. The baby's bedding needs to be treated in the same way.
Do not forget about ironing! Pinworm eggs can only die after being processed at very high temperatures.
- Obligatory daily washes... The anogenital area should be washed twice a day using baby soap. It should not contain any aggressive chemical fragrances that can only intensify allergic manifestations on the delicate skin of a child.
- Daily change of bedding and underwear. During all periods of illness, it is very important to observe this rule. This will help prevent possible re-infections. If there are several kids in the family, then only individual sets of underwear should be used for each child. It is prohibited to use other people's things (even those treated with an iron).
- Medication therapy. Usually, the following drugs are used to eliminate pinworms: Pirantel, Vermox, Piperazine, Medamin and others. The dosage and treatment regimen depends on the age of the child and is determined taking into account his body weight. To prevent pinworms from spreading over the entire anogenital area, you can use a cotton swab soaked in petroleum jelly. For girls, this simple measure helps to cope with pinworms crawling into the vagina.
Prevention
Diseases of "dirty" hands can be prevented only if all preventive rules are followed. Regular hand washing and wearing clean underwear can help reduce the risk of pinworm infection.
After the discovery of a sick child in kindergarten, quarantine is established. Compliance with this forced preventive measure contributes to a significant decrease in the incidence of enterobiasis. These rules should be observed throughout life.
For information on what enterobiasis is in children, see the next video.
