Pinworm infection – Symptoms & causes

Overview

Pinworm infection is the most common type of intestinal worm infection in the United States and one of the most common worldwide. Pinworms are thin and white, measuring about 1/4 to 1/2 inch (about 6 to 13 millimeters) in length.

Pinworm

An adult pinworm generally is 1/4 to 1/2 inch (about 6 to 13 millimeters) in length. The most common symptom of infection is anal itching, particularly at night, as worms migrate to the host’s anal area to lay their eggs.

While the infected person sleeps, female pinworms lay thousands of eggs in the folds of skin surrounding the anus. Most people infected with pinworms have no symptoms, but some people experience anal itching and restless sleep.

Pinworm infection occurs most often in school-age children, and the tiny (microscopic) eggs are easily spread from child to child. Treatment involves oral drugs that kill the pinworms and thorough washing of pajamas, bedding and underwear. For best results, the entire family should be treated.

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Symptoms

Symptoms of pinworm infection may include:

• Itching of the anal or vaginal area
• Insomnia, irritability, teeth grinding and restlessness
• Occasional stomach pain and nausea

Pinworms often cause no symptoms.

When to see a doctor

Consult your doctor if you have severe anal itching, especially at night.

Causes

Accidentally swallowing or breathing in pinworm eggs causes a pinworm infection. The tiny (microscopic) eggs can be carried to your mouth by contaminated food, drink or your fingers. Once swallowed, the eggs hatch in the intestines and mature into adult worms within a few weeks.

Female pinworms move to the anal area to lay their eggs, which often results in anal itching. When you scratch the itchy area, the eggs cling to your fingers and get under your fingernails. The eggs then get transferred to other surfaces, such as toys, bedding or toilet seats. The eggs can also be transferred from contaminated fingers to food, liquids, clothes or other people.

Pinworm eggs can survive for two to three weeks on surfaces.

Risk factors

Risk factors for pinworm infection include:

• Being young. Pinworm infections are most likely to occur in children ages 5 to 10. The tiny (microscopic) eggs are easily spread to family members, caregivers, or other children at school or child care centers. Pinworm infections are uncommon in children younger than age 2.
• Living in crowded spaces. People who live in institutions are at higher risk of developing pinworm infections.

Complications

Typical pinworm infections don’t cause serious problems. In rare circumstances, heavy infestations can cause infection of female genitals.

The parasite can travel from the anal area up the vagina to the uterus, fallopian tubes and around the pelvic organs. This can cause problems such as inflammation of the vagina (vaginitis) and inflammation of the inner lining of the uterus (endometritis).

Although rare, other complications of a pinworm infection may include:

• Urinary tract infections
• Weight loss
• Infection of part of the abdomen (peritoneal cavity)

Prevention

Pinworm eggs can cling to surfaces, including toys, faucets, bedding and toilet seats, for two weeks. So besides regular cleaning of surfaces, methods to help prevent the spread of pinworm eggs or to prevent reinfection include:

• Wash in the morning. Because pinworms lay their eggs at night, washing the anal area in the morning can help reduce the number of pinworm eggs on your body. Showering may help avoid possible re-contamination in bath water.
• Change underwear and bedding daily. This helps remove eggs.
• Launder in hot water. Wash bedsheets, pajamas, underwear, washcloths and towels in hot water to help kill pinworm eggs. Dry on high heat.
• Don’t scratch. Avoid scratching the anal area. Trim your child’s fingernails so there’s less space for eggs to collect. Suggest that your child avoid biting his or her nails.
• Wash your hands. To reduce your risk of getting or spreading an infection, wash your hands well after using the toilet or changing a diaper and before eating.

Pinworm Infection

Last Reviewed: October 2011

What are pinworms?

Pinworms are white, parasitic worms that can live in the large intestine of humans. They are about one-half inch long. While the infected person sleeps, female pinworms leave the intestinal tract and lay their eggs on the skin around the anus. The eggs are laid in a sticky, jelly-like substance that, along with the wriggling of the female pinworm, causes severe itching.

Who gets pinworm infection?

Pinworm is the most common worm infection in the United States. School-age children, followed by preschoolers, have the highest rates of infection. Cases of pinworm infection are seen most often at schools, daycare centers and other institutional settings.

What are the symptoms of a pinworm infection?

Pinworm infection may cause:

• Itching around the anal area, difficulty sleeping and irritability.
• If it is a severe infection, symptoms may include:
  • nervousness
  • restlessness
  • loss of appetite
  • weight loss
  • girls may experience vaginal itching and irritation (vaginitis), if pinworms are near the vagina.

How does someone get pinworms?

Pinworms are spread when an infected person, most often a child, has scratched his/her bare anal area and the eggs get under his/her fingernails. Pinworms can then be spread in the following ways:

• By an infected child not washing hands after using the bathroom. If the child then touches playmates or toys, he/she may pass on the eggs.
• Pinworm eggs can also be transferred to the fingers from clothing or bedding, and then spread around the home.
• Eggs may be inhaled from the air or deposited onto food and swallowed.
• Pinworms can survive up to two weeks on clothing, bedding or other objects, if kept at room temperature.

The eggs may hatch while still attached to the skin around the anus. They then move through the rectum to the lower intestine, where they grow to adult size within two to six weeks. Pinworm infections can be spread as long as either worms or eggs are present.

How is a diagnosis of pinworm infection made?

Finding the female worm or the eggs confirms the diagnosis of pinworms. To find a female worm:

• At night, the adult worms can sometimes be seen directly around the anal area or in pajamas. The worm (one-quarter to one-half inch long) is clearly visible to the naked eye. Finding a worm confirms the diagnosis.
• If adult worms are not visible, conduct a tape test in the morning. Apply a piece of transparent tape against the folds of skin around the anus to pick up any eggs or worms. Seal in a plastic bag.
• Take the tape to a health care provider. The eggs and worms caught on the tape can be identified under a microscope.

Pinworms are rarely spotted in stool samples. Because bathing or a bowel movement can remove the eggs, the tape test should be done as soon as the person wakes up in the morning.

How is a pinworm infection treated?

Treating pinworms involves either prescription or over-the-counter drugs. Consult a health care provider before treating a suspected pinworm infection. Follow these treatment steps:

Step 1: Treat the infected person/any infected family members

1. The infected person should take the medicine orally. It is given in two doses. The second dose should be given two weeks after the first.
2. Bathe first thing in the morning to reduce egg contamination.
3. Wash hands and under the fingernails thoroughly, after using the bathroom, before eating and after changing diapers.
4. Discourage nail biting and scratching bare anal areas to avoid re-infection.
5. Keep fingernails trimmed very short.
6. Infection often occurs in more than one family member. Treat all infected family members at the same time.

Step 2: Treat the household

1. Change and wash underwear and pajamas in hot water daily.
2. Machine-wash sheets, blankets, towels and clothing in hot water to destroy eggs. Machine-dry at high temperature.
3. Eggs are sensitive to sunlight, so open blinds in bedrooms in the daytime.
4. 4. Since pinworm eggs are light and scatter easily, dust should be removed carefully from all surfaces in the home. Careful vacuuming or the use of an oiled cloth (which may be boiled or destroyed later) will help prevent the eggs from scattering.

How can pinworm infection and reinfection be prevented?

• Wash hands and under fingernails frequently.
• Encourage children to avoid scratching their bare anal areas.
• • Pinworm eggs continue to be present (excreted) in the feces of an infected person for up to a week after the treatment, so precautions should be taken to prevent reinfection by washing hands thoroughly, especially under the nails.
• Bathe daily.
• Change and wash clothing and bedding frequently.

What if the pinworm infection occurs again?

If infection occurs again, consult your health care provider. In some cases, it may be necessary to treat the patient and close family contacts more than once.

For more information contact your local health department or go to the Centers for Disease Control and Prevention (CDC) website at http://www.cdc.gov/parasites/pinworm/.

Pinworms: symptoms of pinworms in children and adults, diagnosis and treatment of pinworms

The danger and harm of pinworms

Pinworms are small (up to 13 mm) parasitic helminths, infection with which causes the development of enterobiasis. This disease is one of the most common helminthic invasions and, according to various sources, affects up to 90% of children of primary school age. Although pinworms are more commonly diagnosed in children, adults can also be affected by these parasites.

Features of the structure and life cycle of pinworms

Despite the small size of the human pinworm, it can cause tremendous harm to the body, especially in the case of mass invasion. When an invasive pinworm egg enters the human gastrointestinal tract, a mobile larva hatches from it, which begins a gradual migration through the intestines and reaches puberty in two weeks. After fertilization, the male dies, and the female pinworm continues to migrate to the anus: it is here that she will lay her eggs (from 5 to 20,000). This completes the development cycle of the pinworm.

How long do pinworms live? Their life cycle is relatively short and is 3-4 weeks, but enterobiasis can last much longer, which is explained by the mechanism of self-infection: the patient constantly swallows new eggs, which are scattered over linen, clothes, and fall on the hands. Therefore, the answer to the question “can pinworms pass by themselves?” – negative. Infection with pinworms will not only not pass without effective treatment and the use of suitable drugs, but will also become chronic, leading to new dangerous consequences. The incubation period of pinworms is also minimal.

The body of pinworms is maximally adapted to life in the human body: thanks to the pointed rear end, they easily move through the intestines, feeding on the nutrients in it, as well as beneficial microflora. Pinworm baby lives mainly in the lower part of the small intestine, but can also be found in other parts of it. For example, parasites are often found in the appendix – presumably, their vital activity is capable of causing its inflammation (provoking appendicitis).

Harm from pinworms in humans

Infection with pinworms occurs by accidental ingestion of eggs that have fallen from the hands of the patient to food (fecal-oral transmission mechanism). Therefore, the disease often spreads spontaneously and in outbreaks, especially often it can be found in kindergartens, swimming pools, and medical institutions.

The harm caused by helminths is caused by several factors at once:

• Mechanical damage to the mucosa.
  Pinworms have sharp pterygoid processes that literally cut the walls of the gastrointestinal tract. The wounds become inflamed, an infection can penetrate into them. That is why helminth infestations are so often accompanied by the development of fungal and bacterial infections (development of candida, streptococcus).
• Toxic effect.
  Any type of pinworms (and three types of these worms can parasitize in the human body) has a serious toxic effect, throwing their waste products into the gastrointestinal tract. In addition, after their death, pinworms remain in the intestines, act on it with decay products. Gradually, toxins accumulate and manifestations of intoxication worsen.
• Deficiency of micro and macro elements.
  Like any parasites, pinworms in adults and children feed on the body of their carrier, literally “eating” it. As a result, the body does not receive the micro and macro elements it needs, the imbalance of which disrupts endocrine processes.
• Violation of habitual way of life.
  One of the most unpleasant (from a psychological point of view) symptoms of pinworm infection is associated with its migration to the anus. During these periods, the patient experiences severe obsessive itching in the perineum. As a rule, pinworms are activated in the evening hours and at night. Irritation of the anus does not allow the patient to sleep peacefully, as a result, the usual regimen is disturbed, psychological fatigue accumulates, working capacity decreases, irritability grows.

Pinworm symptoms in children and adults

The main signs of pinworms in children and adults are:

• Obsessive itching around the anus in the evening and at night.
  In some cases, pinworms can also penetrate the vagina (pinworms in women), then the patient may experience discomfort throughout the perineum.
• Violation of the stool.
  With mass infestations, the disease caused by pinworms leads to defecation disorders: the stool becomes more frequent and liquid, fragments of mucus may be present in it. This is a direct indication of developing dysbacteriosis – helminthic invasions lead to the death of beneficial intestinal microflora, as a result of which digestion processes are disturbed, the intestine absorbs less useful substances.
• Mild abdominal pain, bloating.
  In addition, this helminthiasis is characterized by typical symptoms of invasion: episodic headaches, increased fatigue, children become capricious and apathetic. Possible acute allergic reactions to worm toxins (urticaria, Quincke’s edema).

With a chronic process, especially among children, there is a high risk of developmental delay (due to an imbalance of substances caused by parasites). Infection with pinworms undermines human immunity, the patient often suffers from respiratory infections, in addition, the risks of developing HIV and oncology increase.

Pinworm diagnosis

Diagnosis of this helminth is quite simple and painless: the doctor takes a swab from the anus. If there is a parasite, either pinworm eggs or particles of worms will be found in it. Blood on pinworms is usually not prescribed. If pinworm eggs are found, do not despair. The correct remedy for pinworms in adults will quickly defeat the disease.

Pinworm treatment

If the tests confirmed helminthic invasion, it is necessary to immediately begin the treatment of pinworms in children and adults. Currently, various chemicals are used to destroy worms and accelerate their evacuation. Unfortunately, such treatment of pinworms in adults is not always effective enough: highly toxic drugs can have serious side effects, and the impossibility of taking them for long courses practically nullifies the chances of removing not only adult parasites from the body, but also their larvae and eggs. Therefore, after such ill-conceived treatment, the symptoms of pinworms in adults may return. This means there is a re-infection.

How to remove pinworms in adults? Experts recommend choosing a drug that could be taken for long courses, guaranteeing complete relief from invasion. It is also desirable to carry out simultaneous work to increase immunity and intoxication of the body.

Prevention of helminthiasis

If pinworm eggs were found in children, then simultaneously with their treatment, it is recommended that all family members go through the prevention of invasion. In addition, it is important to treat bed linen and clothing from parasite eggs.

How to treat pinworms in adults, and which pills are suitable not only for the treatment of worms (pinworms), but also for their prevention? The best solution would be to choose a drug developed on the basis of natural ingredients. Such an antiparasitic complex is offered by Optisalt. The drug has been certified and proven effective against helminths, their eggs and larvae.

How dangerous are pinworms?

What are pinworms?

The pinworm is a nematode that is medically called Enterobius vermicularis. It is a round worm that is small, thin and white. The length of the pin is usually comparable to the length of the paper clip. The longest pinworms can reach about half an inch.

Although medically known as Enterobius vermicularis, this worm is commonly referred to as the pinworm because the female worm resembles a pin.

What is pinworm infection?

Pinworm infection is considered the most common type of human intestinal infection. In addition, pinworm infestation is also the most common type of helminth infestation worldwide.

Pinworms most often affect children aged 5 to 10 years, as well as those who live in closed institutions or have frequent contact with these institutions.

How are pinworms transmitted?

The size of the pinworms makes them impossible to detect and they can infect a variety of surfaces you may come across.

Pinworm transmission occurs easily among people living in rural areas, and pinworm infection is common among families with small children.

The transmission of pinworms starts from the so-called fecal-oral route. In other words, pinworm eggs can pass from a person’s anus into another person’s mouth. While it’s hard to imagine something like this, it could happen quite easily. Of course, this does not happen directly, but is easily done due to poor hygiene (for example, not washing hands after going to the toilet). Pinworm eggs can be easily transmitted through contaminated bedding, food, or any other items that are used daily.

While the infected person is sleeping, the pinworms are believed to come out and lay their eggs on the layer of skin around the anus. Pinworm eggs are ready to start infection within a couple of hours after they are placed outside the intestines. In addition, pinworm eggs can live up to three weeks on the skin of the anus or any other infested objects or objects.

In most cases, people become infected unconsciously. The eggs could easily reach the fingers or mouth of the next victim, for example through contaminated clothing or bedding.

The considerably small size of pinworm eggs allows them to be airborne in some situations as well. Pinworm eggs can be assimilated from the most unexpected places on your body or any other objects or surfaces.

In addition, if your child is showing symptoms of pinworm infection, or if he or she has already been diagnosed with this type of infection, there is a good chance that you are also infected.

People usually assume that swimming pools are the biggest source of pinworm outbreaks. You should be informed that this information is not entirely accurate. Of course, there are many people who swim without hygiene, and the chances of contaminating the water are high. But in order to become infected with the same pinworm eggs that another person left in the water, you need to touch the very particles of water through which the infected person swam. The chances of this happening are pretty slim considering the pool water needs to be recirculated. So there is a small chance of getting pinworms when you get home from the pool, but the chances are very low.

Also, your pets are not able to infect you with pinworms. Pinworms are specific to humans. Pets are not suitable hosts for pinworms.

Who is at risk of getting pinworms?

Anyone can become infected with pinworms. As we have already emphasized, the transmission of pinworm eggs is very likely, especially in crowded households with children.

Easy transmission makes pinworm infection the most common type of helminthic infection worldwide and in all socioeconomic strata.

However, some categories of people are more likely than others to become infected with pinworm eggs. These are people at risk:

• Children, especially those who go to school;
• Children who constantly put their fingers in their mouths;
• Children and adults who do not practice proper hand hygiene; for example, those who eat without washing their hands are highly susceptible to infection;
• Adults and other family members in close contact with an infected child;
• Institutionalized persons.

Pinworm symptoms

The symptoms of pinworm infestation can be felt differently in different people. Some people may not have any characteristic symptoms.

Symptoms associated with pinworm infection are usually mild and are caused by a female pinworm that is laying eggs.

So you may be suspected of being infected if you or your child has the following symptoms of this type of infection:

• Severe discomfort around the anus;
• Inability to sleep due to anal discomfort;
• Severe itching and irritation of the skin around the anus;
• The appearance of pinworms in the feces.

Pinworm Complications

Although pinworm infection is usually associated with mild symptoms and in some cases no symptoms, it can sometimes lead to more serious health complications. Keep in mind that the health complications that can occur after a pinworm infection are rare, but possible nonetheless.

In very rare cases, pinworm infection can lead to a urinary tract infection in women, but only if the pinworm infection is left untreated.

Another possible risk for women exposed to pinworms is that the worms themselves can pass from the anus into the vagina and seriously damage the uterus, fallopian tubes, or other organs of the female reproductive system. Thus, in women, pinworm infection can lead to a vaginal infection (vaginitis) or inflammation of the lining of the uterus.

If pinworms begin to multiply significantly in your body, you may begin to feel severe pain in your abdomen.

In addition, an increase in the number of pinworms can lead to weight loss, since they can eat most of the nutrients from your body.

Diagnosis of pinworms

The doctor suspects a pinworm infection mainly on the basis of severe nocturnal itching around the anus.

In addition to the detection of pinworms in the stool, the diagnosis of pinworm infestation also consists in the detection of pinworm eggs. They can be found on underwear or other clothing that comes into direct contact with the skin on the back of the body.

The procedure for detecting pinworm eggs is called the “tape test”. When a person suspected of being infected with pinworms wakes up, the test should be started immediately. The reason it is very important to take the test as soon as a person wakes up in the morning is because any activity such as showering, going to the toilet, or even changing clothes can remove any existing eggs from the perineal area and the test results will be incorrect.

This specific test consists of gently applying a sticky piece of transparent tape to the skin around the anus. Existing pinworm eggs, if any, should attach to the tape.

To improve the accuracy of the “tape test”, a person with a suspected infection, be it you or your child, should do this test 3 times in a row in the morning.

Because of severe itching in the anal area, which leads to scratching, it may be useful to take samples for a “tape test” from under the nails.

Sometimes pinworm eggs can also be found in urine or stool samples.

Treatment of pinworm infection

Treatment requires a visit to the doctor, as you need to get advice on this.

Depending on the severity of the pinworm infection, it can be treated with either over-the-counter or prescription medications.

Treatment consists of 2 or even 3 (in severe cases) doses of drugs, the purpose of which is to cleanse the intestines. The second and third doses are supposed to be administered one week apart from the previous dose.

Since the transmission of pinworm eggs is very easy, all family members and those who are in close contact are also required to start treatment.

Unconsciously, other family members may also be infected, and treatment of only the first patient in the household may not be effective and re-infection may occur. Thus, during the treatment of a pinworm infection, it is important to maintain a very high level of hygiene, which includes hand washing, clean and short nails. This period also consists of preventive behaviors such as avoiding anal scratching or nail biting.

Treatment of pinworm infection also includes frequent change of underwear, this is done to remove a large number of pinworm eggs.

It is also important to take a shower instead of a bath. While taking a bath, there is a risk of re-infection with the same pinworm eggs that were deposited on your anal area. Another tip is to carefully handle all garments, objects, or surfaces that you touch during treatment. Also, all clothing, underwear, or bedding should be washed in hot water, especially after taking a certain pinworm medication.

Medicine for pinworms

Once you have noticed pinworms in your stool and discussed it with your doctor, you are likely to try some oral medications to get rid of the infection and associated symptoms. The drugs known to be most effective in controlling pinworms are anthelmintics such as:

• Vermox – Mebendazole;
• Albenza – albendazole;
• Riza – pyrantela pamoat.

The treatment for pinworm infection is 2-3 doses of medication. Each dose should be taken one week apart from the previous one.

Home remedies for pinworms

Medication may not be the only way to deal with pinworms. Although not enough research has been done to confirm or refute the effectiveness of home remedies, some believe that these methods may be helpful.

Although you should not replace your healthcare provider’s treatment plan with home remedies, you can try adding raw garlic, raw carrots, or coconut oil to your medications to help eliminate pinworms from your intestines.

Also, you should really be aware that the same home remedy can have different results in different people. So, if someone strongly recommends a method for dealing with pinworms, it may not work for you. Also, you should avoid home remedies if you suffer from allergies. Ingredients can cause an allergic reaction that will make you suffer more than a pinworm infection. If you just don’t know if you’re allergic to the home remedy ingredients, you can put some of the solution you’re about to prepare on your skin beforehand. If you notice any allergic reaction, stop taking the home remedy.

Raw garlic home remedy is said to kill all eggs and also prevent female pinworms from laying other eggs on the skin around the anus.

Raw Garlic can be prepared to treat pinworm infection either by mouth or applied to the skin as an ointment. To prepare raw garlic for ingestion, you should cut it into cubes and spread it on bread. Alternatively, you can consume raw garlic on its own.

But if you want to cure a pinworm infection with raw garlic ointment, you need to mash the garlic. Garlic paste also needs to be mixed with petroleum jelly. Next, you will have to dip the Q-tip directly into the paste. Then, with a cotton swab, gently apply the garlic paste to the skin around the anus.

If the skin around your anus is sensitive, or there are other inflammations, or if you also suffer from hemorrhoids, this treatment is definitely not recommended for you.

Coconut oil by itself can improve the situation if you suffer from pinworms. To cure a pinworm infection with coconut oil, you will have to drink about 0.33 ml daily in the morning and also apply some coconut oil around the anus in the evening.

People who prefer to treat pinworm infections with natural ingredients also find Raw Carrot a good remedy for removing pinworms from the digestive system. Fiber-rich foods are generally thought to improve digestion and stimulate intestinal motility, so eating carrots at least twice a day should help you get rid of pinworms.

Pinworm prevention

Although pinworm eggs are easy to infect because they can be found on various surfaces and sometimes even airborne, infection can still be prevented.

Since pinworm eggs can survive on surfaces for up to 3 weeks before finding a new host, it is really important to regularly clean surfaces that are used daily. In fact, you should keep your home tidy by regularly cleaning surfaces, clothing, and other items.

So you should:

• Wash in the morning, as pinworms are known to lay their eggs at night in the anal area of ​​an infected person. So, first thing in the morning, in order to definitely reduce the number of pinworm eggs from your body, you need to wash. A very good tip is to prefer a shower to a bath, as while bathing there is a chance that you will become infected again.
• Change bed and underwear daily.
• Wash all your clothes, sheets, pajamas, underwear or towels in hot water. After washing, dry all items at high temperature. This procedure should eliminate most of the pinworm eggs.
• Avoid scratching the anal area, as this is where pinworm eggs are laid. In addition, you can trim your/your child’s nails to reduce the chance of pinworm eggs underneath.
• Avoid biting your nails and keeping your hand away from your mouth.
• Wash your hands often. Washing your hands after going to the bathroom or changing your baby’s diaper can prevent pinworm eggs. Also, always wash your hands before eating.

Can pinworms re-infest?

As you have already learned from this article, the transfer of eggs, as well as infection with pinworms, is very simple. Re-infection can only occur in 3 cases:

• The original source of pinworm infection has not been effectively treated and the treatment must be repeated;
• The actual source of infection is not actually identified and treated;
• Eggs deposited on the skin around the anus can develop into pinworm larvae and re-infect the intestines from which they primarily originated.

If you and your family and loved ones resume medical treatment for pinworm eggs and it still doesn’t work, then there is an infected surface or an infected person that you don’t think of as the source of the infection. Look carefully and you will most likely determine the cause of the re-infection.

Conclusions

Pinworms are small, white and thin roundworms that live in the intestines of their human hosts. Their length is comparable to the length of a paper clip, and the name comes from the pin-like tail of the female worm.

The transmission of pinworm eggs is based on the route of transmission from the anus to the mouth. Although it is very hard to imagine that small eggs, viruses or germs from the anus can enter the mouth of another person, it does happen, both directly and indirectly. Pinworm eggs are tiny and can only be seen under a microscope.

Easy transmission of pinworm eggs makes the infection easily tolerated. Pinworm eggs can be unwittingly aspirated by anyone, anywhere.

Diagnosis of pinworm infestation requires a “tape test”, which is the application of a strip of transparent tape to the skin around the anus, the purpose of which is to adhere most of the pinworm eggs, if any, and place them under a microscope.