What are the symptoms of pinworm infection. How is pinworm infection caused. Who is at risk for pinworm infection. What complications can arise from pinworm infection. How can pinworm infection be prevented.

Understanding Pinworm Infection: A Common Intestinal Parasite

Pinworm infection, also known as enterobiasis or oxyuriasis, is the most prevalent type of intestinal worm infection in the United States and ranks among the most common worldwide. These parasitic worms, scientifically called Enterobius vermicularis, are thin, white, and measure approximately 1/4 to 1/2 inch (6 to 13 millimeters) in length.

The infection cycle begins when a person accidentally ingests or inhales pinworm eggs. These microscopic eggs can be transmitted through contaminated food, drink, or fingers. Once swallowed, the eggs hatch in the intestines and mature into adult worms within a few weeks. Female pinworms then migrate to the anal area to lay their eggs, often causing intense itching, especially at night.

Recognizing the Symptoms of Pinworm Infection

While many individuals infected with pinworms may not experience any symptoms, some common signs can indicate an infection:

• Intense anal itching, particularly at night
• Vaginal itching in females
• Insomnia and restlessness
• Irritability and teeth grinding
• Occasional abdominal pain and nausea

Can pinworm infection cause visible symptoms? In some cases, you may notice small, white, thread-like worms in your stool or around the anal area, especially at night or early in the morning.

The Transmission and Spread of Pinworms

Pinworm eggs are highly contagious and can survive on surfaces for up to three weeks. The infection spreads through various means:

1. Direct contact with contaminated hands or objects
2. Ingestion of eggs from contaminated food or drink
3. Inhalation of airborne eggs
4. Contact with contaminated bedding, clothing, or toilet seats

Is pinworm infection more common in certain populations? Yes, children between the ages of 5 and 10 are most susceptible to pinworm infections. The infection can easily spread among family members, caregivers, and other children in schools or daycare centers.

Risk Factors and Vulnerable Populations

Several factors can increase the likelihood of contracting a pinworm infection:

• Young age (5-10 years old)
• Living in crowded environments
• Poor hygiene practices
• Attending school or daycare
• Having family members with pinworm infection

Are adults at risk for pinworm infection? While less common, adults can also contract pinworms, especially if they live with or care for infected children or reside in institutions with close living quarters.

Potential Complications of Pinworm Infection

In most cases, pinworm infections do not lead to serious complications. However, in rare instances, heavy infestations can cause:

• Urinary tract infections
• Weight loss
• Inflammation of the vagina (vaginitis)
• Inflammation of the uterine lining (endometritis)
• Infection of the abdominal cavity (peritonitis)

Do pinworms pose a significant health risk? While uncomfortable, pinworm infections are generally not dangerous and can be effectively treated with medication and proper hygiene practices.

Diagnosis and Treatment Options for Pinworm Infection

Diagnosing a pinworm infection typically involves one of the following methods:

1. Tape test: Applying adhesive tape to the anal area to collect eggs for microscopic examination
2. Visual inspection: Observing the anal area for worms, especially at night
3. Stool sample analysis: Examining fecal matter for eggs or adult worms

Treatment for pinworm infections usually consists of oral medications that kill the worms. Common antiparasitic drugs include:

• Mebendazole (Vermox, Emverm)
• Albendazole (Albenza)
• Pyrantel pamoate (Pin-X, Reese’s Pinworm Medicine)

Is a single dose of medication sufficient to treat pinworm infection? In most cases, a second dose is recommended two weeks after the initial treatment to ensure complete eradication of the parasites.

Prevention Strategies: Minimizing the Risk of Pinworm Infection

Preventing pinworm infections requires a combination of good hygiene practices and environmental control measures:

• Wash hands thoroughly with soap and water, especially after using the bathroom and before eating
• Keep fingernails short and clean
• Avoid nail-biting and scratching the anal area
• Change and wash underwear, pajamas, and bedding daily
• Launder potentially contaminated items in hot water and dry on high heat
• Clean and disinfect shared surfaces regularly, including toilet seats and bathroom fixtures
• Shower in the morning to wash away any eggs laid overnight

How effective are these prevention methods? When consistently practiced, these hygiene measures can significantly reduce the risk of pinworm infection and prevent its spread within households and communities.

The Importance of Family-Wide Treatment

When one family member is diagnosed with a pinworm infection, it’s crucial to treat the entire household simultaneously. This approach helps prevent reinfection and breaks the cycle of transmission. Consider the following steps:

1. Consult a healthcare provider for appropriate treatment for all family members
2. Implement strict hygiene practices throughout the home
3. Wash all bedding, clothing, and towels used by infected individuals
4. Vacuum carpets and upholstered furniture thoroughly
5. Disinfect commonly touched surfaces, including doorknobs and light switches

Why is treating the entire family important? Pinworms can easily spread among household members, and asymptomatic carriers can unknowingly reinfect others if left untreated.

Special Considerations for Schools and Daycare Centers

Educational institutions and childcare facilities play a crucial role in preventing the spread of pinworm infections. These environments should implement the following measures:

• Educate staff, children, and parents about pinworm transmission and prevention
• Encourage regular hand washing and proper hygiene practices
• Clean and disinfect shared surfaces, toys, and equipment frequently
• Notify parents if a case of pinworm infection is detected
• Implement policies for temporary exclusion of infected children until treatment is completed

How can schools effectively manage pinworm outbreaks? By implementing comprehensive hygiene protocols and maintaining open communication with parents, educational institutions can significantly reduce the risk of pinworm transmission among students.

Debunking Myths and Misconceptions About Pinworm Infection

Several misconceptions surrounding pinworm infections can lead to unnecessary anxiety or ineffective prevention strategies. Let’s address some common myths:

1. Myth: Pinworms are a sign of poor hygiene
   Reality: While good hygiene helps prevent infection, anyone can contract pinworms regardless of cleanliness
2. Myth: Pinworm infections only affect children
   Reality: Adults can also become infected, especially those living with or caring for infected individuals
3. Myth: Pinworms can be transmitted through toilet seats
   Reality: While possible, this mode of transmission is rare; direct contact or ingestion of eggs is more common
4. Myth: Pets can spread pinworms to humans
   Reality: Pinworms are specific to humans and do not infect or spread through pets

Do these myths impact treatment seeking behavior? Yes, misconceptions about pinworm infections can lead to delayed treatment or unnecessary stigma, highlighting the importance of accurate information and education.

The Role of Nutrition in Pinworm Prevention

While proper nutrition alone cannot prevent pinworm infections, maintaining a healthy diet can support overall immune function and potentially reduce susceptibility to parasitic infections. Consider incorporating the following into your diet:

• Probiotic-rich foods like yogurt and kefir to promote gut health
• Garlic, which has natural antiparasitic properties
• Pumpkin seeds, which contain compounds that may help expel intestinal worms
• Carrots, sweet potatoes, and squash, rich in beta-carotene for immune support
• Papaya seeds, known for their potential antiparasitic effects

Can dietary changes alone treat pinworm infections? While certain foods may have mild antiparasitic properties, they should not be relied upon as a sole treatment for pinworm infections. Medical intervention is necessary for effective eradication of the parasites.

Long-term Management and Preventing Recurrence

After successfully treating a pinworm infection, it’s essential to implement strategies to prevent recurrence:

1. Continue practicing good hygiene habits, especially hand washing
2. Regularly clean and vacuum living spaces, particularly bedrooms
3. Wash bedding and clothing in hot water weekly
4. Avoid scratching the anal area and keep fingernails trimmed
5. Consider periodic screenings for high-risk individuals or environments

How long should preventive measures be maintained after treatment? It’s advisable to maintain these practices for at least six weeks after treatment to ensure complete eradication of the parasite and prevent reinfection.

The Psychological Impact of Pinworm Infections

While pinworm infections are primarily a physical health concern, they can also have psychological effects on infected individuals and their families:

• Embarrassment and social stigma
• Anxiety about reinfection or spreading the infection to others
• Sleep disturbances due to itching and discomfort
• Stress related to treatment and prevention measures

How can individuals cope with the psychological aspects of pinworm infections? Open communication, education, and support from healthcare providers can help alleviate anxiety and promote a positive attitude towards treatment and prevention.

Global Perspective: Pinworm Infections Worldwide

Pinworm infections are a global health concern, affecting populations in both developed and developing countries. However, the prevalence and impact can vary significantly:

• In developed countries, pinworm infections are common but generally well-controlled through hygiene practices and available treatments
• In developing regions, limited access to healthcare and sanitation can lead to higher infection rates and potential complications
• Crowded living conditions in certain areas can contribute to increased transmission
• Cultural practices and beliefs may influence prevention and treatment approaches

Are global efforts being made to address pinworm infections? While pinworm infections are not typically targeted by large-scale global health initiatives, efforts to improve sanitation, hygiene education, and access to healthcare indirectly contribute to reducing their prevalence worldwide.

Emerging Research and Future Directions

Ongoing research in the field of parasitology continues to explore new avenues for prevention, diagnosis, and treatment of pinworm infections:

1. Development of more sensitive diagnostic tools for early detection
2. Investigation of natural compounds with antiparasitic properties
3. Studies on the potential long-term effects of chronic pinworm infections
4. Research into the relationship between pinworm infections and gut microbiome health
5. Exploration of community-based interventions for widespread prevention

What potential breakthroughs could impact pinworm management in the future? Advancements in rapid diagnostics, novel treatment options, and improved understanding of host-parasite interactions could lead to more effective strategies for controlling and preventing pinworm infections on a global scale.

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 – 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.

Products & Services

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.

Enterobiasis – pinworm invasion. Causes, symptoms, diagnosis and treatment of enterobiosis

Author

Vanyukova Irina Alexandrovna

Leading physician

Pediatrician, pediatric gastroenterologist, doctor of the highest category

Pediatrician

9 0002 Creation date: 2016. 03.29

Pinworms

Enterobiasis is a parasitic disease, one of the most common helminthiases. Enterobiasis is caused by pinworms. In Latin pinworms are called Enterobius vermicularis, hence the name of the disease.

Pinworms are small round worms of a grayish-white color. The length of male pinworms is up to 5 mm, females – up to 13 mm. The living environment of pinworms is the human intestine (caecum, lower small intestine, large intestine). Pinworm eggs enter the human body by the oral route (through the mouth). In the intestines, larvae emerge from the eggs, which turn into sexually mature individuals. This process takes 2 to 4 weeks. The fertilized female crawls out of the anus and lays eggs around it. Eggs require a temperature of 34-36 °C and high humidity for maturation. The skin folds in the perianal region ideally provide these conditions. The exit of female pinworms most often occurs at night, when the muscles of the anal sphincter are relaxed. After that, the life cycle of the pinworm is completed. Thus, pinworms live no longer than a month.

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Causes of enterobiasis

How pinworm infection occurs

Enterobiasis can only be contracted from a person who is a carrier of pinworms. Pinworms do not live in the body of animals, and enterobiasis cannot be infected from animals.

Self-infection is common. The female pinworm lays up to 13,000 eggs, sealing them with an acid that causes intense itching. A person wants to scratch, and when he does this, the eggs fall under the nails, on the fingers, and from them – on the bed and underwear, household items. During life in a team, the spread of enterobiasis is very likely. If someone in the family becomes infected with pinworms, after some time enterobiasis can affect all family members.

Enterobiasis is a predominantly childhood disease

Most often, enterobiasis is detected in children aged 4 to 9 years. This is
due to the fact that children at this age already take care of their own
hygiene, but have not yet fully mastered all the necessary skills.

Enterobiasis symptoms

The main symptom of enterobiasis is severe itching in the anus. Itching usually begins 12-14 days after infection, when the first female pinworms crawl out to lay eggs. Enterobiasis is characterized by itching (or intensification of itching) at night.

Intensive scratching can lead to dermatitis, the addition of a secondary infection.

At the same time, very often the child suffers from enterobiasis unnoticed by the parents. If there are no other symptoms besides itching, the child may scratch, not considering this a problem and not complaining about anything. Therefore, enterobiasis is often detected only during preventive examinations of children.

Other symptoms of enterobiasis:

Abdominal pain

If there are many parasites in the intestines, abdominal pain and flatulence may occur.

Stool disorder

The presence of pinworms in the intestine leads to disruption of its work, dysbacteriosis develops, stool disorder is observed (alternating diarrhea and constipation).

Allergic manifestations

Pinworms release toxins that poison the body and cause a response in the form of allergic manifestations. With enterobiasis (especially in children), headache, dizziness, increased fatigue, and decreased performance are possible. Children can become capricious, excitable; such children are difficult to put to sleep, their sleep is easily interrupted. In a dream, they can scream, cry, grind their teeth.

Disease of the genitourinary system in women

In women, pinworms, migrating, can leave the anus and enter the vagina. At the same time, intestinal microflora (in particular, E. coli) can be introduced into the genital tract, which can lead to the development of inflammation – colpitis, urethritis.

Diagnostic methods for enterobiasis

Diagnosis of enterobiasis is made on the basis of the results of laboratory tests. Analysis of feces for eggs of helminth pinworms, as a rule, does not detect. This is due to the fact that pinworm eggs do not enter the feces. To detect pinworm lesions, scraping from the folds of the skin around the anus (scraping for enterobiasis) is used.

Scraping for enterobiasis

Scraping for enterobiasis in a child can be done in the treatment room of any of the clinics of the Family Doctor. The procedure is carried out quickly and does not cause any discomfort in children.

Biological material is transferred to the Family Doctor’s own laboratory for microscopic examination.

To accurately diagnose the disease, make an appointment with the specialists of the Family Doctor network.

Enterobiasis treatments

Enterobiosis

Treatment of enterobiasis is carried out by pediatricians, and in adult patients – by gastroenterologists.

For the success of treatment, it is important that all family members are treated at the same time. Careful observance of personal hygiene is also necessary. When treating children, parents should pay special attention to the hygiene of the child.

Anthelmintic drugs

Anthelmintic drugs are used in the treatment of enterobiasis.

Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.

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11/10/2022

Worms are worms that lead a parasitic way of life in the body of their host – a man. Age doesn’t matter. Both adults and children are equally susceptible to infection. The classification of helminthiases is very extensive, especially in countries with a hot climate.

There are 3 classes of parasitic worms:

• round (nematodes) – pinworms, roundworms;
• tape (cestodes) – pork tapeworm, bovine tapeworm, echinococcus;
• flatworms, flukes (trematodes).

The most common worms in children are pinworms that cause enterobiasis . These are helminths of small size, on average up to 1 cm, white-gray in color with a curved body. The place of localization of these parasites is the large intestine, but they can also penetrate into the lower sections of the small intestine. Reproduction of pinworms occurs on the skin near the anus. At night, female pinworms get out to debug eggs in the folds of the skin, often penetrating the labia in girls, which ends with infectious diseases of the genitals. In total, these helminths live for about 1-1.5 months. The process of self-infection in a child can lead to the fact that the malaise will continue for many years. Parasites can be detected with the naked eye in the stool.

Another type of worm most commonly found in children is Ascaris . Characteristic species, reaching a length of 15 cm, these nematodes settle in the lumen of the loops of the small intestine, advancing towards the moving food bolus. In the feces, roundworms are very rare. Females periodically release eggs, which can be found in the analysis of feces. But if they were not found during the study, this does not mean that the child is not infected. The life cycle of roundworm can last several years.

Causes

The child’s curiosity is realized by his fingers, the child, learning the world, actively touches everything that comes to his hand and immediately puts it into his mouth, testing for strength and taste. Thus, pinworm eggs safely enter the digestive tract of their future little host.

A child becomes infected with helminth eggs from the surface of unwashed fruits when drinking contaminated water. Very often, infection occurs when communicating with animals, or when playing in the ground, a sandbox, where cats and dogs like to solve their physiological problems. After a walk, children often do not wash their hands, and all the dirt, along with parasitic eggs, gets into their mouths.

Symptoms of worms

How can you tell if a child has worms? If the child was infected with a large number of eggs of parasitic worms, then after a few days a sharp deterioration in the condition may occur. In milder cases, the first symptoms of invasion appear after a few weeks or even months. Much depends on immunity. It can quite cope with parasites and restrain their development. But gradually the defenses are reduced, and the helminths infect the body, causing serious problems.

The first signs of worms are symptoms of poisoning (intoxication). The vital activity of worms is accompanied by the release of a large number of animal toxins that can poison the child’s body. In the intestines, parasitic worms use nutrients, as a result of which the baby gradually becomes deficient in proteins, carbohydrates, fats and vitamins.

The child develops:

• emaciation,
• pale skin,
• weakness, frequent dizziness,
• rise in body temperature, headache,
• bad dream,
• tearfulness,
• depressed mood.

Manifested intestinal ailments – constipation, loose stools, rumbling and pain in the abdomen, bouts of nausea and vomiting, pain in different parts of the abdomen, bloating. The disease may be accompanied by allergic conditions: itching, rashes, cough, inflammation of the mucous membranes of the respiratory tract. Weakened immunity leads to the addition of infectious diseases.

Diagnosis and treatment of helminthiasis

Diagnosis of helminthiasis by feces is quite difficult. This is due to the fact that ascaris or pinworm eggs do not appear in the feces every day, and the technique of microscopy of smears from the analysis requires great care. To increase reliability, it is desirable to take a stool test for worm eggs for at least 3 days in a row.

In cases of increased risk of infection with worms (contact with animals, the child’s play on the ground or in open sandboxes, the child’s habit of taking things in his mouth, biting his nails or licking his fingers, etc. ), it is advisable to undergo an in-depth examination, which includes, in addition to a threefold analysis of feces special blood tests that detect antibodies to helminths.

In the presence of allergic manifestations of unknown origin, an increase in the number of eosinophils in the blood test, persistent intestinal dysbacteriosis, it is advisable to donate blood for the determination of class E immunoglobulins (Ig E and G) to ascaris and other helminths. You can check for worms in pets.

Based on the totality of indirect signs and history, the physician may recommend antihelminthic therapy without direct evidence of the presence of worms in the child, if other pathologies that cause similar clinical manifestations are excluded.
If worms are found in a child or in one of the family members, it is necessary, if possible, to treat all family members in order to avoid the formation of a focus of infection of each other with helminth eggs. In this situation, in addition, it is necessary to strengthen hygiene measures, in particular, boil and iron bed and personal linen on both sides.