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How to check child for pinworms


Pinworms

Is this your child's symptom?

  • Tiny, harmless worms that can cause anal itching
  • The pinworms live in the colon (large bowel)

Symptoms of Pinworms

  • Itching and irritation of the anus and buttocks is the main symptom
  • Sometimes, moves to the vagina and causes vaginal itching or discharge

Cause

  • A white, very thin, threadlike worm, about ¼ inch (6 mm) long.
  • It moves. If it doesn't wiggle, it's probably lint or a thread.
  • The worm may be seen around the anus or on the child's bottom. It is especially active at night or early morning.
  • Rarely, the pinworm is seen on the surface of a stool.
  • The pinworm's secretions are a strong skin irritant and cause the itching.

When to Call for Pinworms

Contact Doctor During Office Hours

  • Pinworm is seen. Reason: needs a pinworm medicine.
  • Red and tender skin around the anus. Reason: could be Strep infection.
  • Anal itching lasts more than 1 week
  • You think your child needs to be seen
  • You have other questions or concerns

Self Care at Home

  • Anal itching without a pinworm being seen
  • Questions about pinworm exposure or contact

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

  • Bellevue
  • Everett
  • Federal Way
  • Seattle

Care Advice

Treatment for Pinworms

  1. What You Should Know About Pinworm Treatment:
    • Pinworms are the most common worm infection in the US.
    • Pinworms can cause anal itching.
    • Pinworms do not carry any diseases.
    • Treatment is very helpful.
    • Here is some care advice that should help.
  2. Pinworm Medicine:
    • If a pinworm was seen, your child's doctor will suggest a special pinworm medicine. Pinworm medicines are available without a prescription (such as Reese's Pinworm Medicine). There are also prescription medicines that treat pinworms. Your doctor will decide which one is best for your child. Take as directed.
    • Give a repeat dose of the pinworm medicine in 2 weeks. Reason: To prevent the pinworms from coming back.
    • The repeat dose is needed because eggs can live for 1 to 2 weeks. Temperature and humidity levels also affect how long the eggs can stay alive.
  3. Treating Family Members and Close Contacts:
    • Pinworms can spread to others within the same home. How often others get pinworms varies.
    • Treat any child who sleeps with the infected child.
    • Treat family members only if they have symptoms.
    • Treat all family members if other family members develop symptoms.
    • If any of your child's friends have symptoms, be sure to tell their parents. These children should get tested or checked for pinworms.
  4. Return to School:
    • Children with pinworms do not need to miss any child care or school.
  5. What to Expect:
    • After taking the pinworm medicine, itching should stop in 5 to 7 days.
  6. Prevention of Pinworms:
    • Wash hands and fingernails well before meals and after using the toilet.
  7. Call Your Doctor If:
    • Anal symptoms last over 1 week after treatment
    • You think your child needs to be seen
    • Your child becomes worse

Treatment for Anal Itching Without Pinworm Being Seen

  1. What You Should Know About Anal Itching:
    • There are many causes of itching around the anus. Some are more common than pinworms.
    • The most common cause is stool that has been left on the skin. Stool contains chemicals and germs that can cause itchy skin rashes. Try to prevent this by washing the skin off. After wiping off stool with toilet tissue, cleanse the skin with warm water.
    • Bubble bath can also cause an itchy bottom. Children with dry skin are at increased risk. Avoid bubble bath or any soapy bath water.
    • If these changes don't get rid of the anal itching, get a pinworm test.
  2. Pinworm Checks: Check your child for pinworms.
    • Examine the area around the anus, using a flashlight.
    • Look for a ¼-inch (6 mm), white, threadlike worm that moves.
    • Do this a few hours after your child goes to bed. Check him 2 nights in a row. Also, check him first thing in the morning for 2 days.
  3. Scotch Tape Test:
    • If no adult pinworm is seen, call your doctor's office. Ask for instructions on doing a Scotch-tape test for pinworm eggs. You can also use the technique below:
    • Take a piece of clear Scotch tape with the sticky side down. Touch it to the skin on both sides of the anus. Do this in the morning soon after your child has awakened. Also, do this before any bath or shower.
    • Put the sticky tape side that touched the skin on a slide. If you don't have a slide, put it on a second piece of tape.
    • Do it 2 mornings in a row.
    • Bring the 2 samples in to be looked at under a microscope.
  4. Steroid Cream for Itching:
    • For the itching, wash the skin around the anus with warm water.
    • For severe itch, use 1% hydrocortisone cream (such as Cortaid) 2 times per day. Use for 1 or 2 days. No prescription is needed.
  5. Call Your Doctor If:
    • Pinworm is seen
    • Skin around the anus gets red or tender
    • Anal itching lasts more than 1 week
    • You think your child needs to be seen
    • Your child becomes worse

Treatment for Pinworm Exposure

  1. Low Risk for Getting Pinworms:
    • Your child has had contact with a child with pinworms, but no symptoms now. Your child probably won't get them. This is especially likely if over a month has passed.
    • If contact is within the last month, your child may get pinworms. This risk is small.
    • Pinworms are harmless. They are never present very long without being seen or causing anal itching.
  2. Scotch Tape Test:
    • If you're still worried, call your doctor's office. Ask for instructions on doing a Scotch tape test. This can be done to look for pinworm eggs.
    • Do this about 1 month after contact.
    • Reason: The swallowed egg will not become an adult pinworm for 3 or 4 weeks.
  3. Call Your Doctor If:
    • Pinworm is seen (white, ¼ inch or 6 mm, and moves)
    • Anal itching lasts more than 1 week
    • You think your child needs to be seen

Treatment for Reducing Reinfection or Spread to Others

  1. Preventing Pinworm Infections:
    • Infection is caused by swallowing pinworm eggs.
    • A child can get pinworms no matter how carefully you clean.
    • The following hygiene measures, however, can help to reduce the chances of reinfection. It also can reduce the chance of new infections in other people.
    • Pets don't carry pinworms.
  2. Wash Hands:
    • Have your child scrub the hands and fingernails well before each meal. Also, wash the hands well after each use of the toilet.
    • Keep the fingernails cut short, because eggs can collect here.
    • Help your child give up thumb sucking and nail biting.
  3. Shower:
    • Each morning, give your child a shower during the 2 weeks of treatment.
    • Always rinse the anal area.
    • Continue for 3 days after taking the second dose of pinworm medicine.
  4. Vacuum:
    • Vacuum or wet-mop your child's bedroom once a week.
    • Any eggs left on the floor can still infect others for 1 or 2 weeks.
  5. Wash Clothes:
    • Have the infected child wear underwear at night during the 2 weeks of treatment. Caution: it may contain pinworm eggs. Remove it carefully just before showering. Wash the underwear each morning.
    • Bed sheets can also be washed on a more frequent basis.
    • Wash clothes and bedding at a hot temperature. This will kill any eggs left in them.
  6. Return to School:
    • Children with pinworms do not need to miss any child care or school.

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 11/17/2022

Last Revised: 01/13/2022

Copyright 2000-2022. Schmitt Pediatric Guidelines LLC.

Pinworm Infections (for Parents) - Nemours KidsHealth

What Are Pinworms?

Pinworms are tiny worms that can cause an infection in the intestines. Pinworm infections affects millions of people each year, especially school-age kids

If your child develops a pinworm infection, try not to worry. Pinworms don't cause any harm (just itching and restless sleep), and it won't take long to get rid of them.

How Do Pinworm Infections Spread?

Pinworm infections are contagious. The worms get into the body when people swallow the tiny pinworm eggs. The eggs can be on contaminated hands, under fingernails, and on things people touch a lot, such as:

  • clothing, bed linens, and towels
  • bathroom surfaces
  • drinking glasses and eating utensils
  • toys
  • kitchen surfaces
  • desks or lunch tables at school

Less often, eggs can spread when someone shakes out contaminated clothing or sheets, sending the eggs into the air, where they can get inhaled.

The eggs pass into the digestive system, where they hatch. About 1 to 2 months later, adult female pinworms lay eggs on the skin right around the anus, which makes the area itchy. Often, this happens at night.

When someone scratches the itchy area, tiny pinworm eggs get on their fingers. Contaminated fingers can then carry pinworm eggs to the mouth, where they go back into the body, or onto touched surfaces, where they can live for 2 to 3 weeks.

Family pets can't give your child an infection, as pinworms don't come from animals.

What Are the Signs & Symptoms of Pinworm Infection?

Common signs of a pinworm infection are:

  • itching around the anus (especially at night)
  • trouble sleeping
  • vaginal discharge in girls, if pinworms spread to the vagina
  • sore, red infected anal skin (which can happen from scratching)
  • tiny white worms (like a piece of thread, as big as a staple):
    • around the anus (check after your child has been asleep for 2–3 hours)
    • in the toilet or on the toilet paper after your child goes to the bathroom
    • in the underwear in the morning

Belly pain and nausea are less common symptoms but can happen if there are many pinworms in the intestines.

How Are Pinworm Infections Diagnosed?

The doctor will ask questions about your child’s symptoms and check your child’s bottom. The doctor may ask you to help make the diagnosis of pinworms by doing a tape test:

  1. Press the sticky side of a piece of clear tape against the skin around your child's anus at night or when they first wake up (pinworm eggs will stick to the tape).
  2. Wash your hands.
  3. Take the tape to the doctor to check for eggs with a microscope.

The doctor also might take some samples from under a child's fingernails to look for eggs.

How Are Pinworm Infections Treated?

If your child has a pinworm infection, the doctor will recommend an over-the-counter or prescription antiworm medicine. This is given in one dose, then repeated in 2 weeks. The doctor may decide to treat the entire family, especially if your child has had a pinworm infection before.

Although medicine takes care of the worm infection, the itching may continue for about a week. So the doctor also might give your child a cream or other medicine to help stop the itching.

Can Pinworm Infections Be Prevented?

When someone in the house has a pinworm infection, it often spreads to others.

To help prevent a pinworm infection from spreading in your family:

  • Remind kids to wash their hands well and often, especially after using the toilet, after playing outside, and before eating.
  • Keep kids' fingernails short and clean.
  • Make sure your kids shower or bathe every day. Doing so in the morning can help wash away any eggs.
  • Change and wash underwear and pajamas daily.
  • Wash towels, clothes, and sheets in hot water often (daily, if you can).
  • Tell kids not to scratch around their bottom or bite their nails.

When Should I Call the Doctor?

Call the doctor if your child complains of itchy skin or always seems to be scratching the anal or vaginal area.

Also ask if pinworms could be why your child has trouble sleeping or has begun to wet the bed. (Pinworms can irritate the urethra — the tube through which pee leaves the body — and lead to bedwetting.)

Remember that pinworms are quite common among kids and aren't harmful. By taking medicine and following some prevention tips, you'll be rid of the worms in no time.

Reviewed by: Melanie L. Pitone, MD

Date reviewed: November 2022

Pinworms

Pinworms - one of the most common intestinal helminths.

Pinworms are tiny parasitic nematodes (2-14 mm) that live in the intestines and lay their eggs on the skin around the anus.

Pinworm infection is also known as "enterobiasis".

The disease most often occurs in children aged 5 to 10 years.

A person becomes infected by ingesting helminth eggs.

In the intestines, larvae emerge from the eggs, which parasitize in the lower parts of the small intestine, and in the large intestine they turn into an adult.


At night, a mature female leaves the anus and lays eggs on the skin in the folds of skin around the anus, perineum, buttocks lays eggs (from 2 to 15 thousand).

After 4-5 hours, the eggs become "invasive" (infectious) for humans, because. during this time, larvae mature in eggs.

If an infected person touches household items such as bedding, clothing, toilet seat or toys, the eggs are transferred to those items.

Eggs can also be transferred from contaminated fingers directly to food.

Although rare, adults can also inhale airborne eggs by shaking contaminated bedding, towels, or clothing.

The causative agent of enterobiasis is resistant to various disinfectants. On toys, bedding, carpets and other household items, the causative agent of enterobiasis remains viable for up to 21 days, on environmental objects - in the upper soil layers of playgrounds, sand from sandboxes - up to 14 days, in tap and waste water - up to 7 days. The stability of pinworm eggs in the external environment increases as they mature. At a temperature of plus 22-28 ° C and a decrease in humidity to 60%, pinworm eggs remain viable for up to 8 days.

Who is at risk of getting enterobiasis?


Pinworms affect people of all ages, enterobiasis is ubiquitous.

Most susceptible to infection:

  • children attending organized institutions (especially kindergartens, camps)
  • family members or carers of those infected
  • people living in public institutions such as hostels
  • people who do not follow the rules of personal hygiene, namely regular and thorough hand washing before eating
  • children who have a habit of thumb sucking, nail biting

Is it possible to get pinworms from pets?

No, the only source of infection is humans.

Enterobiasis symptoms:

  • Itching, scratching accompanying pinworms on the skin
  • Scratching the skin provokes the spread of pinworm eggs and re-infection, as a result of which the disease can last for a long time. Eggs can survive for hours on hands, under fingernails.
  • Allergic reaction, rash
  • Irritability, tearfulness, restless sleep
  • Presence of pinworms in feces

Some people with enterobiasis may not experience any symptoms.

The danger of enterobiasis lies in the fact that pinworms that parasitize in the human intestine produce toxins - waste products that cause intoxication of the body. Pinworms, parasitizing on the mucosa, injure it, which can lead to the addition of a secondary fungal or bacterial infection.

The diagnosis is made on the basis of a laboratory test.

Treatment is prescribed by a doctor.

Children infested with pinworms, which are sources of the spread of enterobiasis, are not allowed into preschool educational institutions for the period of treatment and control laboratory examination.

In addition to following the doctor's recommendations, it is necessary to prevent the spread of infection and the risk of re-infection.

Washing your hands with soap and warm water after using the toilet, changing diapers, and before eating is the most effective way to prevent pinworm infection.


Parents are advised to ensure that children do not bite their nails.

Follow the rules of personal hygiene and change your underwear daily.

Infected people should not share bathing with other people.

Those infected should avoid taking baths. It is necessary to take a shower every morning.

Prevention of enterobiasis includes a set of measures:

  • detection of patients (parasite carriers) with enterobiasis
  • treatment of identified infested persons and prophylaxis of persons in contact with infested persons
  • monitoring of the circulation of the enterobiasis pathogen in groups with an increased risk of infection

Disinfestation is carried out in the focus of infection:

  • furniture and other surfaces are wiped with special disinfection-disinfestation agents
  • soft toys, upholstered furniture and carpets are treated with a vacuum cleaner, followed by dust disinfection. In the process of processing, it is recommended to remove carpets and toys for 3 days.
  • Linen, bed linen - boiled
  • Hard toys - wash with detergents.

01/14/2019

Enterobiasis - invasion by pinworms. Causes, symptoms, diagnosis and treatment of enterobiasis

Author

Irina Vanyukova

Head of the Department of General Practitioners and Pediatrics

Doctor

Doctor of the highest category

Pediatrician

Creation date: 2016.03.29

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.

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