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Threadworms 

Threadworms
Chapter:
Threadworms
DOI:
10.1093/med/9780198729228.003.0081
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date: 19 November 2019

Threadworm or pinworm (Enterobius vermicularis) is a small, thin roundworm that very commonly affects preschool and school-aged children. Infestation occurs via the faecal–oral route with ingestion of eggs directly from contaminated hands or indirectly through contaminated fomites. Threadworm infestation may cause pruritus ani (and/or pruritus vulvae in girls), insomnia, irritability, anorexia, and weight loss; some children are asymptomatic. Diagnosis is made by microscopic demonstration of eggs on a moistened perianal swab or via the adhesive tape test. Treatment is with an antihelminthic (usually mebendazole), together with hygiene and preventative measures. As re-infestations are common, two doses of mebendazole are recommended at an interval of 2 weeks. Hygiene measures include frequent change of undergarments and bedding, keeping fingernails short, handwashing before and after using the toilet and before meals, and avoidance of nail biting and finger sucking. All family members or a group of infected persons in an institution should be treated simultaneously. For children ≤6 months old, hygiene measures alone are recommended. Children with threadworms do not need to be excluded from nursery or school.

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