Rectal Drooper Whipworm
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Synonyms
Trichuris trichiura
Trichuriasis synonyms
Whipworm infection, Trichocephaliasis, Trichocephalosis.
Epidemiology
The epidemiology is worldwide but the whipworm thrives best in warm, moist tropical countries making it more prevalent in the areas of high rainfall, high humidity and dense shade. Hence infections are more frequent in areas with tropical weather and poor sanitation practices and among children.
Symptoms
Symptoms are determined largely by the parasitic worm burden, less than ten worms may remain asymptomatic or with minor symptoms which may include nervousness, irritability, headache, insomnia, decreased cognitive ability, vomiting, abdominal distention etc.
Heavier infections, as in the case of massive infantile trichuriasis, are characterized by diarrhea (often bloody and with mucus as the anterior portions of the adult worms are threaded into the mucosal lining of the intestine), dysentery, tenesmus, abdominal pain (usually in the right lower quadrant), rectal prolapse (bulging/drooping of the rectum out of the anus), weakness, pallor, weight loss or anorexia, dehydration etc. The infection may result in malnutrition, weight loss and anemia and sometimes even death.
Diagnosis
Diagnosis is based on symptoms and the presence of eggs in feces under microscopic stool examination.
Spread/life cycle
The un-embryonated eggs are passed with the stool. In the soil, the eggs develop into a 2-cell stage, an advanced cleavage stage, and then embryonate; eggs become infective in fifteen to thirty days. After ingestion through contaminated food or unhygienic hands, the eggs hatch in the small intestine, and release larvae that mature and establish themselves as adults in the colon. The adult worms live in the cecum and ascending colon. The adult worms are fixed in that location with the anterior portions threaded into the mucosa. The females begin to oviposit sixty to seventy days after infection. The life span of the adults is about one year.
Contagious?
Not that severe, but yes in poor sanitary conditions where eggs can be ingested.
Prevention
- Ensure clean drinking water.
- Improved hygiene and sanitary eating habits are most effective in control. Ensure good personal hygiene and eating habits. Keep hands always clean. Trim nails. Wash hands before eating or preparing food. Wash hands after a toilet visit. Any anti-bacterial soap will usually insure a worm-free existence. (Now you know the importance of washing hands.)
- Deworm regularly or as directed by your primary physician.
- Discourage thumb sucking/nail biting of children.
Medications
Conventional drug options are Mebendazole, 200 mg, for adults and 100 mg for children, for 3 days. Albendazole is an alternative. Accompanying infections must be treated accordingly. Talk to your doctor for more information and appropriate dosages and intervals.
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