Whipworm infection

 

Whipworm infection.

Trichuris trichiura infestation.

P.K. Ghatak, MD

Whipworm is a roundworm and sexes are separate. The worm is light pink in color and adult worms are about 2 inches long, females are longer than males. The mouth part of the body is thin and the bottom part of the female worms is thicker and rounded, whereas it is thin and coiled in males resembling a whip that gave them the name Whipworm.

The worms live in the large bowel, from cecum to rectum, and can live up to a year. Within 3 months of ingestion of infected eggs, the female worm begins releasing 20,000 eggs in the stool daily. Using human waste as fertilizer and open air defecation made Whipworm infection more widespread. The WHO estimates about 1 billion people are currently infected with this round worm.

Mode of infection and people at risk:

By ingestion of matured eggs.

Poor people in worm countries, due to lack of education and access to clean water and having poor hygienic practices, are susceptible to infection and reinfections; children are specially so.

Chronology of symptoms:

Most infections or ingestion of eggs are asymptomatic. Eggs hatch and move to the small intestine. The newly released larvae penetrate the mucous membrane of the small intestine and mature into adult worms in 3 months. Some patients develop mild abdominal pain and diarrhea but most people do not feel any symptoms. The adult worms take up permanent residence in the large bowel wall. Heavy infection is the usual. Many adults and specially children develop frequency of bowel movement and the stool is mixed with heavy mucus and some blood. Children can become very sick with rectal prolapse, nutritional deficiency, bloody dysentery and anemia.

Diagnosis:

Stool examination shows typical eggs – barrel shaped brown colored eggs with distinct plug like ends

.

Treatment:

One dose of Albendazole kills all round worms. But reinfection is common.

Prevention:

Educating the public about sanitation and prevention of fecal-oral infection are essential part of eradicating program of this common worm infection.

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