Worms (helminths)

Worms are parasitic worms that live in the body of humans and animals. They are difficult to detect as they disguise themselves like many other diseases and conditions. Symptoms of helminth infestation range from mild discomfort to fainting with severe poisoning. We will tell you where you can get infected with worms and how to get rid of them.

What is it

Worms are considered the most common parasites in humans. Today, science knows about 300 diseases caused by worms. The most common are intestinal worms: enterobiasis and ascariasis, which affect more than 2 billion people.

The size of the worms that live in the body varies from a few millimeters to several meters. For example, the length of pinworms that cause enterobiasis does not exceed 1 cm. Some tapeworms (for example, the broad tapeworm) reach 12-15 meters.

Causes of helminthiasis

Helminthiasis is a disease in which a worm infection occurs. The worms enter the human body and stay there. These parasites live not only in the intestines, but also in other organs and tissues.

According to the World Health Organization, one in four people on Earth is infected with worms. At the same time, WHO experts point out that the actual number of infected people is at least 50%. This mainly affects countries with a low health culture (these are some countries in Africa and Southeast Asia). In other countries, more than 1. 5 million cases of helminth infection are recorded annually. Most are children.

How can you get infected with worms?

There are 4 ways of infection:

1. Through the ground. These diseases are called soil-transmitted helminth infections. Unwashed fruits can harbor tens of thousands of parasites. Therefore, it is very important to wash vegetables, fruits and hands well before eating. Walking pets are another source of terrestrial parasites.
2. Upon contact with an infected person. Parasitic worms are incredibly prolific. In just one day, the female roundworm can lay up to 5, 000 eggs in the human body. Eggs and adults can be transmitted to other people through bedding and other household items. After that, it is enough that the infected do not wash their hands and the worms will penetrate inside.
3. By eating contaminated food. These helminthic diseases are called biohelminthiasis. You can contract the parasite with insufficient heat treatment of meat, poultry, or fish.
4. Through an insect bite. This type of transmission is rare. As a general rule, very small parasites can be transmitted through insect bites.

Consider the risk factors that increase the likelihood of worm infection in adults and children:

• Ignore the hygiene rules: if you do not wash your hands after the street, going to the bathroom or before eating.
• The habit of biting your nails - there is a lot of dirt under them with microbes and parasites. This also includes the habit of putting pens, pencils, and other objects in your mouth.
• Poor pet care, especially those that go outdoors.
• Eat unwashed vegetables and fruits.
• Using water from questionable sources.
• Poor cleaning of the houses.
• Passion for animal nutrition that has not undergone proper culinary processing.

Who is at risk

No one is immune from worm infection. It is enough to give slack in terms of hygiene, and the larvae of the parasite can "penetrate" into the body. The following categories of people are especially susceptible to helminthiasis:

• Small children. Very often, helminthic invasions are observed in children. This is due to the fact that the child neglects the rules of hygiene. Young children put objects in their mouths and, in the streets, they often dig in the mud. In groups, children tend to have closer contact with each other than adults, which also increases the likelihood of infection.
• Families with pets. Parasite eggs and larvae, which came from the street to homes with pets, can be everywhere. Often times, owners of dogs, cats and other animals are not even aware of the problem and learn of the presence of worms when they contact a veterinarian for another reason.
• Food lovers. Lovers of exotic cuisine such as sushi, raw meat or fish are also at risk.
• Travellers. This is especially true for people traveling to countries with a low level of sanitation.
• Summer residents, agricultural workers. People who work in orchards, orchards or simply live in the field.
• People who come across raw fish or meat at work. For example, salespeople or chefs: when processing, cutting and preparing food.

Myth 1: there are no parasites in marine fish.

Many people mistakenly believe that worms are only found in river fish and that they are not in the sea due to the salt water. In fact, marine fish are predominantly affected by parasites that are not dangerous to humans. In this sense, raw river fish is more dangerous than raw sea fish. But this does not mean that sea fish is completely safe: it is always recommended to process any fish: fry it, boil it or freeze it for 3 days.

Helminthiasis classification

There are several classifications of parasitic worms. By location, the worms are:

• Intestinal: lives in the small or large intestine. These include roundworms, eels, whipworms, bovine tapeworms, and others.
• Pulmonary: lives in the tissues of the bronchopulmonary system. Most of the time it is a lung fluke.
• Tissue: parasitizes various tissues of the body. Tissue worms include schistosomes, trichinella, and toxocar.
• Parasites of the liver and gallbladder. They are liver parasites, giant liver parasites, and clonorch (Chinese parasites).

There are 4 classes of helminthic diseases, depending on the pathogen:

• Nematodes: caused by roundworms. These are ascariasis, enterobiasis, trichinosis, whipworm, toxocariasis, hookworm, and others.
• Cestodosis: the causative agents are tapeworms. Such pathologies include hymenolepiasis, taeniasis, teniarinchiasis, diphyllobothriasis, and cystcerciasis.
• Dystomiases are diseases caused by flatworms. These are fascioliasis, opisthorchiasis, dichroceliosis.
• Protozosis: the causative agents are protozoa, such as lamblia, toxoplasma or amoeba.

More than 70 species of parasitic worms are distributed. The most common are the following helminthic diseases (see table).

Helminthic invasions

Disease	The causal agent and its characteristics.	Transfer method
Ascariasis	Called ascaris. These are roundworms that live in the intestines. They can grow up to 30-40 cm. Roundworms eat almost all the nutrients in food. In the process of vital activity, the worms injure the intestinal walls up to perforations.	Most often, roundworm eggs are transmitted by the fecal-oral route. They persist for a long time in the soil and on the surface of vegetables, fruits, herbs, and berries.
Enterobiasis	It develops when pinworms enter the body. These are small round worms, the size of which is 0. 5-1 cm. The main danger of enterobiasis is the toxic waste products of worms.	Contact with an infected person. Pinworm eggs remain on various surfaces for some time.
Giardiasis	Caused by microscopic parasites - lamblia. Pathogens produce toxic substances and damage tissues.	Giardia is transmitted by the fecal-oral route, as well as through contaminated food and water.
Opisthorchiasis	The causative agents are small worms up to 2 cm in size, which most often parasitize the liver and bile ducts. With opisthorchiasis, poisoning with toxic substances and mechanical damage to tissues occur.	Opisthorchiasis pathogens are transmitted with raw fish.
Echinococcosis	It is caused by echinococci, tapeworms, the size of which does not exceed 5 cm. Echinococci parasitize various tissues, including the heart and brain. Pathogens cause serious disturbances in the functioning of body organs and systems. In some cases, they can provoke a malignant tumor process.	They are transmitted through dirty hands and contaminated food. Echinococcus carriers can also be dogs and rodents.
Diphyllobothriasis	Causal agents: large tapeworms, reaching 10-15 meters. Tapeworms live in the small intestine and cause serious damage to the host's body. Worms produce toxic substances and significantly impair the functioning of the digestive tract.	It is transmitted by eating raw fish.
Trichocephalosis	Named for whipworms, a round worm that looks like a hair. Vlasoglava can reach 5-6 meters. The worms live in the intestines and penetrate the submucosa layer. Cause intoxication, inflammation, and acute anemia.	The invasion takes place by swallowing the parasite's eggs.

Worm infestations are also classified according to the stages:

• Acute helminthiasis: appear 2 to 4 weeks after infection. In this case, the symptoms of worms are observed from 1 week to several months. If you do not do therapy, the disease becomes chronic.
• Chronic helminthiasis: manifestations depend on the type of parasite. For example, if it is parasites with larval reproduction, prolonged allergic reactions will follow. Other chronic worm diseases can be asymptomatic or accompanied by pain, discomfort, fatigue, and other symptoms.

Helminthiasis complications

If helminthiasis is not treated, this leads to serious, sometimes life-threatening complications:

• Anemia: anemia, insufficient amount of red blood cells and hemoglobin in the blood. This condition is due to the worms consuming part of the nutrients necessary for normal hematopoietic function.
• Destruction of tissues and organs. Worms live not only in the lumen of the gastrointestinal tract, but also in the thickness of tissues, for example, liver, lungs, muscles. Above all, tissues are affected during the migrations of worms, when they move from one department (or organ) to another: ulcers and foci of constant inflammation are formed. In this context, the risk of developing infections and malignant tumors increases.
• Diseases of the nervous system. This is due to the toxic waste products of the worms that poison the body. Nerve tissues are more sensitive to toxins. This can lead to irritability, headaches, insomnia, and other signs of nervous system damage.
• Allergic reactions. Toxic substances secreted by worms can also act as allergens. Human immunity can respond inappropriately to these substances. This leads to the appearance of typical allergic symptoms: rashes, redness of the skin, itching, and sometimes nausea and vomiting.

The presence of worms in the body also leads to a lack of the following minerals:

• Zinc. With a lack of zinc, immunity decreases, a person often catches a cold and suffers from other infectious diseases. The probability of developing prostatitis and infertility increases, because this trace element is extremely important for the health of the reproductive system.
• Selenium. It lowers immunity and also increases the risk of malignant tumors.
• Iodine. Iodine deficiency in children leads to a delay in growth and development (physical and mental). In adults, the work of the thyroid gland worsens, metabolic processes slow down.
• Manganese. With a lack of manganese, bones become brittle. A person loses weight quickly, he is often worried about cramps and dermatitis.
• Chrome. The deficiency of this element leads to a delay in development and an impaired carbohydrate metabolism.

Worms and immunity

Often the worms are accompanied by other parasites: toxoplasma and chlamydia. This is due to the suppression of immunity. A healthy body is able to resist invaders, but with helminthiasis, the protection is weakened. Toxoplasmosis is especially dangerous during pregnancy, as it can lead to fetal death.

Symptoms of helminthiasis.

The signs of worms are diverse in both adults and children. The most common symptoms are:

• itchy anus is the most common symptom of pinworms;
• grinding teeth in a dream - occurs due to toxins released by worms;
• drooling during sleep and in the morning;
• nausea when brushing your teeth in the morning;
• peeling of the skin on the hands and feet;
• allergic skin rashes;
• a strong feeling of hunger, even fainting;
• swelling (often allergic);
• skin itch;
• chronic fatigue;
• headache and dizziness;
• mental disorders for no known reason (stress, neurosis, depression);
• swelling
• symptoms of intestinal disorders;
• change in body weight (both overweight and thin);
• the simultaneous course of several diseases (or the succession of one disease to another);
• cramps or pulling pains in the abdomen;
• anemia;
• delayed physical and mental development in children;
• child hyperactivity or lethargy;
• enlarged lymph nodes (often in the acute stage of helminthiasis).

When to see a doctor

An infectious disease therapist or specialist deals with the treatment of parasitic diseases. A physician should be consulted if one or more of the above symptoms are found. Due to a rather sophisticated worm-masking system, you need to explain the symptoms as precisely as possible to the doctor, and also talk about your lifestyle: what food you prefer, whether you have recently traveled and where, there are pets, etc.

Diagnosis of the disease

If the doctor suspects a helminthic invasion, it is not difficult to identify it. To do this, the following diagnostic procedures are used:

• Stool examination. A stool sample is given to the laboratory. They can contain eggs or larvae of parasites that live in the intestines.
• Scraping for enterobiasis. A swab is taken from the anus with a cotton swab. With this test, pinworms can be identified. Scraping should be done early in the morning, before going to the bathroom.
• A blood test to check for antibodies. This is a fairly informative test with which you can identify many parasites. However, even with a positive result, there is no 100% guarantee that the parasites are still in the patient's body, because the antibodies remain even after they are removed.
• Instrumental diagnosis. The use of radiography, MRI and computed tomography with the use of contrast agents. These diagnostic methods allow the identification of both large worms and some pathological changes in tissues caused by helminthic invasion.

As a general rule, the doctor prescribes different studies to increase the reliability of the data obtained. Sometimes a patient must be examined multiple times to make an accurate diagnosis.

Important!When confirming helminthiasis, it is necessary to notify other close relatives about this. An exam is also recommended. If the test is positive, it is important that all infected family members receive treatment. Otherwise, the parasite eggs will re-enter the body of the recovered person, and everything will have to be repeated from the beginning.

Treatment of helminths in children and adults.

Despite the abundance of antiparasitic drugs in pharmacies, you cannot take them yourself. By prescribing a comprehensive treatment, the doctor seeks not only to eliminate parasites, but also to eliminate the consequences of their vital activity.

As a rule, in addition to anthelmintic drugs, the patient is also prescribed vitamins and other drugs that eliminate the symptoms of the disease. The doctor selects the medications separately for each patient, because the symptoms are different for everyone.

Medicines for the treatment of helminthiasis.

With helminthic invasions, patients are prescribed a complex of the following drugs:

• Anthelmintic drugs. These are anthelmintic drugs that kill or kill the worms. These goals are achieved by disrupting the metabolism of parasites or paralyzing their muscles. In the latter case, they lose the ability to stay in the intestine and are excreted.
• Antihistamines. If the patient is allergic to parasites, at the time of treatment, doctors prescribe anti-allergic drugs. This is extremely important, since with the mass death of worms, a large number of allergens are released, which can provoke a strong allergic reaction. Antihistamines block the production of histamine, the main mediator of an allergic reaction.
• Enterosorbents. These are drugs that can bind to substances in the gastrointestinal tract. During the treatment of worms, enterosorbents are used to bind and remove the toxic substances secreted by the worms.
• Vitamins and minerals. Most often, B vitamins (folic acid and B12) and iron preparations are prescribed. This is necessary to treat anemia.
• Hepatoprotectors. These are drugs that protect the liver from toxic substances. These include preparations based on essential phospholipids or plant materials (milk thistle, artichoke, licorice, St. John's wort, and other plants).
• Probiotics and prebiotics. Prescribed to restore the intestinal microflora. Probiotics are live cultures of beneficial bacteria. Prebiotics are indigestible food components (such as fiber) that are only fermented by the intestinal flora.

Surgery

In most cases, it is enough to drink a complex of drugs. However, sometimes doctors are still forced to resort to surgery. For example, a large accumulation of pinworms can cause intestinal obstruction. This is an urgent condition that requires surgery.

Worms can accumulate in the bile duct, against the background of which obstructive jaundice and even liver abscess develop. The same situation can occur in the pancreas and lead to acute pancreatitis. If the worms enter the appendix, appendicitis develops. All of these conditions require immediate surgery.

Surgery is often used when organs are damaged by echinococcus. These parasites accumulate and form echinococcal plugs in the liver, lungs, bones, kidneys, and even the brain. The danger of such a plug is that it can become infected and explode.

Folk remedies for worms

Home remedies for worms are not as effective as anthelmintic medications. This is just an auxiliary method - the main treatment is prescribed by a doctor.

Folk remedies include pumpkin seeds, which contain cucurbitin, a substance that has an anthelmintic effect.

Myth 2: garlic enemas kill worms

Worms really don't like garlic, because it contains phytoncides, antibacterial and antiparasitic substances. However, it is not necessary to do garlic enemas for helminthiasis. In the large intestine, where the contents of the enema are injected, there are very few worms. Most parasites live in the small intestine, so this procedure is useless. Also, with such an enema, you can get severe irritation of the mucous membrane.

Prevention and precautions

In most cases, the prognosis for treating helminthiasis is favorable. A timely visit to a doctor will prevent a number of complications that worms lead to.

Preventing worms comes down to complying with the following recommendations:

• Wash your hands with soap and water before eating, after returning from the street, going to the bathroom, or after contact with animals.
• Wash vegetables, fruits and herbs well. It is better to add boiling water.
• Do not use other people's hygiene items or other people's dishes.
• Give up bad habits (smoking, alcohol).
• Avoid stress, it will have a beneficial effect on immunity.
• Regularly show your pet to the vet, vaccinate in a timely manner.
• Every year, get a comprehensive preventive exam, including pinworm egg tests.
• Cook meat, poultry, fish, and eggs properly.

Myth 3: parasites die in frozen meat.

This is only true for some worms. For example, the bovine tapeworm actually dies when the meat is deep frozen (minus 12 and minus). And, for example, Trichinella larvae can be removed only after 2-3 hours of cooking.

conclusion

The main cause of helminthic invasions is inadequate hygiene. Improved sanitation and proper cooking of animal feed significantly reduces the likelihood of helminthiasis. In most cases, worms do not pose a danger to human health if they are caught early. However, the lack of treatment has serious consequences: anemia, damage to the nervous system and other infections.