Enterobiasis
Disease Details
Family Health Simplified
- Description
- Enterobiasis, also known as pinworm infection, is a common parasitic infestation caused by the nematode Enterobius vermicularis, primarily affecting children and characterized by intense perianal itching.
- Type
- Enterobiasis, also known as pinworm infection, is a type of parasitic infection. It is not genetically transmitted; instead, it is spread through the ingestion of Enterobius vermicularis eggs, which can be transmitted via contaminated surfaces, food, or directly from person to person.
- Signs And Symptoms
- One-third of individuals with pinworm infection are totally asymptomatic. The main symptoms are itching in and around the anus and perineum. The itching occurs mainly during the night, and is caused by the female pinworms migrating to lay eggs around the anus. Both the migrating females and the clumps of eggs are irritating, as well as the sticky substance that is produced by the worms when the eggs are laid. The intensity of the itching varies, and it can be described as tickling, crawling sensations, or even acute pain. The itching leads to continuously scratching the area around the anus, which can further result in tearing of the skin and complications such as secondary bacterial infections, including bacterial skin inflammation, and hair follicle inflammation. General symptoms are trouble sleeping, and restlessness. A considerable proportion of children experience loss of appetite, weight loss, irritability, emotional instability, and bed wetting.Pinworms cannot damage the skin, and they do not normally migrate through tissues. However, they may move onto the vulva and into the vagina, from there moving to the external orifice of the uterus, and onwards to the uterine cavity, fallopian tubes, ovaries, and peritoneal cavity. This can cause inflammation of the vulva and vagina. This causes vaginal discharge and itchiness of the vulva. The pinworms can also enter the urethra, and presumably, they carry intestinal bacteria with them. According to Gutierrez (2000), a statistically significant correlation between pinworm infection and urinary tract infections has been shown; however, Burkhart & Burkhart (2005) maintain that the incidence of pinworms as a cause of urinary tract infections remains unknown. One report indicated that 36% of young girls with a urinary tract infection also had pinworms. Painful urination has been associated with pinworm infection.The relationship between pinworm infestation and appendicitis has been researched, but there is a lack of clear consensus on the matter: While Gutiérrez maintains that there exists a consensus that pinworms do not produce the inflammatory reaction, Cook (1994) states that it is controversial whether pinworms are causatively related to acute appendicitis, and Burkhart & Burkhart (2004) state that pinworm infection causes symptoms of appendicitis to surface.
- Prognosis
- Enterobiasis, also known as pinworm infection, typically has a good prognosis with appropriate treatment. The infection is usually not serious and can be effectively treated with medications such as mebendazole, albendazole, or pyrantel pamoate. Good hygiene practices, including regular hand washing and cleaning household surfaces, can help prevent reinfection. With proper care and attention to hygiene, most individuals recover fully without complications.
- Onset
- Enterobiasis, commonly known as a pinworm infection, typically has an onset of symptoms around 1 to 2 months after initial ingestion of pinworm eggs. The main symptom is perianal itching, particularly at night.
- Prevalence
- Enterobiasis, caused by the pinworm (Enterobius vermicularis), is highly prevalent worldwide, particularly among children. In the United States, it is estimated that millions of people are infected annually, with prevalence rates in some areas reaching up to 50% among children. Globally, rates of infection can be higher, especially in regions with crowded living conditions and poor hygiene practices.
- Epidemiology
- Pinworm infection occurs worldwide, and is the most common helminth (i.e., parasitic worm) infection in the United States and Western Europe. In the United States, a study by the Center of Disease Control reported an overall incidence rate of 11.4% among people of all ages. Pinworms are particularly common in children with approximately 30% of children being infected and most commonly seen in children between 7 and 11 years old. The prevalence rates in children having been reported as high as 61% in India, 50% in England, 39% in Thailand, 37% in Sweden, and 29% in Denmark. Finger sucking has been shown to increase both incidence and relapse rates, and nail biting has been similarly associated. Because it spreads from host to host through contamination, enterobiasis is common among people living in close contact, and tends to occur in all people within a household. The prevalence of pinworms is not associated with gender, nor with any particular social class, race, or culture. Pinworms are an exception to the tenet that intestinal parasites are uncommon in affluent communities.
- Intractability
- Enterobiasis, also known as pinworm infection, is typically not considered intractable. It is usually treatable with over-the-counter or prescription medications, such as mebendazole, albendazole, or pyrantel pamoate. Proper hygiene practices, such as regular handwashing and laundering of bedding and clothing, are crucial to prevent reinfection and manage the spread. However, recurrence can happen if proper precautions are not followed, but it can generally be managed effectively with appropriate treatment and hygiene.
- Disease Severity
- For enterobiasis (commonly known as pinworm infection), the disease severity is generally considered mild. However, it can cause significant discomfort due to itching, especially at night. Serious complications are rare.
- Healthcare Professionals
- Disease Ontology ID - DOID:7457
- Pathophysiology
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Enterobiasis, also known as pinworm infection, is caused by the intestinal nematode Enterobius vermicularis. Here's a brief overview of its pathophysiology:
1. **Ingestion of Eggs**: Infection begins when microscopic eggs are ingested. These eggs are typically transmitted via contaminated hands, food, or surfaces.
2. **Larvae Development**: Once swallowed, the eggs hatch in the small intestine, releasing larvae.
3. **Migration to Colon**: The larvae migrate to the colon, where they mature into adult worms.
4. **Maturation and Reproduction**: Adult female worms move to the perianal region, usually at night, to lay thousands of microscopic eggs, causing perianal itching.
5. **Egg Dissemination**: Scratching the perianal area due to itching dislodges the eggs, contaminating the fingers and under the nails. These eggs can then be transferred to various surfaces, leading to further spread of the infection.
6. **Reinfection Cycle**: Eggs can be ingested again, continuing the cycle of infection and propagation.
This cycle can lead to persistent infections if not properly treated, as the eggs are highly resilient and can survive in the environment for up to three weeks. - Carrier Status
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Enterobiasis, also known as pinworm infection, is caused by the parasitic worm Enterobius vermicularis. The carrier status refers to being infected without showing significant symptoms. Carriers can still spread the infection to others, particularly in households or communities with close contact.
Nan, typically referring to "nanodisease" or "nanotechnology-associated" contexts, isn't applicable here as enterobiasis is a parasitic infection and not related to nanotechnology. - Mechanism
-
Enterobiasis, also known as pinworm infection, is caused by the intestinal parasitic nematode Enterobius vermicularis.
**Mechanism:**
1. **Transmission:** The primary mode of transmission is through the ingestion of pinworm eggs, which can be found on contaminated surfaces, food, or through hand-to-mouth contact.
2. **Ingestion and Hatching:** Once the eggs are ingested, they hatch in the small intestine, releasing larvae.
3. **Larval Migration:** The larvae migrate to the large intestine, where they mature into adult worms.
4. **Reproduction:** Adult female pinworms move to the perianal region at night to lay eggs, causing itching and prompting further spread through scratching and subsequent hand-to-mouth transfer.
**Molecular Mechanisms:**
1. **Egg Viability:** Pinworm eggs possess a resilient outer shell that protects them in the environment and within the host’s digestive tract until they reach the ideal hatching site in the small intestine.
2. **Larval Gastric Response:** The larvae respond to the stomach's acidic environment and other intestinal signals, which trigger them to hatch.
3. **Adhesion Molecules:** Adult worms express specific adhesion molecules that allow them to attach to intestinal mucosa, aiding in their survival and nutrient absorption.
4. **Immune Evasion:** Enterobius vermicularis produces molecules that modulate the host’s immune response, allowing the worms to evade detection and destruction. This includes secretions that can dampen local immune activity and inflammation.
5. **Nocturnal Migration:** The nocturnal migration of female pinworms to the perianal area is triggered by a combination of circadian signals and possibly host body temperature.
Understanding these mechanisms provides insights into how pinworms survive, reproduce, and spread, which is critical for developing effective treatments and preventive strategies for enterobiasis. - Treatment
- Medication is the primary treatment for pinworm infection. However, reinfection is frequent regardless of the medication used. Total elimination of the parasite in a household may require repeated doses of medication for up to a year or more. Because the drugs kill the adult pinworms, but not the eggs, the first retreatment is recommended in two weeks. Also, if one household member spreads the eggs to another, it will be a matter of two or three weeks before those eggs become adult worms and thus amenable to treatment. Asymptomatic infections, often in small children, can serve as reservoirs of infection, and therefore the entire household should be treated regardless of whether or not symptoms are present.The benzimidazole compounds albendazole (brand names e.g., Albenza, Eskazole, Zentel and Andazol) and mebendazole (brand names e.g., Ovex, Vermox, Antiox and Pripsen) are the most effective. They work by inhibiting the microtubule function in the pinworm adults, causing glycogen depletion, thereby effectively starving the parasite. A single 100 milligram dose of mebendazole with one repetition after two weeks, is considered the safest, and is usually effective with cure rate of 96%. Mebendazole has no serious side effects, although abdominal pain and diarrhea have been reported. Pyrantel pamoate (also called pyrantel embonate, brand names e.g., Reese's Pinworm Medicine, Pin-X, Combantrin, Anthel, Helmintox, and Helmex) kills adult pinworms through neuromuscular blockade, and is considered as effective as the benzimidazole compounds and is used as a second-line medication. Pyrantel pamoate is available over the counter and does not require a prescription. Pinworms located in the genitourinary system (in this case, female genital area) may require other drug treatments.
- Compassionate Use Treatment
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Enterobiasis, commonly known as a pinworm infection, typically does not require compassionate use treatments or experimental therapies due to the availability of effective standard treatments. The following are medications and approaches sometimes considered:
1. **Standard Treatments**:
- Mebendazole
- Albendazole
- Pyrantel pamoate
2. **Off-label or Experimental Treatments**:
- **Ivermectin**: Although not primarily used for enterobiasis, ivermectin has shown some efficacy in treating various parasitic infections and might be considered in specific or resistant cases.
Consultation with a healthcare provider is necessary for appropriate diagnosis and treatment recommendations. - Lifestyle Recommendations
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For enterobiasis (pinworm infection), here are some lifestyle recommendations to help manage and prevent the condition:
1. **Good Hygiene Practices**:
- Wash hands thoroughly with soap and water after using the toilet, before eating, and after changing diapers.
- Keep fingernails short and clean to prevent re-infection and reduce the risk of spreading the eggs.
2. **Laundry and Cleanliness**:
- Wash bedding, pajamas, underwear, and bath towels regularly in hot water and ensure they are thoroughly dried.
- Change underwear and pajamas daily to prevent the spread of pinworm eggs.
- Clean and vacuum living areas frequently, especially bedrooms.
3. **Avoid Scratching and Nail-Biting**:
- Encourage children to avoid scratching the perianal area as this can lead to the transfer of eggs to hands and under the fingernails.
- Discourage nail-biting or thumb-sucking which can facilitate oral ingestion of eggs.
4. **Personal Items**:
- Do not share personal items such as towels, bedding, and clothing to reduce the spread of the infection.
5. **Regular Bathing**:
- Take a shower every morning to wash away pinworm eggs laid during the night.
These measures, combined with appropriate medical treatment, can help eliminate the infection and prevent its recurrence. - Medication
-
For the treatment of enterobiasis, also known as pinworm infection, the commonly used medications are:
1. Mebendazole
2. Albendazole
3. Pyrantel pamoate
These antiparasitic medications are typically effective with a single dose, though a second dose may be required two weeks later to prevent reinfection. It is also advisable to treat all household members simultaneously and follow strict hygiene measures to prevent recurrence. - Repurposable Drugs
- Repurposable drugs for treating enterobiasis (pinworm infection) primarily include anti-parasitic medications such as albendazole, mebendazole, and pyrantel pamoate. These drugs are effective in eliminating pinworms and are typically used off-label for treating various other parasitic infections.
- Metabolites
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Enterobiasis, also known as pinworm infection, is caused by the helminth Enterobius vermicularis. While specific metabolites are not typically highlighted in the diagnosis or treatment of enterobiasis, the condition is better understood through its clinical features and management.
If you need additional information or have more specific questions, I'm here to help. - Nutraceuticals
- For enterobiasis (pinworm infection), there is no substantial scientific evidence supporting the use of nutraceuticals for effective treatment. The standard treatment involves anti-parasitic medications such as mebendazole or albendazole, alongside strict hygiene practices to prevent reinfection. Nutraceuticals, a broad category including dietary supplements, vitamins, and herbal products, are not recognized as a primary or effective treatment for enterobiasis.
- Peptides
- Enterobiasis, also known as pinworm infection, is caused by the nematode *Enterobius vermicularis*. Peptides have not been established as a standard treatment or intervention for this condition. The primary method for treating enterobiasis is with antiparasitic medications such as mebendazole, albendazole, or pyrantel pamoate. Management also involves maintaining strict hygiene practices to prevent re-infection and transmission.