Worms (helminths)

Worms are parasitic worms that live in the body of humans and animals. They are difficult to detect as they masquerade as many other diseases and conditions. Symptoms of helminthic infestation range from mild malaise to fainting with severe intoxication. 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 worm diseases. The most common are intestinal worm diseases - enterobiasis and ascariasis, which affect more than 2 billion people.

The size of worms living 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 infection with worms occurs. Worms enter the human body and remain 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 note that the real number of infected people is at least 50%. This mainly concerns countries with a low sanitary 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 of them are children.

How can you get infected with worms?

There are 4 ways of infection:

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

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

• Disregard for hygiene rules - if you do not wash your hands after going outside, using the toilet, or before eating.
• The habit of biting nails - there is a lot of dirt under them with microbes and parasites. This also includes the habit of taking pens, pencils and other objects into your mouth.
• Poor pet care, especially for those who go outside.
• Eating unwashed vegetables and fruits.
• Using water from questionable sources.
• Poor cleaning of living quarters.
• Passion for animal food that has not undergone proper culinary processing.

Who is at risk

No one is immune from infection with worms. It is enough to give slack in matters of hygiene, and the larva of the parasite can "break through" into the body. The following categories of people are especially susceptible to helminthiasis:

• Small children. Most often, helminthic invasions are noted in children. This is due to the fact that the child neglects the rules of hygiene. Small children put objects in their mouths, and on the streets they often dig in the mud. In groups, children tend to contact each other more closely than adults, which also increases the likelihood of infection.
• Families with pets. Eggs and larvae of parasites, which got from the street into the living quarters with pets, can be everywhere. Often, owners of dogs, cats and other animals are not even aware of the problem and find out about the presence of worms when contacting a veterinarian for another reason.
• Foodies. Lovers of exotic cuisine such as sushi, raw meat or fish are also at risk.
• Travelers. This is especially true for people traveling to countries with a low level of sanitation.
• Summer residents, agricultural workers. Persons working in vegetable gardens, orchards or simply living in the countryside.
• People who come across raw fish or meat in their work. For example, vendors or chefs - when processing, cutting and preparing food.

Myth 1: there are no parasites in marine fish.

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

Classification of helminthiasis

There are several classifications of parasitic worms. By localization, worms are:

• Intestinal - live in the small or large intestine. These include ascaris, eels, whipworms, bovine tapeworm and others.
• Pulmonary - live in the tissues of the bronchopulmonary system. Most often it is a pulmonary fluke.
• Tissue - parasitizes on various tissues of the body. Tissue worms include schistosomes, trichinella and toxocar.
• Liver and gallbladder parasites. They are hepatic fluke, hepatic giant fluke, and clonorch (Chinese fluke).

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

• Nematodes - caused by roundworms. These are ascariasis, enterobiasis, trichinosis, trichocephalosis, toxocariasis, ankylostomiasis and others.
• Cestodoses - the causative agents are tapeworms. Such pathologies include hymenolepiasis, teniasis, teniarinchiasis, diphyllobothriasis and cystcerciasis.
• Dystomyases are diseases caused by flatworms. These are fascioliasis, opisthorchiasis, dicroceliosis.
• Protozoses - the causative agents are protozoa, such as lamblia, toxoplasma or amoeba.

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

Helminthic invasions

Disease	The causative 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. Ascaris feed on almost all nutrients from food. In the process of vital activity, worms injure the intestinal walls up to perforations	Most often, ascaris 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 in enterobiasis is 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 injure tissues	Giardia is spread by the faecal-oral route, as well as through contaminated food and water
Opisthorchiasis	The causative agents are small worms up to 2 cm in size. Most often they parasitize in 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 on various tissues, including the heart and brain. Pathogens cause severe disturbances in the functioning of organs and body systems. In some cases, they can provoke a malignant tumor process.	They are spread through dirty hands and contaminated food. Echinococcus carriers can also be dogs and rodents.
Diphyllobothriasis	Causative 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	Transmitted by eating raw fish
Trichocephalosis	Called by whipworm, a round worm that looks like a hair. Vlasoglava can reach 5-6 meters. Worms live in the intestines, penetrating into the submucosal layer. Cause intoxication, inflammation and acute anemia	The invasion is carried out by swallowing the eggs of the parasite

Worm infestations are also classified according to stages:

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

Complications of helminthiasis

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

• Anemia - anemia, insufficient number of red blood cells and hemoglobin in the blood. This condition is due to the fact that the worms consume 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. Most of 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. Against this background, the risk of developing infections and malignant tumors increases.
• Diseases of the nervous system. This is due to the toxic waste products of worms that poison the body. Nerve tissues are most sensitive to toxins. This can lead to irritability, headaches, insomnia, and other signs of damage to the nervous system.
• Allergic reactions. Toxic substances secreted by worms can also act as allergens. Human immunity may respond inadequately to these substances. This leads to the appearance of typical allergic symptoms - rashes, skin redness, 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 likelihood of developing prostatitis and infertility increases, because this trace element is extremely important for the health of the reproductive system.
• Selenium. Decreases immunity, and also increases the risk of malignant tumors.
• Iodine. Iodine deficiency in children leads to stunted 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 quickly loses weight, he is often troubled by cramps and dermatitis.
• Chromium. Deficiency of this element leads to developmental delay and impaired carbohydrate metabolism.

Worms and immunity

Often, 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, protection is weakened. Toxoplasmosis is especially dangerous during pregnancy, as it can lead to fetal death.

Symptoms of helminthiasis

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

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

When to see a doctor

Therapist or infectious disease specialist deals with the treatment of parasitic diseases. A doctor should be consulted if one or more of the above symptoms are found. Due to the rather sophisticated system of masking worms, you should as accurately as possible explain the symptoms to the doctor, as well as talk about your lifestyle: what food do you prefer, whether you have recently traveled and where, are there pets, etc.

Diagnosis of the disease

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

• Stool examination. A sample of faeces is handed over to the laboratory. They may 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 analysis, pinworms can be identified. Scraping should be done in the early morning, before going to the toilet.
• A blood test 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 antibodies remain even after they are eliminated.
• Instrumental diagnostics. The use of radiography, MRI and CT with the use of contrast agents. These diagnostic methods make it possible to identify both large worms and some pathological changes in tissues caused by helminthic invasion.

As a rule, the doctor prescribes different studies to increase the reliability of the data obtained. Sometimes a patient has to be tested several times to make an accurate diagnosis.

Important!When confirming helminthiasis, it is necessary to notify other close family members about this. An examination is also recommended for them. If the test is positive, it is important that all infected family members receive treatment. Otherwise, the eggs of the parasites will again 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. Prescribing a comprehensive treatment, the doctor seeks not only to remove 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 medications that eliminate the symptoms of the disease. The doctor selects drugs separately for each patient, because the symptoms are different for everyone.

Drugs for the treatment of helminthiasis

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

• Anthelmintic medicines. These are anthelmintic drugs that either remove or kill worms. These goals are achieved by disrupting the metabolism of parasites or by paralyzing their muscles. In the latter case, they lose their ability to stay in the intestine and are excreted.
• Antihistamines. If the patient is allergic to parasites, then during treatment, doctors prescribe antiallergic 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 are able to bind substances in the gastrointestinal tract. During the treatment of worms, enterosorbents are used to bind and remove 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 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 medicines. However, sometimes doctors are still forced to resort to surgery. For example, a large accumulation of roundworms 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, leading to acute pancreatitis. If the worms enter the appendix, appendicitis develops. All these conditions require prompt surgery.

Often, surgery is resorted to when organs are damaged by echinococcus. These parasites accumulate, forming echinococcal plugs in the liver, lungs, bones, kidneys, and even in the brain. The danger of such a plug is that it can fester and burst.

Folk remedies for worms

Folk remedies for worms are not as effective as anthelmintic drugs. This is only an auxiliary method - the main treatment is prescribed by a doctor.

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

Myth 2: garlic enemas get rid of worms

Worms really do not 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 of the parasites live in the small intestine, so this procedure is useless. In addition, from such an enema, you can get serious irritation of the mucous membrane.

Prevention and precautions

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

Prevention of worms is reduced to compliance with the following recommendations:

• Wash your hands with soap and water before eating, after returning from the street, using the toilet, or after contact with animals.
• Wash vegetables, fruits and herbs thoroughly. Better to pour boiling water over them.
• Do not use other people's hygiene items and 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 veterinarian, vaccinate in a timely manner.
• Every year, undergo a comprehensive preventive examination, including tests for worm eggs.
• Cook meat, poultry, fish and eggs appropriately.

Myth 3: parasites die in frozen meat.

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

Conclusion

The main cause of helminthic invasions is inadequate hygiene. Improving sanitation and proper cooking of animal food significantly reduces the likelihood of helminthiasis. In most cases, worms do not pose a danger to human health if detected in time. But the lack of treatment nevertheless leads to serious consequences - anemia, damage to the nervous system and other infections.