Helminthic infestations are a fairly common phenomenon. According to WHO, they are found in 70% of the world's population. Most often, worm infection is observed in countries with a low economic level, where people do not have conditions for a normal life and hygiene skills. In developed countries, the percentage of such diseases is an order of magnitude lower, but it cannot be discounted. At risk are small children, as well as adults who do not care about cleanliness.
Among helminthic infestations, ascariasis is one of the first places. In a child, he can provoke life-threatening complications, delay development, significantly weaken the immune system. They cause roundworm disease. These are large worms, dangerous already because their sizes cause disturbances in the intestines. In addition, like any other living organism, roundworm secrete waste products that are toxic to humans.
This article provides information on what constitutes ascariasis in children. The photo of these worms gives an exhaustive picture of their appearance. Not all parents know how to get infected with ascariasis, what are the symptoms of the disease, how to get rid of parasites with medical and folk methods. The answers to all these questions are in our article.
"Portrait" and some features of the worm
Roundworms belong to the group of roundworms (nematodes), of which there are up to a million species. Most of them are very selective in relation to their owners and victims at the same time. For example, roundworms of a sheep cannot parasitize in a wolf that ate it. Even if he swallows thousands of live eggs and larvae, they will not develop in his body.
In humans, only Ascaris of the species Ascaris lumbricoides parasitize. These creatures are bisexual. Females are approximately twice as large as males, which is explained by their purpose - egg production. One individual per day is able to postpone them about 200 thousand. The role of the male is to fertilize the eggs so that adults can develop from them.
If for any reason only female roundworms enter the baby’s intestines, they also productively lay eggs, but unfertilized, that is, they are not dangerous. Females after about a year and a half die of old age, ascariasis in a child is cured by itself. The same can be expected if by chance only Ascaris males enter the intestines. They will live there as long as they have been given fate, all this time allocating waste products and thereby causing painful symptoms in a person, but the disease will not get further development. However, such cases are rare. As a rule, individuals of both sexes enter the intestines.
The body of an adult female can grow in length up to 40 cm, and in rare cases up to 45 cm. Moreover, the thickness of the worm is 3-6 mm. Males are 25 cm long, but most individuals grow to 15 cm. In addition to size, their distinguishing feature is the rounding at one end. The body of the parasites is covered with a shell (cuticle) that protects them from the action of chemicals, such as gastric juice. The color of roundworms is from grayish translucent to pale pink. These worms do not have suction cups, therefore, they do not attach to the walls of organs and do not leave wounds on them.
Adults live mainly in the small intestine, so it is impossible to cure ascariasis in a child with an enema. Worms are held in the right place by the continuous movement of their body. They are able to move in cavities due to changes in the speed and nature of the muscles. People are shocked by the appearance of worms, for example, from the nasal opening. With feces, live roundworms go out in isolated cases. As a rule, they are to death in the body of the owner.
Life cycle
Roundworms in their development go through a certain cycle. It is carried out in the host's body (except for a short stay of eggs in the environment). At each stage, different symptoms of ascariasis are observed in children and adults. Worms begin their life in eggs laid by a fertilized female. With feces, they go outside, where under favorable climatic conditions (warm and humid), microscopic larvae begin to develop in them, able to breathe oxygen. If such eggs enter the human digestive tract, their shell dissolves in the alkaline environment, and the larvae turn out to be free. They drill the intestinal mucosa to get into the bloodstream. With blood flow, the larvae alternately enter the liver, heart, and lungs. From here, they with bronchial secretions penetrate mainly into the bronchi, trachea, pharynx, and through it into the victim’s mouth, where they are swallowed with saliva into the stomach, and from there transferred to the intestines. There, worms grow to a mature form and begin to lay eggs. The cycle ends.
Infection pathways
Of the 100 patients with ascariasis, approximately 80 are children. This pattern is determined by the path of penetration of the worm into the body of its victim. You can get infected only from a person with ascariasis. Worm eggs, leaving with feces, fall on the soil, sand. Children, especially preschoolers, playing outside often put their fingers in their mouths. If they have ascaris eggs with larvae starting to develop, ascariasis in a child will occur in 100% of cases. Infection is also possible when eating unwashed vegetables, fruits, greens.
Another way is water, into which worm eggs can also get. Infection occurs if you use it for drinking, without first disinfecting at least boiling.
Some insects, in particular flies, also play a role in the spread of ascariasis in the population. On their feet, they can carry parasite eggs from the ground and feces to food.
Thus, the pathway of infection with ascariasis is only fecal-oral.
It is impossible to catch this disease from cats or dogs. You can not get sick with it and eating insufficiently thermally processed meat of animals and birds.
Also, cases of transmission of infection through kisses, sneezing and coughing are not known.
Symptoms
The clinic of ascariasis in children depends on the stage of the disease and the individual capabilities of the body. In adult patients, at the stage when the eggs just entered the intestines and began to free themselves from the membrane, as a rule, no signs of infection were observed. In children, the body is more tender and weak, therefore, it reacts to the penetration of foreign agents much more actively. Already at the very first stage, which lasts one to three days, parents can notice a loss of appetite and interest in toys in the child, some babies complain of stomach pains, nausea. But in most children, this stage is asymptomatic.
Penetrating into the portal vein, the larvae of worms with blood flow into the liver, where they very actively seep into the liver lobules, as well as into the hepatic, and then the vena cava. This stage can also take place without symptoms, although tissue injury occurs in the liver along the pathway of parasite migration, inflammatory infiltrates occur, containing an increased number of eosinophils. At the hepatic stage of ascariasis in children, symptoms can occur with pain in the right side, poor appetite, slight yellowing of the skin, and enlarged liver.
Ascaris larvae from this organ enter the right atrium, and from there into the capillaries of the lungs. Through their thin walls, parasites seep into the lumen of the alveoli, fall into the trachea. Infiltrates may also appear in the lungs. The child has cough, shortness of breath, fever. This condition many parents take for ARVI. This entire stage takes about 10 days. From the lungs, the larvae move into the mouth, and from there again into the intestines, where they continue to develop. Symptoms of ascariasis at this stage are as follows:
- Abdominal pains.
- Violation of the stool.
- Rumbling in the stomach.
- Weight loss.
- Flatulence.
- Enlarged lymph nodes.
- Moodiness, refusal to eat, weight loss.
- Teeth grinding in a dream.
- Pallor of the skin.
When the worms become sexually mature, ascariasis becomes chronic. Symptoms of this condition are as follows:
- Nausea, especially before breakfast.
- Headache.
- Sleep disturbance.
- Fatigue.
- Stomach ache.
- Upset stool.
- Weight loss.
- Mental disorders.
- Allergic reactions in the form of a rash.
- Sometimes, children have seizures and epileptic seizures.
- Frequent infectious diseases due to a decrease in immunity.
If the long course of ascariasis has led to complications, the symptoms of diseases provoked by helminthic invasion are observed.
Research methods
Diagnosis of ascariasis in children is carried out comprehensively. For analysis take:
- Blood. It determines the level of leukocytes, which is always elevated at the migration stage of the disease.
- Sputum. At the pulmonary stage (determined by symptoms), worm larvae can be easily detected in the secretions.
- Urine. This analysis is not specific. Larvae of worms in urine cannot be detected. Using biochemical methods, the level of volatile fatty acids is checked in it. These substances are released in the process of maturation of roundworm. You can suspect their presence in the child’s body at an early stage, when the individuals have not yet begun to produce eggs. However, fatty acids are excreted in some other processes, so their presence in the urine cannot indicate exactly ascariasis.
- Feces. Worm eggs in it can be found only at the stage when roundworms became sexually mature. In this case, using a microscope in the feces, it is possible to clearly distinguish small elliptical grains of light yellow in size from 30 to 60 microns. Ascaridosis in children, fecal analysis does not always reveal. It may not be informative during the first three months after infection. That is exactly what ascaris needs to become an adult out of a larva. Also, the analysis is not informative if the intestines contain worms of the same sex. The males do not lay eggs, and the unfertilized eggs of the females are so large that it is almost impossible to detect them with a microscopic examination.
Patients are also prescribed:
- Tests for the presence of antibodies to roundworms.
- Ultrasound Worms cannot be detected using this method, but it helps to identify other ailments that are complications of ascariasis.
- X-ray Perform if a child has a cough that cannot be treated with classical methods.
How to treat ascariasis in children
Therapy is carried out at home. Only those patients are sent to the hospital for whom the disease has caused complications requiring emergency assistance and constant medical supervision.
The child is necessarily prescribed an antiparasitic drug. There are many such medicines. Only a doctor can figure out which is more effective in a particular situation. Among them are such funds that children can not take. This is Dekaris, Levamisole.
The drug "Vermox" in children with ascariasis is allowed to use only from 2 years of age. It is also contraindicated in liver failure and ulcerative colitis. Destroys the "Vermox" only adult worms and larvae. It does not apply to eggs. The drug is produced in tablets of 6 pieces in a blister. Children aged 2-5 years should take no more than ¼ tablets once. Children 5-10 years old - ½ tablet, and from 11 years old - a whole. After 2 weeks, you need to repeat the method to destroy those worms that during this time managed to emerge from the eggs.
Some enterprises produce Vermox in the form of a 2% suspension (30 ml vials). For the treatment of children, this form is more preferable. Dosage - 20 ml once.
Many doctors ascribe to children with ascariasis "Nemozol." This medication comes in three forms:
- Pills in a shell. They need to be washed down with water.
- Chewable tablets. They have a pleasant taste, so they can be consumed like caramel.
- Suspension.
Children over 2 years of age are prescribed once 1 tablet in any form or 20 ml of suspension.
Children under 2 years of age are prescribed only a suspension, which is given at the rate of 15 mg per 1 kg of the baby's weight.
Pirantel is another drug recommended by the famous pediatrician Komarovsky. Ascaridosis in children, this medication treats very effectively. Unlike other similar drugs, Pirantel can be taken by pregnant women and infants from 6 months. It is available in the form of a suspension for children and tablets for adults. Dosage is calculated taking into account the age of the baby:
- 6 months to 2 years: a single dose of 2.5 mg or a half cap attached to the bottle;
- 2-6 years: 1 cap is given, which corresponds to 5 ml;
- 6-12 years, 2 capsules (10 mg) must be taken at a time;
- From 12 years, one-time 3 caps.
Any remedy for worms can cause a number of adverse reactions - nausea, headache, diarrhea, abdominal pain, dizziness, vomiting. Therefore, they must be taken in consultation with a pediatrician or infectious disease doctor.
In parallel with antiparasitic drugs, the doctor may prescribe:
- Antihistamines ("Zodak", "Suprastin").
- Enzymes to improve the digestive tract ("Festal", "Creon", "Mezim").
- Probiotics for the restoration of microflora (Linex, Bifiform).
- Vitamins
Folk remedies
Many parents are looking for the answer to the question of how to treat ascariasis in children with traditional medicine methods so as not to give the babies the pill that causes so many adverse reactions. Healers have accumulated rich experience in ridding people of helminths. In their recipes they use only natural remedies. Among them:
- Garlic.
- Horseradish.
- Pomegranate peel.
- Bow.
- Sagebrush.
- Tansy.
- Raw pumpkin seeds.
The action of the decoctions and infusions of these plants is based on their taste and bitterness, supposedly capable of forcing the worms to leave their prey. In fact, all folk remedies are one of the methods of prevention (together with hygiene). They also benefit in combination with the main therapy, as they have in their composition many useful substances that have a beneficial effect on the body:
- Onions, horseradish, garlic - these are real founts of vitamins. Consuming these foods in reasonable amounts is very beneficial.
- Pomegranate peel has astringent, antimicrobial, wound healing properties. Decoctions of it are often given to children from diarrhea.
- Wormwood improves digestion, has antiseptic and anti-inflammatory properties.
- Tansy can be used as a choleretic, antimicrobial, antispasmodic, antipyretic.
On the treatment of alternative methods of ascariasis in a child, the reviews are contradictory. There are parents who claim that the use of garlic with milk, pumpkin seeds or a decoction of tansy helped get rid of worms. But most respondents claim that the expected effect after such therapy did not occur. There are reports that treatment with a decoction of wormwood and tansy caused in babies about the same negative reactions as pills - nausea, vomiting, abdominal pain. About official medicines, reviews are also different. All parents call the side effects of medications. A plus is their high efficiency.
Many doctors, including Komarovsky, warn that it is unacceptable to treat helminthic infestations with the help of only folk remedies.
Complications
Ascaridosis in children and adults can lead to serious complications. A large accumulation of such large worms in the intestine causes its obstruction. There were cases when there was a rupture of the intestinal wall, which caused peritonitis.
Ascaris migrations to other organs almost always cause their inflammation. So, worms in the pancreas are the cause of acute pancreatitis, in the biliary tract - purulent cholangitis.
In the liver, roundworms cause obstructive jaundice, an organ abscess.
Ascarids in the lungs do great harm. Here they provoke the development of pneumonia, suffocation, asthma.
Many of these complications can be fatal.
Ascaridosis and enterobiasis in children
Not observing hygiene, you can become infected not only with roundworms, but also with other worms. Pinworms are perhaps the most common type of nematode parasitizing in humans. In appearance, they can be called a copy of ascaris reduced by about 40 times, only their color is not pink, but white-cream. Pinworms have a suction cup at one end of their body, with which they attach to the intestinal mucosa. They parasitize in the small, blind and colon intestines, as well as in the appendix.
You can catch these worms only from a sick person. The route of infection is fecal-oral. Enterobiosis is called childhood helminthiasis, because they are especially often affected by preschool children, pulling everything in their mouths.
Pinworm lifestyle has one significant feature - they lay eggs only outside the intestines on human skin. For this, females creep out of the anus every night. In this case, a person experiences severe itching. In the perianal folds, the eggs begin to ripen. After about 6 hours, they are already able to cause enterobiosis. During combing, eggs fall on the fingers, under the nails. A sick child can swallow them again (if he takes his hands in his mouth). He can also transfer eggs from his hands to toys, household items.
The main symptom of enterobiasis is itching in the anus. In the feces, pinworms themselves can be identified, but their eggs do not exist there. To confirm the diagnosis, a scraping is taken from the perianal folds.
Enterobiosis treatment follows the same scheme as ascariasis. Drugs of choice: Vermox, Pirantel, Nemozol. Doctors also attribute Piperazin, Mebendazole, Zentel and their analogues. To completely get rid of the worms, after 12-14 days the course is repeated.
How to avoid infection with worms
Prevention of ascariasis in children and adults is the only measure - hygiene. Children need to instill the concept that you can’t eat without washing your hands first. You also need to wean them by pulling fingers, toys, and any objects into their mouths. Parents should make it a rule to eat only washed vegetables and fruits. They are obliged to teach this to children.
Water from open sources must be boiled before use for drinking.
Prevention of enterobiasis also involves hygiene. In addition, in the presence of pinworms, it is necessary to change underwear and bedding daily, and only wear tight-fitting underpants to the body. If a patient with enterobiasis is identified in a family, kindergarten, classroom, all team members must undergo treatment.