A common intestinal parasitosis in young children, pinworm infection is mild but needs to be diagnosed and treated. It is a parasitosis very widespread in developed countries, the transmission of which is through the hands brought to the mouth and promotes community life.

A pinworm is a common intestinal parasitosis in young children and their families. 

How does it contaminate?

Its mode of contamination is favored by community life (nurseries, nursery schools, etc.) and contact with hands soiled by pinworm eggs brought to the mouth or in contact with other children (manual contamination). Pinworms are lodged in the intestine and contamination is through the eggs laid by the females and which are found around the anus and in the stool.

Pinworm is a small roundworm (nematode), called Enterobius vermicularis, which measures eight to thirteen millimeters for the female and two to five millimeters for the male. The egg of this nematode, found in particular around the anus (anal margin) is quite resistant to the outside and can survive, in underwear, bedding and soil, several weeks after its expulsion and remain contaminating . 

This parasitosis is common in developed countries and 30% of children are infected worldwide.

Its mode of contamination goes through the hands brought to the mouth (hand-carried contamination), hands which have not been washed after having scratched the anus. The hands can also touch other children who will also put their hands to their mouths. This contamination can also pass through contaminated food.

Symptoms of pinworm infection are dominated by itching (pruritus) in the anus of children or adults who are infected. This pruritus occurs most often in the evening or at night, when the females come to lay their eggs in the anus, in episodes of two to four days.

But there are also other symptoms:

• Episodic and intermittent diarrhea which cannot be explained, such as gastroenteritis or food poisoning;
• Diffuse abdominal pain of low intensity;
• Irritability of the child with easy crying and anger;
• Insomnia related to scratching activity and irritability;
• Nightmares and restlessness at night;
• Fatigue and trouble concentrating;
• Vulvitis and vulvovaginitis in young girls, sometimes accompanied by urinary leaks and cystitis;
• Eczema localized to the scratching areas at the anal margin.

Severe complications are rare with pinworm apart from salpingitis or vulvovaginitis in women which are rare but have been described.

The diagnosis of pinworm infection is already suspected from the symptoms presented (itching of the anus in the evening or at night, irritability, etc.) and community life for young children. 

Adult worms are sometimes visible to the naked eye on the anal margin or in the bedding, but the diagnosis is confirmed by the “scotch test” which is a transparent tape stuck to the anus and which will wear on its surface. pinworm eggs observed under a microscope.

A parasitological examination of the stool can find pinworms or their eggs, but it can also detect other potentially present intestinal parasitoses. Finally, a blood test sometimes finds an increase in eosinophilic white blood cells, but not always.

The prevention of contamination by pinworm eggs is already a measure to be taken in young children in the community with hand hygiene (hands washed before and after meals, after using the toilet) and nails (nails cut short and brushed), grooming the buttocks regularly every morning, washing underwear, nightwear and bedding at a sufficient temperature (over 60 °), cleaning the premises (vacuuming up dust) and objects brought to the mouth (toys), disinfection of bathrooms and toilets.

Adults and the whole family are concerned by these preventive measures when a child has been infected.

Once the diagnosis is made, treatment will involve taking a drug against intestinal parasites (anthelmintics), usually in a single dose (albendazole). The whole family should be treated at the same time. Given the contagiousness and reproductive cycles of pinworms (three weeks), a second treatment is prescribed two to three weeks after the first treatment.

Finally, garlic is a natural dewormer and would be effective against pinworms. It is necessary to infuse several cloves of garlic overnight and drink the preparation which will have been previously filtered the next day.