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Five-year-old Ellie had been asleep for just 20 minutes when she awoke in a panic. “She was writhing and uncomfortable,” says her mom, Celena Gowan, who soothed her daughter back to sleep. When Ellie awoke a second time complaining that “her whole private area was itchy and uncomfortable,” Gowan took her to the emergency room. After an examination, she was told to follow up with their family doctor about pinworms. Sure enough, the test results came back positive for the parasite. “I felt grossed out and wondered how this could have happened,” Gowan says.
Pinworms are tiny white roundworms that enter the body through the mouth after you touch something that's contaminated with pinworm eggs, then touch your hands to your mouth. The worms make their way through the digestive system and lay their eggs in the rectum. This may seem like a scary scenario from one of the Alien movies, but it’s really quite common, particularly among school-aged children.
According to the US Centers for Disease Control, around 50 percent of kids under 18 get them at some point. “It’s so easy to spread their eggs,” says Janice Heard, a Calgary-based paediatrician. “They’re in the sand, in our houses and on children.”
The thought of this is gross for sure, but it’s par for the course when you’ve got kids. Schools are a common place to find pinworm transmission. If you’re squeamish, steel yourself: Here’s all you need to know about pinworms and how to treat them.
The most common symptoms are itching and discomfort around the anus. Girls can experience vaginal discomfort and discharge too, as worms can get into the vagina as well. Disturbed sleep is also common, because pinworms tend to emerge in the dark. However: “Kids can be carrying them for a long time and not know,” says Heard. “Sometimes it’s seeing a worm after a bowel movement in a diapered child that alerts parents.” You may also spot the tiny worms crawling out of your kid’s bottom - they are about the size of a staple.
It may be startling to see the worms, but they only cause minor skin irritation. “Pinworms don’t cause harm to the body,” says Heard. “They don’t go into the liver or brain; they don’t cause disease.” Just like getting a cold or flu, pinworms don’t discriminate and can affect anyone – they have nothing to do with cleanliness.
If you suspect your kid has pinworms, your doctor may ask you to test for them yourself by putting a piece of tape over your child’s anus. If eggs are present, they’ll stick to the tape. Take the tape in a sealed plastic bag to your paediatrician’s office, where it will be tested for the presence of pinworms, which can only be seen under a microscope. It’s a painless procedure, but don’t be surprised if your kid freaks out a bit. “It’s really fun to try to get your child to cooperate, because it’s weird to cover their anus with tape,” says Gowan. “Ellie said, ‘Ew, gross, Mom!’”
If the diagnosis is confirmed, it’s recommended that all family members who have symptoms be treated. Your doctor will either suggest an over-the-counter anti-parasitic medication or give you a prescription for one, plus may recommend a cream to reduce the itching. The first dose of medication is taken immediately and the second dose is taken two weeks later. Kids can still go to school while they’re being treated.
In the two weeks between treatments, you’ll have to be diligent about hygiene. Each family member should bathe separately every morning. Wash bedding in hot water and detergent every three to seven days, and launder pajamas and hand towels every day. You’ll also want to clean toilet seats frequently, wash toys, wipe off surfaces in bedrooms and avoid shaking out linens and pajamas so you can keep the worms and eggs contained. Another hot tip from Heard: Flood your bedrooms with daylight. Pinworms hate the sun.
“There should be an improvement in symptoms after the first dose and a marked decrease in itching seven days after the second dose,” says Phil Emberly, director of practice, advancement and research for the Canadian Pharmacists Association. If symptoms persist or if your child has any abdominal pain that doesn’t go away, it’s best to report back to your doctor.
It’s tough to avoid pinworms because they are so contagious, but fastidious handwashing can help keep them at bay. Cut kids’ nails short, especially in the camp and back-to-school seasons, when infections are apt to ramp up. Try to discourage thumb sucking and nail biting, as eggs tend to hide out under fingernails. But overall, don’t worry too much about pinworm infection, says Heard. “It’s likely most people have had them in their lives at some point, and this, too, shall pass.”
This story was originally published in 2018.