Pinworms When An Itchy Bottom Signals Problems
PINWORMS When an Itchy Bottom Signals Problems
There's a voice coming from the darkness next to your bed and it doesn't belong to the morning radio newscaster. ''I can't sleep,'' it says in that whining pitch you know oh-so-well. So you turn on the light and find your child standing there, scratching his pajama bottoms. This is the third morning in a row that he's been a walking alarm clock, rousing you before 6:30 A.M. with complaints of itching.
If this scenario sounds familiar, your child may have pinworms.
Pinworms are a type of intestinal nematode (a round worm) that live only in people. In the United States, they are the most common worm infection. ''Pinworms are quite prevalent,'' says Robert Pond, M.D., physician with the Epidemic Intelligence Service at the Centers for Disease Control and Prevention in Atlanta. ''Studies show that between 10 and 30 percent of children get them.''
Because pinworms lay microscopic, infectious eggs that can spread from person to person, the problem is easy to pass along, says J. Owen Hendley, M.D., professor of pediatrics and head of pediatric infectious diseases at the University of Virginia School of Medicine in Charlottesville. Pinworms take up residence in the large intestine of an infected child. At night or in the early morning, the female worms travel down to the anal opening and deposit their eggs on the surrounding skin. When the child scratches the itchy area, pinworm eggs get on his hands and under his fingernails.
Then, if he doesn't wash his hands, the pinworm eggs get on whatever he touches, including toys and other household objects. Other children come along, touch what the infected child touched, and get the eggs on their hands, too. If they stick their hands in their mouth without washing them first, says Dr. Hendley, they can swallow the eggs, get infected, and the next thing you know, those kids have itchy bottoms, too.
Once your doctor has confirmed that your child has pinworms, he'll probably prescribe medication. And, meanwhile, here's what to do yourself.
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| When to See the Doctor One of the recommended ways to get rid of pinworms is with a medication that must be prescribed by your physician, says J. Martin Kaplan, M.D., professor of clinical pediatrics at Hahnemann University in Philadelphia. So you should take your child to the doctor when the telltale signs appear. The prescribed medication, mebendazole ( Vermox), is a pill that your child will take once or twice, depending on your physician's advice. The medication causes the worms to be expelled with bowel movements. ''Treatment with mebendazole usually does the trick,'' says Janice Woolley, M.D., a pediatrician in private practice in Mercer Island, Washington. In very rare instances, pinworms can enter the vagina and cause vaginitis, says Dr. Kaplan. If your little girl has pain or discharge, be sure to tell your physician. |
Reassure your child. The thought of having worms could upset anybody, especially a youngster. So it's important to explain to your child that this does not mean that he is bad or dirty, and that he does not have to be embarrassed. Lots of children get worms.
''These worms do not have much of a mouth. They have no teeth and they can't bite,'' says J. Martin Kaplan, M.D., professor of clinical pediatrics at Hahnemann University in Philadelphia. He recommends saying to your child, ''There is nothing to be afraid of. You can't be hurt. The only thing you will be bothered by is some itching, and the medicine the doctor has given you should take that away.''
Put water to work against itching. If your child has a lot of itching, taking a bath or wiping the anal area with a moist cloth can bring some temporary relief, says Janice Woolley, M.D., a pediatrician in private practice in Mercer Island, Washington. But be sure to keep that cloth away from other members of the family--and wash your own hands thoroughly if you touch it.
Buy cartoony soap. To stop pinworm from spreading and to prevent reinfection, you should take steps to emphasize cleanliness. Good hand-washing habits are particularly important, says Dr. Kaplan. If your child is potty training, encourage hand washing by overseeing her. Buy a soap that she will relate to and want to play with, such as soap in the shape of a cartoon character, he says.
Keep nails cut short. Regularly trimming back your child's fingernails can also help, adds Dr. Woolley. Long fingernails provide convenient hiding places for eggs in transit. If you cut them short, it's easier for the child to wash up thoroughly--and wash away those eggs.
Practice moderation. Emphasize good hygiene, but don't go overboard. '' You can wash your child's anal area, but don't scrub too hard in an effort to achieve ultra-cleanliness,'' says Donald Gromisch, M.D., professor and chairman of the Department of Pediatrics at Nassau County Medical Center in East Meadow, New York, and professor of pediatrics at the State University of New York at Stony Brook. Scrubbing can be counterproductive if it irritates the child's behind, he says.
| The Detective Work Is Up to You Experts say that the best way to pin the rap on pinworms is for parents to collect the hard evidence themselves. While your child is sleeping, spread the cheeks of his buttocks and look at the anal opening with a flashlight. Sometimes you can see the female worms, which are a whitish color and about 1/4 to 1/3 inch long. ''They look like a small piece of cotton,'' says J. Martin Kaplan, M.D., professor of clinical pediatrics at Hahnemann University in Philadelphia. If you can catch one with a pair of tweezers, stick it in a bottle or small plastic bag and take it to your doctor, says Dr. Kaplan. But even if you're not quick enough to nab a worm, be sure to tell the doctor that you've seen one, he says. You may be able to collect a sample of pinworm eggs from a sleeping child by pressing a piece of cellophane tape against the skin around the anal opening. You can't see the eggs, but if they're there, the tape will pick them up. Seal the potential evidence onto the tape by placing it on a glass slide (which you can get from your doctor or buy at the drugstore), sticky side down. Take this to your doctor who will look for the presence of eggs under a microscope. Usually, the detective work doesn't even wake kids up, says Dr. Kaplan. You can also check when your child comes to you complaining of itching, or first thing in the morning before your child has had her bath. |
| It's a Family Affair Because pinworms are so mobile, there's a chance that if one member of your family gets infected, others will, too. ''I usually treat the entire family the first time around because it is so common for others to get infected,'' says Janice Woolley, M.D., a pediatrician in private practice in Mercer Island, Washington. The usual treatment is for each family member to take a mebendazole (Vermox) pill. Other doctors treat only the infected child at first. But if the worms make a repeat performance, the entire family is then checked. ''If reinfection occurs, everyone in the household should be examined, because you can get a Ping-Pong infection, where pinworms just move from one person to the next,'' says Donald Gromisch, M.D., professor and chairman of the Department of Pediatrics at Nassau County Medical Center in East Meadow, New York, and professor of pediatrics at the State University of New York at Stony Brook. Since thorough hand washing helps prevent reinfection, be sure all the children in the family lather up. Also, remember that being infected once does not ''vaccinate'' you from being infected again, says Dr. Woolley. So keep up the good habits. |
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