Apr 1, 2013
By Nathan Friesen, Pharmacy Student at the Dauphin Clinic Pharmacy
Hi, my name is Nathan Friesen, I am a 4th year pharmacy student currently working at Dauphin Clinic Pharmacy. The pharmacy program at the University of Manitoba is quite intensive and successful completion of the program involves a large investment of time on the students behalf in terms of attending class, studying, and doing homework. The pharmacy program provides us as students, not only with extensive information on the medications that we will see in our future careers as pharmacists but also on a wide variety of other subjects. Attending lectures and reading books however, is only part of how we learn the profession of pharmacy as students. In each year of the pharmacy program, we get let loose on the world for a number of weeks to put our knowledge and skills to practice in pharmacies across Manitoba. Throughout my years in school I have had the opportunity to work in a number of communities across Manitoba for short periods of time, one of these being Dauphin. Through these work experiences I have learned a lot about the practice of pharmacy, the medications that we dispense regularly, and the various medical conditions that present during my time working. At each of the pharmacies I have been able to work in, there have been a number of common topics/questions/concerns routinely brought up by patients. One such topic is the discussion of pinworms.
What are Pinworms?
Pinworms or otherwise called Enterobius Vermicularis, are small parasites that live in the digestive system of humans. Pinworms are small, white, thin, roundworms that are primarily found in the rectum or colon.
Who Gets Pinworms?
Pinworms are a very common problem and are the most common type of intestinal worm infection in the United States. Pinworm infections are most common in younger children ages 5-14 years old but can occur in the young and old alike. Pinworm infections can happen to anyone and are not related to being unclean.Poor personal hygiene and unsanitary living conditions however, can contribute to the spread of Pinworm infection.
Pinworms are spread from human to human by a variety of ways. Pinworm infection generally starts with eggs being introduced to the body via the mouth. This can occur when someone with pinworms scratches around their bum, gets eggs on their fingers, and touches you or a surface that you touch later. The eggs can transfer onto your hands, then onto your food, and finally make their way into your mouth through your digestive tract to your rectal area. Pinworm infection can also occur when:
- An uninfected person puts their hand in their mouth after being touched by an infected person or an object carrying pinworm eggs.
- An uninfected person places an object carrying pinworm eggs in their mouth(ie food that has been handled by an infected person).
- Or when, Pinworm eggs are swallowed from the air after the bedding or clothes of an infected person are fanned in the air, however, this is rare.
The life cycle of the pinworm from egg to mature worm takes about 3-6 weeks to complete and occurs inside the human body. Pinworms live inside the large intestine and feed on nutrients in the digested food. At night, female pinworms crawl out of the body and lay eggs on the skin around the anus. This process can cause itching and subsequently scratching resulting in the eggs being transferred onto the persons fingers and onto other objects/people.
Pinworm eggs can survive indoors for about 2-3 weeks and can be present on a variety of surfaces such as; clothing, bedding, furniture, food, faucets, hands, and the fur of pets. It is important to note that pinworms can only infect humans and do not infect household pets such as dogs and cats. However, pets can carry pinworm eggs in their fur and thus contribute to the spread of infection. Due to the many ways pinworms can be spread and the fact that the eggs can survive on surfaces for a number of weeks, pinworms are spread easily in families, schools, day care centers, and other institutions where groups of people live in close contact with each other.
What are the Symptoms?
Pinworm infection is not usually associated with serious complications and many infected people may not actually experience any symptoms. The most common symptom is itching around the anus. Some people may experience difficulty sleeping and loss of appetite due to the severity of the itching.
Treatment of Pinworm Infection
Pinworm infections can be treated with a number of different anti-worm medications. One commonly used medication that is available from your pharmacy over the counter is Pyrantel Pamoate or Combantrin. This medication comes only in tablet form but can be chewed or crushed and sprinkled onto food. When used to treat pinworm infections, Combantrin is generally given in 2 single dose treatments 2 weeks apart as the medication works to kill live adult pinworms but does not kill the eggs. Dosing of Combantrin is based upon the persons weight thus consulting your pharmacist for proper instruction on its use is important. Alternative options available with a prescription from a doctor include albendazole and mebendazole or Vermox. Since pinworms are highly contagious, some doctors suggest that all close contacts of an infected person be treated at the same time to minimize the risk of re-infection. Although the use of these medications is crucial in the elimination of the infection, non-drug measures are very important as well to prevent re-infection as the medication will not cure the infection if the eggs are not controlled and removed from the household. Steps to prevent re-infection include the following:
- Wash hands often
- Machine wash clothes bedding, towels, and dishes at the hottest setting
- Wash underwear, pyjamas, and bedding in hot water and dry in a heated dryer daily for 2 weeks
- Practice good personal hygiene
- Bathe and change underwear daily- make sure skin around anus is cleaned. Showers may work better than baths.
- Avoid scratching around your anus- wear gloves at night
- Scrub washable toys
- Change sheets and towels frequently(every 3-7 days for 2-3 weeks)
- Keep fingernails short
- Tell children to keep hands away from their mouth
How Can I Prevent Pinworm Infection?
Proper, frequent, hand washing is the best way to prevent infection with Pinworms. Here are some tips to reduce your risk of infection with Pinworms:
- Wash hands thoroughly and often
- Keep fingernails short
- Avoid sharing a bathtub, face cloths, or reusing face cloths
- Do not fan the bedding of an infected person
- Keep hands out of mouth
- Wash your hands after using the bathroom
- Wash hands before meals
If you suspect you have a Pinworm infection be sure to consult your physician prior to starting any medication therapy as well as discuss any questions or concerns you may have with your Dauphin Clinic Pharmacist.
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.