Understanding Worms: A Kid's Guide to Intestinal Parasites

Parasitic infections can happen to anyone, even kids! This article explores different types of worms that can affect children, how they spread, and what you can do to stay healthy.

What are Intestinal Parasites?

Intestinal parasites are tiny organisms, including worms and protozoa (single-celled organisms), that live inside your intestines. A parasite is an organism that lives off another organism (the host), using the host's body for food and shelter. Intestinal parasites don't offer any benefits to your body. Instead, they can cause unpleasant symptoms and sometimes even serious health problems.

Types of Intestinal Parasites

There are two main types of intestinal parasites: helminths (parasitic intestinal worms) and protozoa.

Helminths (Parasitic Intestinal Worms)

Helminths are worms that can be round or flat. They live and grow inside your body, but most can't reproduce there. Instead, they lay eggs that leave your body in your poop. These eggs can then infect other people.

Here are some common types of intestinal worms:

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Pinworms (enterobiasis): These tiny, thread-like worms are very common, especially in kids. Pinworm eggs spread when you touch a surface contaminated with the eggs and then put your hands in your mouth. The eggs hatch in your small intestine, and the worms move to your large intestine. At night, the female worms come out of your body to lay eggs around your anus (where poop comes out), causing itching. Scratching the area and touching surfaces without washing your hands spreads the eggs to other surfaces.
Ascaris (ascariasis): These worms look like tiny earthworms under a microscope. They spread when you swallow eggs after touching contaminated soil. "Contaminated" means the soil contains poop with worm eggs in it. This can happen where people poop outside or use human poop as fertilizer.
Whipworms (trichuriasis): Whipworms have a whip-like shape. Like Ascaris, they spread when you swallow eggs from contaminated soil.
Hookworms (ancylostomiasis): Hookworms have hook-like heads that they use to attach to the walls of your intestines and feed. Hookworms also spread through contaminated soil. The eggs in the soil hatch into larvae (immature worms). If you walk barefoot on the soil, the hookworms can enter your body through your skin.
Strongyloides (strongyloidiasis): These worms also spread through contact with contaminated soil. You can swallow them or they can enter your body through your skin if you walk barefoot. Unlike other helminths, Strongyloides can reproduce inside the host.

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Tapeworms (taeniasis): These segmented worms have bodies that look like ribbons. They live in the digestive systems of humans and animals (like pigs, cows, and fish). They spread when you swallow their eggs or larvae in undercooked pork, beef, or fish. You can also get a tapeworm infection by touching a contaminated surface and then touching your mouth.
Trichinella (trichinosis): These roundworms spread to humans who eat raw or undercooked meat from infected animals, usually pigs.
Flukes: You can get a fluke infection from drinking contaminated water or eating infected aquatic plants or fish.

Protozoa

Like helminths, protozoa spread when you swallow tiny amounts of poop containing their eggs. This often happens through contaminated water or fruits and vegetables. However, protozoa can reproduce inside a human host.

Common types of protozoa include:

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Giardia (giardiasis): Infants, toddlers, and young children in day care settings are at risk for giardiasis, which causes diarrhea and spreads through contaminated feces. Children of all ages can also get giardiasis from swallowing contaminated water while swimming or playing in contaminated recreational water.
Entamoeba histolytica (amebiasis).
Cyclospora (cyclosporiasis).
Cryptosporidium (cryptosporidiosis): Children of all ages can develop cryptosporidiosis from swallowing contaminated water during swimming, playing, and other activities in contaminated recreational water.
Blastocystis species (Blastocystosis).
Cystoisospora belli (cystoisosporiasis).

How Do Kids Get Worms?

Kids can get worms in several ways:

Contaminated food and water: Eating food or drinking water contaminated with worm eggs or larvae is a common way to get infected.
Contact with contaminated soil: Walking barefoot on soil contaminated with worm eggs or larvae can allow the worms to enter your body through your skin.
Poor hygiene: Not washing your hands properly after using the toilet or before eating can spread worm eggs.
Contact with infected animals: Pets and other animals can carry parasites that can infect humans. For example, toxoplasmosis is spread by ingesting soil or litter-box contents with infectious cat feces.
Mosquito bites: Lymphatic filariasis is transmitted through mosquito bites.
Blackfly bites: Onchocerciasis ("river blindness") is transmitted by the bite of a type of blackfly that breeds near flowing water.

Specifically about Pinworms:

Pinworm eggs get inside the body through the mouth after you touch something that's contaminated with pinworm eggs, then touch your hands to your mouth. After getting in your mouth, the eggs pass through the digestive system. The eggs hatch in the small intestine, and the baby worms grow and move on to the large intestine. There, the pinworms grab onto the wall of the intestine. After a few weeks, the female pinworms move to the end of the large intestine, and they come out of the body at night to lay their eggs around the anus (where poop comes out). The amount of time that passes from when someone swallows the eggs until the worms lay new eggs is about 1 to 2 months.

Pinworm eggs can end up on anything touched by someone who has pinworms: on a counter in the kitchen, in a bed, or on a desk at school. The eggs also can be on clothes, towels, or eating utensils. The eggs can live for about 2 weeks, and when you accidentally touch them and then put your fingers in your mouth, you can swallow the eggs without even knowing it.

Kids in school get pinworms easily because they spend a lot of time with other kids, who may have pinworms. They might touch something with pinworm eggs on it when they're playing with other kids and eat the eggs without even knowing it. The eggs are so light that a few may even end up in the air, where they could be swallowed when you breathe in. This is not a common way of getting pinworms, though. If you already have pinworms, you could swallow more eggs if you scratch around your bottom and then put your fingers in your mouth.

What are the Symptoms of Worm Infections?

Symptoms of worm infections can vary depending on the type of worm and the severity of the infection. Some people may not have any symptoms at all. Common symptoms include:

Diarrhea
Abdominal pain
Intestinal obstruction
Anal itching (especially with pinworms)
Anemia
Retarded growth and cognitive development
Itching and impaired vision (with onchocerciasis)

How Do I Know If I Have Pinworms?

If you have pinworms, you might see the worms in the toilet after you go to the bathroom. They look like tiny pieces of white thread. You also might see them on your underwear when you wake up in the morning. But the pinworm eggs are too tiny to be seen without a microscope.

The itching from the pinworms might wake you up in the middle of the night and make you squirm a lot. So if you're itchy and sore on your bottom, tell your mom or dad. And if you see worms in your underwear or in the toilet, you should tell a parent right away.

You should know, though, that some people with pinworms don't have any symptoms at all.

What Will the Doctor Do?

If you might have pinworms, your mom or dad will take you to the doctor so you can get medicine to get rid of the worms.

To see if you have pinworms, the doctor may have your parent help you do an easy test at home. Your parent will place a small piece of tape on the skin around your anus at night or when you first get up in the morning, then take it off and bring it to the doctor. It doesn't hurt at all, and the doctor will look at the tape under a microscope to see if there are any eggs on it. He or she might also take some samples from under your fingernails to see if there are any eggs.

If you have pinworms, don't worry. They don't cause any harm (just itching!), and it won't take long to get rid of them. Your doctor will give you some medicine to take right away and then again 2 weeks later to be sure the worms are gone. The doctor can also give you a cream to help stop the itching.

Because it's easy to pass pinworms on to other people, the doctor may want the other people in your house to take medicine, too. Your mom or dad will probably want to wash everyone's sheets, towels, and pajamas to get rid of any eggs that might still be around.

How to Prevent Worm Infections

Preventing worm infections is all about practicing good hygiene and being careful about what you eat and drink. Here are some tips:

Wash your hands: Wash your hands thoroughly with soap and warm running water, especially after using the toilet and before eating. This is one of the most important ways to prevent parasitic diseases.
Drink clean water: Drink water from safe sources, such as bottled water or water that has been boiled.
Cook food thoroughly: Cook meat, poultry, and fish to the proper temperature to kill any parasites.
Wash fruits and vegetables: Wash fruits and vegetables thoroughly before eating them.
Avoid contact with contaminated soil: Avoid walking barefoot in areas where the soil may be contaminated with human or animal feces.
Control mosquitoes: Use mosquito repellent and sleep under an insecticide-treated bed net to prevent mosquito bites.
Dispose of feces properly: In developing countries, it's important to ensure that feces are disposed of properly to prevent the spread of worm eggs.
Regular deworming: Periodic mass drug administrations for soil-transmitted helminth infections and schistosomiasis can greatly reduce these infections and the diseases they cause.
Keep your fingernails short and clean.
Don't scratch around your bottom or bite your nails.
Change your underwear every day and always put on a clean pair.
Ask someone to wash your pajamas every few days too.

Worm Infections Around the World

While some worm infections are rare in the United States, they are widespread in developing countries. Soil-transmitted helminth (STH) diseases are a major concern in these regions. Children in malaria-endemic countries are at high risk of malaria infection. Schistosomiasis, another major parasitic disease among children in some developing countries, can cause impaired growth and development and can lead to severe health problems later in life. Onchocerciasis ("river blindness") can cause itching and impaired vision in children, and lead to blindness in adulthood. Lymphatic filariasis is another disease that affects children in developing countries.

According to the World Health Organization (WHO), approximately 25% of the worldâs population has an infection related to an intestinal parasite. In tropical and subtropical areas with limited access to clean water and sanitation, that number is as high as 50%. The most common intestinal parasite infection globally is ascariasis.

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