Roundworms

Roundworms are among the most common parasites in humans. More than a fifth of the world's population suffers from one Roundworm infestation (medical: Ascariasis) and in about one percent of those infected the infection is fatal. The treatment of this parasitic disease can be very complex, but prevention is relatively simple.

What are roundworms?

With the eggs from Roundworms you usually get infected through food that has not been sufficiently washed and not cooked through. This is especially true for salads and vegetables that grow close to the ground such as cucumbers or cabbage.
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Roundworms belong to the group of roundworms and are very similar in body shape and color to earthworms. There are several species that specialize in different hosts. In addition to the actual human roundworm, humans can also be attacked by dog, cat or pig roundworms.

The human roundworm becomes about 5 mm thick and up to 40 cm long. It does not need any intermediate host and, with the exception of the ice stage, spends its entire life cycle in the human body. When roundworm eggs get into the digestive tract with food, the larvae hatch in the small intestine and penetrate the intestinal wall. They first reach the liver via the blood vessels, where they reach another larval stage. Then they move on to the heart and the lungs.

After they have shed their skin again, they are coughed up due to the phlegm and the coughing stimulus they cause. Some of them are swallowed again and thus get back into the gastrointestinal tract. As soon as they are back in the small intestine, they reach sexual maturity. This hike takes place on average over a period of 30 to 35 days.

The adult roundworms can reach an age of up to one and a half years. During this time, a female roundworm lays around 200,000 eggs every day, which are excreted in the faeces. Roundworms, for which humans are a false host, do not reach sexual maturity in the human intestine.

causes

With the eggs from Roundworms you usually get infected through food that has not been sufficiently washed and not cooked through. This is especially true for salads and vegetables that grow close to the ground such as cucumbers or cabbage. Strawberries can also be contaminated with roundworm eggs. But worm eggs can also be transferred to other foods by flies.

Gardening is another route of transmission, as the soil can be contaminated with feces. The same goes for the sand in playgrounds. When cleaning the litter box or removing dog waste, you can get infected with cat and dog roundworms. Under certain circumstances, even the drinking water can be contaminated.

Symptoms, ailments & signs

In the course of their development, roundworms migrate through the human body. Therefore, not only symptoms in the gastrointestinal tract occur, but also temporarily symptoms that affect the airways. In the first time after infection with roundworm eggs, there are no symptoms.

If the larvae get into the lungs in the next stage, this leads to asthma-like attacks with coughing and shortness of breath, heavy mucus, painful breathing and bloody sputum. Skin rashes and facial swelling can also occur as an allergic reaction. These symptoms are temporary for a week or two. In children, however, life-threatening pneumonia can develop.

The young worms then end up in the small intestine, where the adult roundworms prefer to live. A slight infestation is usually not noticeable through symptoms. However, you may experience mild abdominal pain, nausea, and vomiting. In the case of severe infestation, metabolic products of the parasites can lead to allergic reactions and complaints such as fever, severe abdominal pain, nausea, vomiting and diarrhea.

The worms can also impair food utilization. Deficiency symptoms can be the result. If roundworms penetrate the intestinal wall, they can cause suppuration and abscesses. In rare cases, a severe roundworm infestation leads to an intestinal obstruction, inflammation in the pancreas or gallbladder.

Diagnosis & course

In the initial phase or with only a slight infestation with Roundworms the disease can initially go completely unnoticed. The first symptoms of an infection with roundworms are usually abdominal pain and more or less severe malaise. In addition, there can be loss of appetite or cravings. A clear sign in this context can also be severe weight loss and an overall unhealthy appearance.

When the larvae reach the liver, colic pain and the first allergic reactions can occur. These increase when the roundworm larvae reach the lungs. There they can cause a heavy build-up of mucus, which is accompanied by a cough and fever. In the intestine, the adult worms can cause appendicitis and even an intestinal obstruction in the event of severe infestation.

An infestation with roundworms is usually detected with a fecal examination in which the eggs are flushed out in the laboratory with the help of a liquid solution. However, this diagnostic method is not suitable if the person is only infected with immature roundworms or roundworms that specialize in other species. In these cases, a colonoscopy may be necessary.

Occasionally roundworms also come out with the feces. A previously undetected roundworm infestation can become noticeable during anesthesia, as this affects the body's metabolism. This can induce the worms to leave their host through the anus, but possibly also through the mouth and nose.

Complications

If left untreated, a massive roundworm infestation can cause serious complications. Large amounts of roundworms in the intestine lead to severe diarrhea, vomiting and abdominal cramps. If the damaged intestinal mucosa can no longer properly absorb nutrients, this leads to an undersupply, especially in children, which becomes noticeable in weight loss and deficiency symptoms.

If they are clustered together, the worms can completely close the intestines (worm ileus). The situation is extremely critical when the inflamed intestinal mucosa tears and intestinal contents enter the abdomen. In this case, an immediate operation is necessary to avoid life-threatening peritonitis. If roundworms penetrate the bile ducts, they obstruct the outflow of bile and can cause inflammation of the bile ducts or the liver.

A characteristic symptom for this is jaundice with strong yellowing of the skin and eyes. Abscess formation in the liver rarely occurs, which, if left untreated, can lead to serious complications such as blood poisoning (sepsis). Roundworms can also cause massive inflammation in the pancreas, which requires immediate medical attention.

Severe roundworm infestation of the lungs is characterized by dyspnoea, fever, cough and bloody sputum; if untreated, pneumonia can develop. In rare cases, allergic reactions such as facial swelling or skin rashes can also occur as a complication of roundworm infestation.

When should you go to the doctor?

People who suffer from disorders of the gastrointestinal tract or pain in the stomach area should consult a doctor to clarify the symptoms. Fever, nausea and swelling in the abdomen indicate an irregularity in the organism that should be treated. A doctor is needed in the case of exhaustion, reduced physical performance and digestive disagreements. If living beings can be seen in the feces after using the toilet, this must be checked by a medical examination.

Changes in the appearance of the skin, coughing and impaired breathing are further signs of an existing disease. If there are changes in the shape of the face, anxiety or metabolic problems, a doctor is needed. If existing complaints increase in scope and intensity, a diagnosis is advisable. A treatment plan is drawn up and medical care initiated. The germs can spread further in the organism without medical supervision.

Vomiting, diarrhea or diffuse deficiency symptoms occur. Inflammation can develop, which contributes to a further deterioration in health. Bleeding from the bowel, abscesses, or an obstruction in the bowel should see a doctor immediately. With these symptoms, the disease is already advanced and the person concerned needs therapy. Since roundworms can cause pneumonia in children, they should be examined by a doctor at the first sign.

Treatment & Therapy

An infestation with Roundworms can be treated with drugs relatively easily. In addition to some over-the-counter products, there are various prescription-only active ingredients available. These kill the worms in the intestines and ensure that they are excreted with the faeces.

The larvae remain unaffected by this, so that a repeat treatment may be necessary. The duration of treatment depends on how severe the disease is. In rare cases, physical interventions are necessary. These can be performed endoscopically as well as with classic surgical methods.

prevention

The most effective means of having an infestation Roundworms prevention is hygiene. On the one hand, this means that fruits and vegetables are thoroughly cleaned before they are prepared. On the other hand, care should be taken to wash hands consistently. This is of course particularly important after gardening, contact with a sandpit, going to the toilet and cleaning the litter box. However, it is also advisable to wash your hands thoroughly before preparing food, before meals and after contact with pets.

Aftercare

Medicinal treatment of ascariasis or mechanical removal of the worms as part of a colonoscopy only affect adult roundworms that are in the intestine. Worms that are still in larval stages III and IV in organs such as the liver, lungs and larynx due to their specific development cycles are not killed.

They survive the treatment unscathed. After completion of larval stage IV, they leave the larynx and enter the gastrointestinal tract through coughing and swallowing. Only in the small intestine do they grow into adult roundworms and then attack the large intestine. It is therefore very likely that there will be a renewed infestation after a successful treatment and in most cases cannot be attributed to a new infection.

For the reasons given above, successful drug treatment of ascariasis should be repeated three weeks after treatment is completed. Within the three-week waiting period until the next treatment, all larvae that were not recorded developed into adult worms and settled in the intestine. The renewed medication ensures that all "followers" are recorded and that freedom from worms is finally achieved. However, the measure does not protect against re-infection with roundworms, which have developed in the soil from the egg to the larval stage II.

You can do that yourself

In everyday life, it is important to ensure that fresh food such as fruit and vegetables are always cleaned before consumption. Rinse them under running water. It is also important that some foods are only consumed when they have been sufficiently cooked. Especially foods that grow near the ground should be boiled, fried or baked before consumption. It is important to ensure that they cannot be consumed raw under any circumstances.

When preparing salad, make sure that it has been washed thoroughly. As soon as residues of soil or sand appear in a meal, the absorption should be stopped. The storage of purchased food must also be checked in everyday life and, if necessary, optimized. The transmission of pathogens through flies or other insects must be prevented. Therefore, fruit and vegetable items in particular should be covered or refrigerated.

People who have pets should take special care with hygiene. The feces of the animals must not come into contact with food to be consumed. The intake of fluids should also be checked in everyday life. The drinking water should be checked to avoid the transmission of diseases. When showering, washing and brushing your teeth, you should pay attention to the quality of the water.