Dr Phil Kieran: Does everyone in the family need to be treated for worms?

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Dr. Phil Kieran

GENERAL PRACTITIONER

My seven-year-old picked up worms two weeks ago, which we quickly treated with over-the-counter antiparasitic medication. I’ve since read that all family members should have taken the tablets. Is it too late?

Worms! Infestation! An outbreak of worms! People frequently talk about worms using dramatic language and often with tones of disgust, which is a bit ridiculous for something so common and mild.

Approximately 5-20% (British figures) of the population has worms at any given time. You may hear people talk about pinworms, threadworms, or simply worms, and these are most common in those aged five to nine, but can affect any age.

Worm eggs are picked up from another infected person and can be transferred by hand-to-hand contact, sharing food, or touching an infected surface and then your mouth.

The worms live in the gut and the female worm comes out of the anus at night to lay eggs on the surrounding skin. This leads to the most common symptom, itching (usually worst at night). The eggs can’t hatch on the skin or in the gut and must be taken in through the mouth. Teaching children to wash their hands first thing in the morning and not to bite their nails goes a long way towards reducing or shortening infections.

Treating worms is straightforward: A single dose of medication and the dose repeated after seven days. This medication can be bought over the counter in the pharmacy without a prescription, and your pharmacist will help with questions about how to take it.

Treating the whole family is usually recommended, as worm eggs are easily passed from hands to surfaces. If no one else has symptoms since you treated your child two weeks ago, there is no need to treat the household.

In cases of infection, the worms will typically be visible in the stool, so it’s a good idea to check the toilet before you flush it. The worms look like small (about 1cm long), white threads wriggling on the stool’s surface. If you don’t see them but still think they may be there, you can use a ‘tape trap’. This involves curling a small piece of sellotape back on itself to make it double-sided, applying it to your child’s skin beside the opening of the anus, and leaving it overnight. If they have worms, you will almost certainly see one or more stuck to the tape in the morning.

Interestingly, there is evidence that having at least one episode of exposure to worms in childhood can reduce the incidence or severity of some allergic-type conditions, particularly eczema and asthma. However, the evidence supporting this isn’t strong.

Most of us have had worms and most children will get them at some stage. It’s best not to panic and treat them as one of those common infections most of us go through.

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