There is hardly any person (of any age or sex) who had never had worm infestations, rather it would be more correct to say that almost every person carries worms in the intestines. This a major public health problem and the number of such infected persons is on the rise. Worm infection is present to the extent of 90% in the residents of tropical countries, like India, where standard of personal and general hygiene is apallingly low and the underlying cause is an impure and contaminated water supply, unhealthy environments, and socio-economic status. The position is still worse in other Asian & African countries where hygienic standards are still poorer.
Generally an infected person doesn’t know presence of worms unless there are serious complications and problems. Once eradicated, through medication, the worms hatch and cause agonizing distresses again. Hence, a total immunity from worms cannot be had, due to recurrence factors. Lack of knowledge, as to hygiene, water and vegetables contamination and impurities, prohibitive and high cost of medicines which not many people can afford, lack/absence of proper medical facilities (more so in remote corners and villages, small towns) and high rate of infection are some of the contributory factors that lead to various worms and worm-related disorders-some of which are quite serious and may threaten even life.
Types of Worms
1. Roundworms
2. Hookworms
3. Pinworms
4. Tapeworms
5. Threadworms
6. Giardia
7. Whipworms
It may be remembered that worms hatch only where there is filth and filth is created by chronic constipation when stools re-main lodged in the intestines and cannot be compelled due to weak/ absent peristaltic action of intestines & rectum. In fact faeces remain lodged in the intestines for days together and putrefy there, giving birth to various types of worms, constipation, foul smell, gas formation, flatulence, gastralgia etc.
As long as worms remain lodged in die intestines there are symptoms like gnashing of teeth, pillow wetting, irritation in the anus, occasional pain, general distress in abdomen, incarcerated and foul smelling wind, constipation, occasional piles (blind or bleeding) etc. Problem gets complicated and serious when worm infection travels to liver (as in the case of amaebic dysentery). Worms may even travel to brain or, for that matter, any other part of the body. But, once the body has been freed from worm infectations, most of the symptoms disappear and normal health is restored. If ever anyone or more of the said symptoms are felt or observed, get the stools tested which, in all probability, will disclose the type and presence of worms in the system. Once it has been confirmed as ‘Positive’, there should be no delay in treating the patient.
Treatment
Anthelminthics and other antirinfestive drugs are used for killing different types of worms, such as
1. Pyrentel
2. Piperazine
3. Bephenium
4. Diethylcarbimazine
5. Niclosamide
‘Pyrantel’ has a neuromuscular blocking action that produces spastic paralysis in the worms. It is safe, effective and alternative to ‘Mebendazole’ but must be used with utmost caution as there can be liver impairment.
Piperazine’: It is an alternate drug for the treatment of round and hookworms but is poorly absorbed, hence its toxic effects are quite rare. It is also less effective than “Mebendazole.’
‘Diethylcarbamazine’ : It is used for treating Fialariasis but mut not be used unless advised by a doctor, due to its severe hypersensitivity reactions.
Nilosamide : Is an effective drug against tapeworms. It should also not be used unless a doctor advises; as it may cause vomiting/ constipation.
Drug Therapy
Albendazole 400 mg tables (Trade names ABZ, Albezole, Alminth, Emanthal, Idibend, Mebex, Tazazole, Wormin, Zentel, Zumin)
Used for: Roundworm, hookworm, whipworm, tapeworm, threadworm infestations.
For Threadworms : For adults and children over 12 years 400 mg (single dose only), to be followed by 100 mg dose after 2-3 weeks.
For Tapeworms : 400 mg once daily for 3 consecutive days.
For Hydatid : 400 mg twice daily with meals for 28 days. This therapy may be repeated after a lapse of two weeks for a total of 3 cycles.
This drug is also available in suspension form of which 5 ml. suspension contains 200 mg. Dosage is the same as mentioned earlier in the case of tablets.
Note : This therapy is also an adjunct to hydated cysts or primary treatment, especially when surgery is not possible.
Do not use in pregnancy, hormonal contraceptive, child bearing women, malfunctioning of liver, breast-feeding. It may cause headache, gastro-intestinal disturbances, fever, rashes, dizziness, alopecia (baldness), convulsions and meningism in cerebral disease.
Now-a-days only a single drug treatment is given for all the worm infections and it is quite convenient also for the patient.
Auxiliary Measures
1. Clip nails of hands and feet and keep them clean.
2. Before going, coming back, before and after eating, after defecation wash hands with soap.
3. Wash thoroughly all fruits and vegetables
4. Take plenty of roughage to ward off chances of any constipation.
5. Observe yourself and also educate children about personal hygiene.
6. Ensure that the cooks and servants also observe requisite level of cleanliness and personal hygiene.
7. Do not eat/drink any foodstuff which is exposed to dust, flies, insects, is impure & contaminated, stale, foul smelling or rotten.