Posted on December 9, 2009, under Gastrointestinal.

Q. What about worms? Are these very common?

A. Indeed they are and I guess nearly every child in Australia has suffered from worms. The most common kind here is the threadworm, also called the pin worm. It commonly affects children of school age, for eggs are readily transmitted on fingers and hands, school implements, toys and play things.

The eggs quickly hatch out in the bowel and adult worms leave the anus to deposit eggs around the anal margin at night. This causes irritation and the desire to scratch, which in turn transmits more eggs to the fingers and under the nails and so they are spread to others, either members of the family or school chums. Apart from irritation there are rarely any severe effects.

Q. What is the best treatment?

A. Ideally the whole family or the whole class or school should be treated at the same time. A variety of medications is used, Mebendazole (Vermox) is very satisfactory. One tablet, or 5 ml of liquid, is all that is required irrespective of age. If the worms recur, which is common, a further dose or two at weekly intervals will again have a beneficial effect. Other worm killers are also used with good effect.

Q. What about other worm infestations. Are these common?

A. In certain under-developed countries they are notoriously common. In Australia, in the main, they are not commonly seen. Round worm (ascariasis) sometimes occurs. There may be no symptoms, although nausea, vomiting and colic may be present. Piperazine citrate is effective treatment. Hookworm, strongyloides and tape worm are occasionally seen.

Q. What about giardiasis? This seems to have suddenly taken off in Australia in recent years.

A. True, and the parasite called giardia lamblia which came here from the Mediterranean area is now very common all around Australia, especially along the eastern seaboard. It usually comes from infected water, maybe swimming pools, is swallowed, multiplies in the duodenum and causes ongoing diarrhoea with frothy stools. The organism may be identified by material taken from the duodenum or from the contaminated stools.

Q. What about treatment?

A. This is excellent. Metronidazole (Flagyl) given three times a day for a week is curative. A simpler method is taking tinidazole (Fasigyn), four tablets of 500 mg as a single dose. These drugs should be taken under medical supervision after the diagnosis has been confirmed.


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