If it's your first child, then the first you'll know of
'worms' is when your child wakes up one night screaming,
wriggling around and often clutching at the diaper area, or
scratching herself. A child like this will often be very
difficult to settle, writhing and screaming, such that you
are convinced that this is an emergency. If you get through
the night in one piece, the problem seems to be gone in the
morning, only to reappear again the next night.
Because the child seems all right in the day, it can be
quite confusing. Veterans of worm infestations in their
children will recognize that scream straight away, and will
have the appropriate remedy in the house already.
Pinworms are small white worms that live in the human gut.
They crawl out at night and lay their eggs on the skin
around the back passage. Their wiggling around can cause
intense itchiness, causing the sufferer to scratch. Each
worm lays thousands of eggs. The eggs are then transferred
by scratching to the fingers, and eventually end up in the
mouth. They pass back down into the gut where they hatch,
thus completing the life cycle. The eggs will also be all
over the pajamas and bedding, and can even be carried by air
currents throughout the house, and in this way they can even
be inhaled.
Because there are so many eggs and because they are so hardy
— living for weeks outside the body — and
because they are so easily spread, this is one of the most
common parasitic infestations. It has no social barriers,
infecting rich and poor, with equal vigor. The eggs are
easily passed among young children in crowded situations,
like daycare and busy households.
How much a person suffers from this parasite depends on how
many they have, and their sensitivity to them. As it is such
a common infestation, almost everyone will have some worms
inside their gut. Most people can tolerate a low infestation
load, and it only becomes a problem if there are enough
worms to cause symptoms. Some people feel weak, lethargic,
and irritable; have a loss of appetite, lose weight, become
anemic, or suffer itchiness in other parts of the body.
Sometimes the worms can lose their way and wander into other
openings in the body, especially in girls, causing soreness.
If they travel far enough up into the body they can cause
other medical complications. Other people seem to suffer no
particular symptoms.
There are easily available remedies to kill the worms, in
the form of a liquid or a chewable tablet. However the eggs
survive, and often another treatment is required after ten
days to kill the freshly hatched worms. Many people are
happy to treat worms if an infestation is suspected, even if
it is not confirmed. The preparations are very safe, even
for young children. However if you want to know for sure if
there is an infestation present, then the best way is the
'scotch tape test.' Stick double-sided scotch tape
(cellotape in English) onto a lollipop stick or similar. At
night, or in the morning before the bathroom is used, press
the stick onto the sides of the opening of the back passage.
You may be able to see the worms caught on the tape, but
otherwise, if this is sent to a laboratory (through your
physician), it can be examined under the microscope for
eggs.
Because the worms' life cycle relies entirely on the
ingestion of eggs, the amount of worms a person has cannot
increase without adding more eggs through the mouth. If no
more are consumed, those worms already in the gut will
eventually die and pass out of the body, and the infestation
will be over. Therefore the most important thing to do,
besides killing the worms directly, is to establish good
hygiene habits.
To prevent infestation, or re-infestation, the nails
should be kept short, and the hands washed well before
eating, and after using the bathroom, or when adults have
been changing diapers. Frequent underwear and towel changes
are also advisable. Thumb sucking obviously creates a
particular hygiene challenge, as does the fact that young
children put almost everything in their mouth.
Advice given often includes treating everyone in the house
together, even if you have only one confirmed case, and
washing all the linen and towels at high temperatures (to
kill the eggs). All this can place an unnecessary burden on
a large household, and can be very frustrating because the
children are very likely to pick it up again in kindergarten
or school, and the whole procedure would have to start
again.
This infestation is most common in young children, but
adults do also get infected, and this can often be missed,
especially if there is not excessive itchiness. So if you
are concerned that some "feeling under the weather" might be
associated with worms, then speak to your doctor.
Precautions at home can only go some way to solving the
problem, because the main difficulty is the ease of spread
among small children in kindergarten. However one need not
get too obsessive about this infestation, and aim for
control rather than eradication. As children get older, they
tend to get it less often and it will eventually become one
of those forgotten childhood problems.
[Ed. note: There are many home remedies for those who prefer
to stay away from medication. These include raw garlic taken
orally, garlic used as a suppository, and very importantly:
not to let children have sweets before bedtime (Shabbos
included)!]
