What is Ascariasis?
Ascariasis (as-kuh-RIE-uh-sis) is an infection of the small intestine caused by a species of roundworm (parasite). These worms use the human body as a host to mature from larvae to adult worms. Adult worms can grow to be more than a foot (30 centimeters) long.
It is one of the most common human worm infections worldwide, particularly in tropical and subtropical regions where sanitation is poor. While mild cases often have no symptoms, heavy infestations can cause serious complications in the lungs and intestines.
Symptoms
Symptoms vary depending on which part of the body the worms are currently inhabiting (Lungs or Intestines).
1. In the Lungs
After eggs are ingested, they hatch into larvae and migrate through the bloodstream to the lungs. During this stage (6 to 10 days), you may experience symptoms similar to asthma or pneumonia:
- Persistent cough.
- Shortness of breath.
- Wheezing.
2. In the Intestines
The larvae eventually travel to the throat, are swallowed, and return to the intestines to mature into adults. Mild cases may cause vague pain, but heavy infestations cause:
- Severe abdominal pain.
- Nausea and vomiting.
- Diarrhea or bloody stools.
- Fatigue and weight loss.
- Visible worms in vomit or stool.
Consult your doctor immediately if you have persistent abdominal pain, diarrhea, or nausea. Seek emergency care if you see a worm in your stool or vomit.
Causes & Life Cycle
Ascariasis is not spread directly from person to person. It is caused by ingesting soil mixed with human feces containing worm eggs, or eating unwashed raw food grown in such soil.
- Ingestion: You accidentally eat microscopic eggs present in contaminated soil or food.
- Migration: Eggs hatch into larvae in the intestine, penetrate the wall, and travel via blood to the lungs.
- Maturation: After a week in the lungs, larvae break into the airway, travel up the throat, are coughed up, and swallowed back down.
- Reproduction: Back in the intestines, they grow into male/female worms. Females can lay 200,000 eggs a day, which leave your body through feces.
Risk Factors
- Age: Most common in children 10 years old or younger (as they play in dirt).
- Climate: Prevalent in warm, humid, tropical regions.
- Sanitation: Common in areas where human feces are used as fertilizer or where sanitation is poor.
Complications
Mild cases usually resolve without major issues, but heavy infestations can lead to:
- Nutritional Deficiencies: Worms steal nutrients, leading to loss of appetite and poor growth in children.
- Intestinal Blockage: A mass of worms can physically block the intestine, causing severe cramping and vomiting.
- Duct Blockages: Worms can block the narrow ducts of the liver or pancreas, causing severe pain.
Diagnosis
Doctors may use the following methods to confirm infection:
- Stool Tests: To look for microscopic eggs and larvae. (Note: Eggs appear 40 days after infection).
- Blood Tests: To check for increased white blood cells (eosinophils).
- Imaging (X-ray/Ultrasound): A mass of worms may be visible in abdominal X-rays. Chest X-rays can reveal larvae in the lungs.
Treatment
Infections with no symptoms may not need treatment, but symptomatic cases require medication.
1. Medications
Anti-parasite medications are the first line of defense. They kill the adult worms:
- Albendazole (Albenza)
- Ivermectin (Stromectol)
- Mebendazole
2. Surgery
In severe cases, surgery may be required to remove a mass of worms causing intestinal obstruction, perforation, or appendicitis.
Prevention & Lifestyle
The best defense against Ascariasis is good hygiene and common sense regarding food safety:
- Wash Hands: Always wash hands with soap and water before eating and after using the toilet.
- Wash Produce: Thoroughly wash, peel, and cook all raw fruits and vegetables.
- Avoid Soil: Teach children not to put hands in their mouths after playing outdoors.
- Water Safety: Drink only bottled or boiled water when traveling to developing regions.
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