Roundworms

The Roundworm Ascaris lumbricoides is the most common intestinal parasite in the world, infecting an estimated one billion people. It is also the largest of the round worms, reaching an average of forty cm (sixteen inches) in length. It can be as thick as a pencil and weigh almost as much. It is pink with bright red “speed stripes.” The female grows in the intestines, producing an enormous number of eggs estimated to be about twenty-seven million in her lifetime of a year or so. The eggs expelled in the feces can live outside the body for up to seven years in warm soil. Food, water, and soil contamination are the means of infection for humans. However, humans are not a viable host for the mature worm, but the immature form is the one that causes the disease. When the larvae hatch, they travel to various parts of the body like the lungs, liver, brain, or eye. They can enlarge the liver, cause abdominal pain, and often pneumonitis, as well as anemia as evidenced by a high eosinophil count.Children are more prone to contracting the worm since they often play in dirt and then put their hands into their mouths. It is estimated that fifty-five million American children are infected with some type of worm. An infected person may have vague symptoms, with the most unusual being a full, pale upper lip with white lines around the mouth.

Symptoms in children that are typical of parasite infestations include the following: nervousness and irritability, colic, poor or ravenous appetites, failure to thrive, allergic reactions, dry or wheezing cough, and restlessness at night. Other symptoms of this parasite often include the folowing: convulsions or spasms, twitching in various parts of the body, itching or irritation of the nose or anus, oral pallor, as well as a lactose intolerance. Children also frequently pick their nose. Malnutrition is a characteristic of a heavy ascaris infection because the worms compete for the nutrients. Ascaris inhibits absorption of proteins, fats, and carbohydrates as well as other nutrients. Treatment is not usually rendered because it is a common childhood complaint, but if there is a community wide infestation, then steps are usually taken that include mass therapy every six months, along with an improvement in sanitation facilities, diet, and hygiene.

Adults can exhibit vague symptoms including the following: abdominal pain, edema of the lips, allergic reactions, insomnia, anorexia, and weight loss. Commercial blast-freezing is the most effective way to kill Anisakine larvae.

Dog and cat roundworms, Toxocara canis and T. cati, are the cause of a disease called ‘visceral larva migrans’ first recognized in 1952 and found mainly in children. More than half of all dogs are infected with at least one parasite: hookworm, roundworm, tapeworm, or heartworm. ALL puppies are born with the dog roundworm Toxocara canis, which is often the reason for their distended bellies, diarrhea, and lackluster coats. Both puppies and kittens are continually infected with larvae from their mother’s milk. Puppies from three weeks to three months of age present the greatest hazard because they excrete large numbers of roundworm eggs. Consequently, the most susceptible are young children. Roundworm eggs are deposited everywhere a child often plays – playgrounds, back yards, parks, beaches, sandboxes, etc. The eggs are very hardy and can survive for years in all kinds of weather. There are no known chemicals that will kill them in the soil. A dog with a mild roundworm infection can pass at least 10,000 eggs a day from just one of the several hundred worms that usually infect its system. Multiply this by the number of dogs in the country and the number of parks, etc., to which they have access, and it is easy to see where there would be an enormous health hazard to both humans and animals if owners do not properly take care of the feces left behind in public areas. Another must is the deworming of animals. This should begin when puppies are two to three weeks old and kittens about six weeks old. This should be repeated every three months during the first year of life, and then twice a year after that.

The disease is characterized by flu-like symptoms, continual abdominal pain, inability to gain weight, blood changes, cough, rash, and enlargment of the spleen and liver, where they can create severe tissue irritation and allergic reactions. The larvae can also migrate through the lungs, muscles, brain, liver, and eye. In the more serious cases involving the eye, tumors can appear, producing a condition called ‘ocular larva migrans.’ This condition is the result of the larvae becoming trapped in the retina of the eye. Symptoms include eye pain, strabismus (the inability to focus both eyes at the same time), and loss of vision. This syndrome may be misdiagnosed as ‘malignant retinoblastoma,’ resulting in an unnecessary removal of the eye.

Roundworms: Wuchereria bancrofti, Brugia malayi, Onchocerca volvulus, Loa loa, Mansonella streptocerca, M. perstans, M. ozzardi are all microscopic filaria of which there are eight species known to infect humans. They are transmitted by bloodsucking insects, including flies and mosquitoes Culex, that ultimately produce diseases endemic to tropical Africa, Southeast Asia, and the South Pacific. The lymphatic filariae (W. bancrofti and B. malayi) invade the bloodstream and lymphatic system with pronounced effects, ranging from simple fever and lymph node infection to such deformities as elephantiasis of the legs, arms, scrotum, and breasts. Together, river blindness and elephantiasis infect more than 100 million people worldwide. Elephantiasis is the more dramatic of the two, causing swelling of immense proportions resembling that of an elephant. These deformities are the result of the reproductive activity of the three- to four-inch long female worm that lies coiled in a lymph gland or duct. Everyday she pumps out thousands of offspring in the form of tiny threadlike larvae called ‘microfilaria.’ Over time, these organisms clog the lymph ducts, causing the lymph fluid to back up, which, in turn, causes the tissues to swell in certain areas of the body depending, on which lymph gland or duct is affected.

O. volvulus causes dermatitis, subcutaneous nodules, and eye lesions. In some areas of West Africa, almost 30% of all adults become blind as a result of infections from this parasite. All three species of the Mansonella filariae cause a type of itching dermatitis.

In West Africa, a tiny roundworm causes river blindness (onchocerciasis). The parasite is transmitted through the bites of black flies, and often live as a tangled mass in nodules under the skin, where females can release 200 to 300 offspring (micro filariae) everyday. These micro filariae migrate through and under the skin, causing itchy red patches that eventually turn to white leathery areas. When they reach the eyes, blindness results.

The dog heartworm, Dirofilaria immitis, is most endemic to areas of the US along the Mississippi River Valley and the Atlantic and Gulf Coasts. Man is not a viable host for the mature worm but only for the larvae, which is the cause of infections. The parasite is transmitted by an infected mosquito, and usually remains in subcutaneous tissue. The larvae rarely complete their life cycle, but, if they do, they migrate to the lung, where they become localized in a coin-like lesion that can be misdiagnosed on an X-ray as lung cancer, leading to unnecessary surgery. The symptoms are generally mild, with an occasional cough.

The roundworm Trichinella spiralis can masquerade as at least fifty or more common diseases, ranging from flu to generalized, as well as, specified areas of aches and pains. The most familiar of the diseases is “trichinosis.” Most roundworms are transmitted through the soil, but the exception is the spiral-shaped trichinella, which is found in animal muscle that is ingested by humans. These roundworms become enclosed in cysts found in the tissue of a variety of such animals as bears, pigs (most often), walrus, etc. If the meat is not thoroughly cooked before being eaten, the cysts, which are not affected by digestive juices, mature and travel to the muscles, where they become encased. Eventually, the worms can burrow into the larynx, chest, diaphragm, abdomen, jaws, and upper arms, where they calcify, causing severe muscle soreness accompanied by fever. The worms have been known to survive in a human body for as long as thirty-one years when pathologists found as many as 1,200 of them in a single gram of tissue. They can range in size from a fraction of a centimeter to more than three meters (ten feet). The symptoms of trichinosis change according to the progression through the body. Incubation period is seven to fourteen days. During the first week of infection, acute diarrhea, nausea, vomiting, and colic occur as the larvae penetrate the first part of the small intestine. Then, when the larvae migrate to muscle tissue, about two to four weeks after ingestion of infected meat, severe muscle pain is experienced. When the larvae finally encyst themselves in muscle fiber, extreme dehydration and toxic edema can appear. Edema of the lip, face, or eyelids, difficulty breathing or speaking, chewing problems, enlarged lymph glands. meningitis, and encephalitis can take place. Brain damage, pneumonia, pleurisy, and nephritis are further complications. Blood counts will remain normal for quite some time, however.

Known since ancient times, trichinosis was avoided by abstaining from eating pork. Found in the Mosaic law. This method is hailed as being the first step toward preventative medicine. It was not until the middle of the 19th century that it was discovered that thoroughly cooking pork could prevent an infestation. Salting, smoking, and pickling are also preventative methods – but trading safety from this organism for other health concerns. Roundworms eggs are not found in stool samples until sixty to seventy-five days after initial infection. By this time, they have gone through their pulmonary phase, creating symptoms of coughing, wheezing, bronchial spasms, and increased mucus. Symptoms related to the intestinal phase can mimic those of a peptic ulcer, or ulcerative colitis, but require an entirely different treatment regimen.

The roundworm Anisakis marina causes an infection called anisakiasis. The larvae burrow into the stomach wall, producing severe inflammation and pain with the symptoms mimicing appendicitis, gastric ulcers, or cancer. Surgical removal of the worms is often required, but this also means removing sections of the intestine – a common procedure in Japan where raw fish is a staple. Humans become infected by consuming raw, pickled, smoked, or undercooked fish. With the increased use of microwaves for cooking, the risk increases since this method distributes heat unevenly.

Most often, this Eustrongylides worm infection has been the result of eating homemade sushi dishes rather than from restaurant preparations, where chefs are well-trained to spot the larvae. The custom of sampling such ethnic dishes as homemade sausage or gefilte fish for seasonings can also transmit trichinosis and fish worms into humans. Pacific rockfish (red snapper) and Pacific salmon are most frequently infested with anisakid worms, but they have also been found in such other Atlantic fish as herring, cod, and haddock.

The fish roundworm , Anisakis simplex is acquired by eating raw or undercooked fish, including any pickled, marinated, and salted marine life. They are large, bright red worms that can be seen with the naked eye in the flesh of any type of fish – freshwater, marine, or brackish water. They can remain very active, even after the death of the fish. The larvae normally mature in wading birds, especially after they eat minnows. It takes only one larva to cause an infection in humans. Misdiagnosis is common since it mimics such other diseases as acute appendicitis, Crohn’s disease, gastric ulcers, or gastrointestinal cancer. Some chronic cases have lasted a year. Some have had a tickling sensation in the throat and have coughed up the worm and manually removed it before being swallowed again. Symptoms of nausea can persist after the expulsion of the worm (no doubt after something like that!) because the parasite can leave lesions containing remnants of the worm. If the parasite is able to penetrate the intestinal wall, peritonitis can result, leading to death.

Some suggested natural methods for ridding the system of roundworms include the following:

1. eating raw carrots and beets. Chew well and wash down with raw sauerdraut juice;
2. boil some garlic, horseradish, and onions in water and drink it slowly, as hot as possible;
3. eat as much raw garlic as possible, then take a laxative. Repeat for several days;
4. sit in a milk bath sufficient for covering the rectal area. Worms “smell” the milk and crawl out. Remain in the warm bath for about an hour until all the worms are out;
5. extracts of garlic, onion, pomegranate rind, turmeric, and various citrus rinds possess anti-worm properties. Bromelain, papain, and other proteoplytic enzymes are useful in dissolving the outer layer of the worms. Figs are a good laxative.

Antiparasitic drugs have not proven to be very effective. The symptoms may diminish for a couple of months and then return. In addition, one lesser known side effect of the drugs is that it can drive a parasite out of one organ and into another, where it could cause even more damage. A typical example is finding Ascaris in the bile duct or liver. These worms do not commonly leave the intestinal tract unless the patient has taken a drug that is toxic, but not lethal, to the parasite, or there happens to be a GI disorder that alters the normal digestive process.

See also Nematodes.

Hello,
I am doing a biology project on roundworms and their affect on the human body. Since you seem to be an expert in this field, I was wondering if I could ask you some questions on the topic. If you could get back to me as soon as possible, that would be great. N.

Hi N.
I am not an expert in the field. I only did some simple research on the subject for our website. This is what my husband and I do since we retired from our respective professions. However, I am willing to help you in any way I can. Pam

(2nd email)
I was wondering if I could ask you some questions on the topic we have discussed. The questions are:

I put my answers in with your questions below.

1. What is a common roundworm infection that most people have problems with?Roundworm infections are more common in warm climates and usually result from the lack of proper hygiene or sanitary conditions. The PINWORM is the most common of all roundworm infections in the US. Because it infects children most often and is easily spread, infections will be found mainly where humans gather like in families, day cares, camps, and schools.Other more common roundworm infections in humans include:
   • Enterobius vermicularis, the pinworm that causes enterobiasis (not very dangerous but does cause a great deal of itching around the anus which is then spread from dirty fingernails)
   • Ascaris lumbricoides, the large intestinal roundworm that causes ascariasis
   • Necator and Ancylostoma, two types of hookworms that cause ancylostomiasis (most common in the world – but not in the US – causes intestinal blockage, abdominal swelling and severe pain, and shortness of breath)
   • Trichuris trichiura, the whipworm that causes trichuriasis (can cause severe anemia and rectal prolapse [where the rectum collapses])
   • Strongyloides stercoralis, that causes strongyloidiasis, (an intestinal infection that persists because of the worm’s ability to go virtually unnoticed. It may replicate for decades.)
   • Trichinella spiralis, that causes trichinosis, (also called Trichinellosis is caused by eating undercooked meat infected with the worm. It can cause severe flu-like symptoms with diarrhea that can last for months, eye swelling, joint pain, and coordination may be affected. If symptoms are severe enough, brain damage and death may occur)

   ?

2. Are free-living roundworms regarded with the same attentions as parastic roundworms? If not, then why?Not really. Free-living roundworms are more abundant than the parasitic roundworms and can be just as harmful but in a different way. Although they feed on such materials as algae, fungi, small animals, fecal matter, and dead organisms, they also feed on living tissue. They destroy plant roots, causing the entire plant to die. In the small animals, they will deprive them of nutrients that they need to survive. Parasitic roundworms are more commonly known, however. They also live in plant matter as well as body fluids and tissues of animals, including humans. They have to have a host in order to survive. They also harm that host and can move to different locations within it. The most common parasitic types are whipworms, hookworms, pinworms, ascarids, and filarids.

• Are roundworms a serious problem that we should all watch out for?Yes, see the previous answers. Also, these infections can cause pain, cramping, nausea, vomiting, anemia, pneumonia, intestinal infections, as well as taking much of the nutrients a person needs for good health. This nutritional depletion leads to severe malnutrition which, in turn, can lead to other diseases. Some worms can perforate organs or infiltrate them including the brain. Some can cause intestinal blockage (which causes death if not treated immediately) while others cause kidney disease, pus accumulation in the liver, pancreatic inflammations, appendicitis, heart disease, and blindness.
• Are ringworms a form of roundworms or are they something else?Ringworm (Tinea) is a fungal disease and not a parasite like the roundworm. Ringworm on the feet is commonly called “athlete’s foot”. However, it can infect other places on the body – the scalp, groin, around the nails, for example. The name comes from the characteristic red ring that is seen around the edge.
• Are roundworm infections easy to treat? What are some treatments given to patients?A roundworm can lay as many as 200,000 to 300,000 eggs a day, but it takes a couple of weeks for an infection to set in in a host. The drugs of choice are:
  • Mebendazole (Vermox or Combantrin-1 – used for those older than 2 years). It is given twice a day for 3 days and is not repeated unless there is evidence that it needs to be.
  • Pyrantel pamoate (Povan or Combantrin) is a non-prescription med used mainly for pinworm infections. Two doses are usually needed and given 2 weeks apart since it kills the adult worms but not the eggs it has laid.
  • Piperazine is given as a single dose and often combined with senna. This is a good combination since piperazine paralyzes the worms while senna expels them. It can be repeated for up to 3 months if need be.
  • Levamisole paralyzes the worms but is not used in some countries. It is used only when other medications have not worked.

  There are alternative treatments that are just as effective, cheaper, and do not have the side effects that always come with pharmaceuticals. Some of these include:

  • An extract from a fig tree species (Ficus glabrata). This has been particularly effective against infections from threadworms, whipworms, and hookworms.
  • Garlic is my personal favorite for most any infection. It has over 70 active ingredients and is effective against all infections – including those from fungi, parasites, viruses, and bacteria. Harmful microbes can’t wait to get out of the body when garlic is present (some humans run too when someone has eaten it but so what!!)
  • Turmeric is an ordinary spice that is excellent for the digestion and virtually little taste. However, it does turn things yellow so be careful what touches it. Like garlic, it also destroys the activity of the parasites but does not damage the body.
  • Pumpkin seeds (raw, unroasted) have a long history of treating roundworms and other parasites.
• Are there specific people that are usually infected with roundworminfections (i.e: children, women etc.)Children are most often affected because they are constantly putting their fingers in their mouths. They play in dirt, on the floor, etc., and easily swallow whatever organism is on whatever they touch.
• Is there anything general that we as people can do avoid roundworm infections?There are two main things that can be done to prevent any illness, including roundworms. One is basic hygiene. This means keeping yourself and your surroundings clean. Washing hands frequently is very important, and keeping your fingernails clean. The other main factor is nutrition. By eating wholesome food and keeping your vitamins and minerals high, you can avoid many diseases. Microbes (parasites, fungi, bacteria, viruses, etc.) all love junk food because it is full of sugars and fats that they feed on. By keeping your diet as healthy as possible and eating good sugars and fats, harmful microbes cannot gain a hold.If you don’t know the answer to some of the questions, that’s fine as well.I hope this gives you the answers you are looking for. I do wish you well with your project and PLEASE let me know how you did on it.

(3rd email)
Thanks,
N.

You are very welcome.
Pam

*Note: Are you aware of the effect of drugs — prescription and over-the-counter — on your body’s nutrients? Check drugs.