Worms (Helminths) are soft-bodied, elongated, naked invertebrates of the phyla Annelida (leeches), Acanthocephala, (thorny or spiny headed worms), Aschelminthes(roundworms), and Platyhelminthes (flatworms). It is a common belief, that intestinal worms are more active during the full moon cycle. Worms most often develop when the immune system is compromised in some way, whether from another illness or from a poor diet. It is noted that when the diet improves, the worms die off. Garlic is a natural antiparasitic as well as an antibacterial, antifungal, and antiviral – a cheap all-purpose medicine. Onions, figs, and pumpkin seeds also create an uninhabitable environment for worms. Increased nutrients forces worms out of the body. Since absorption in the intestines is impaired by infestations, the body requires large amounts of nutrients. Animals, as well as humans, that are fed diets deficient in protein and vitamins A and B become infested with several types of parasites. Acidophilus is especially helpful for amebic dysentry, as well as all intestinal infestations. Sufficient stomach acid destroys parasites contained in the food eaten.
There are three main groups of these multicellular eukaryotes known simply as intestinal worms: (See also Endoparasites.)
- Cestodes are tapeworms: class Cestoidea; phylum Platyhelminthes; subclass Cestoda. They have a head (scolex) and segments (proglottides). The adults are endoparasites found in the alimentary tract but their larvae can be found in various organs and tissues. Cestodaria is the unsegmented subclass of tapeworm which affects various fish and some reptiles. Examples include: Dipylidium caninum (dogs), Diphyllobothrium latum (fish), Hymenolepsis nana (dwarf tapeworm), Taenia saginata (beef), Taenia solium (pork).
- Nematodes are roundworms: class Nematoda; phylum Aschelminthes; in some classifications, it is sometimes known as Nemathelminthes or a class of that phylum. There are about 12,000 classified species, but an estimated 200,000 plus are known to exist. Examples include: Ancylostoma caniunum (hoodworm), Anisakis simplex (fish roundworm), Ascaris lumbricoides (giant intestinal roundworm), Dirofilaria immitis (dog heartworm), Enterobium vernicularis (pinworm or seatworm), Eustrongylides spp. (fish roundworm), Necator americanus/Ancylostoma duodenale (hook worm), Strongyloides stercoralis (thread worm), Toxocara canis/cati (dog and cat roundworms respectively), Trichinella spiralis (pork roundworm), Trichostrongylus (herbivore roundworm), Trichuris trichiura (whipworm).
- Trematodes are flukes: class Trematoda; phylum Platyhelminthes. Important ones affecting man belong to the genera Schistosoma, Echinostoma, Fasciolopsis, Gastrodiscoides, Heterophyes, Metagonimus, Clonorchis, Fasciola, Dicrocoelium, Opisthorchis, and Paragonimus. Some specific examples include: Clonorchis sinensis (liver), Fasciolopsis buski (intestinal), Nanophyetus spp. (fish flu flukes). Paragonimus westermani (lung), Schistosoma spp. (blood).
- Are intestinal worms other than tapeworms and usually cover such worms as the roundworm, pin worm, hookworm, etc. They are multicellular organisms and larger than Protozoa. The adult worm multiplies by producing eggs called larvae, which become infectious in soil or in an intermediate host before infecting humans. Usually, a person will show no symptoms unless there is a heavy infestation of worms with both coexisting until the worms grow in numbers that create an obstruction. The following are some of the more common nematodes, except for the roundworm. It will be dealt with separately.
- Hookworms (Necator americanus and Ancylostoma duodenal)
- Are found worldwide in warm moist soil where the larvae penetrates the skin of those usually walking barefoot. The larvae then travel through the bloodstream to the lungs, into the alveoli, and up the trachea to the throat where they are swallowed, ending up in the small intestines about seven weeks later. When the larvae passes through the lungs, bronchitis may develop. The teeth-like hooks of the larvae attach to the intestinal mucosa, where they inject an anticoagulant to prevent the blood from clotting. They rob the body of large amounts of blood, extracting an estimated seven million liters of blood each day from 700 million individuals around the world – which explains its name – Necator americanus “American murderer”. Although, not all infections cause disease since it usually takes more than twenty-five adult worms to do that, but so much blood can be taken from an infestation to cause anemia. They are most likely to infect those who have a poor diet and, thus, compromised immune systems. The first sign of a hookworm infection is itchy patches of skin, pimples or blisters known as ground itch or dew itch. The skin itches for a few months until the worm dies. Other symptoms include the following: itching at the site of entry, nausea, dizziness, pneumonitis, anorexia, weight loss, and anemia. A heavy infestation will produce the following: anemia, protein deficiency, dry skin and hair, edema, distended belly, stunted growth, delayed puberty, and mental dullness. Treatments include improving nutritional status with special attention to the anemia. Adult worms are small, cylindrical, grayish-white, with a head that is often curved in a direction opposite that of its body giving it the “hooked” appearance. Both species infect humans, but only one possesses four sharp structures like teeth, while the other has cutting plates. They are the only worms known to have teeth. These worms can live up to fifteen years in the human body, extracting .2 to .3 ml. of blood every day. This amount can be considerable since the females are known to release 10,000 to 20,000 eggs every day. Hookworm affects about 900 million people worldwide and causes 60,000 deaths, yet world agencies spend less than a million dollars on hookworm research.
- The pinworm (Enterobius vermicularis)
- Is the most common of all worms in the US and the bane of a mother’s existence since it is most prevalent in children. Over 80% of children between the ages of two and ten will be affected at one time or another. It has infested people to the tune of over 200 million worldwide and over 40 million in the US alone. It is found in both warm and cold climates and shows no socioeconomic boundaries. Pinworms are about the size of fine silk threads a fraction of an inch long. Some can reach lengths of thirty cm (twelve inches). Transmission occurs through contaminated food, water, and household dust as well as person-to-person contact. The adult female pinworm moves outside the anus, during the night, to lay her eggs. These eggs are then transferred to fingernails during scratching and then, to the mouth, where the cycle starts again. One female pinworm can deposit over 15,000 eggs that become infective immediately, or within a few hours. Children can easily transmit the eggs to the entire family via the bathtub, toilet seat, and bedclothes. The eggs can stay viable for weeks on carpets, walls, sheets, and clothes. Perianal itching is the most classic sign of pinworm infestation. These threadlike ¼-inch worms have been connected to an enormous range of neurological and behavioral symptoms. A study published in 1961 by Pediatrician Leo Litter, documented his ten-year study of 2,000 children, where he was able to link some unusual conditions not previously associated with parasitic infections. Some of his findings included abnormal EEG’s that often mimic that of a brain tumor. Symptoms in children range from poor appetite, teeth grinding, hyperactivity, nervousness, irritability, insomnia, bed wetting, stomach aches, nausea and vomiting, to more severe forms including epileptic seizures, vision problems, mental depression, appendicitis, and anorexia. Eggs are seldom found in the feces, but are laid around the anus at night. It is often necessary to treat the entire family simultaneously and repeat the process in abou two weeks since reinfection is extremely common.
- Strongyloides (Strongyloides stercoralis)
- Is a unique nematode. Sometimes called a threadworm, the mature adult can reproduces entirely in the human host or can grow freely in soil. In humans, they produce autoinfections and can remain in the body for more than thirty years. Extremely difficult to diagnose, strongyloides are found mainly in southeast Asia, the Middle East, South America, and the southeastern part of the US. The life cycle and pathology is similar to that of the hookworm, except that the eggs hatch into larvae inside the intestines before passing in the feces. The larvae enter the human body by penetrating the skin, or through pores and hair follicles. Most often penetration is between the toes or at the bottom of the feet. The larvae then travel to the intestines, where they reach maturity. If the larvae invade lung tissue or the intestinal wall, a fatal condition called disseminated strongyloides sometimes develops. Pulmonary disorders, abdominal pain and bloating along with greasy-stool diarrhea are the primary symptoms, with infections lasting more than thirty years. The pulmonary disorders often show up in AIDS victims. The parasite seems to be relatively harmless if the immune system is functioning properly.
More severe infections are characterized by abdominal pain and bloating, nausea, vomiting, alternating diarrhea and constipation, and greasy stools. The liver and pancreas ducts, the entire small bowel, colon, heart, lungs, and CNS may all be involved in malabsorption caused by the worms. With a heavy infestation, a person may complain of heartburn and tenderness often aggravated by food intake. A pain like that of peptic ulcer associated with an elevated eosinophil count on blood tests often indicates a Strongyloides infection. Chronic reinfection can lead to a disease state lasting thirty years. Lab tests find the parasite in blood samples as eggs are rarely found in stool samples, except after a violent purge of diarrhea.
- Guinea worm (Dracunculus medinensis)
- Is one of the more serious discomforts of India, Africa, and Asia. Humans become infected by drinking impure water containing copepods (small crustaceans) infected with the larvae of the guinea worm. Following ingestion, the copepods die, releasing the larvae, which penetrate the stomach and intestinal wall of the host, thereby entering the abdominal cavity. After maturation, the worms copulate, and the males die. The female can be over a meter long, but the male is only about two or three centimeters (about an inch). About a year after the initial infection, the female migrate towards the surface of the skin, where it will settle down just under the skin, looking like a coiled vericose vein. This is usually occurs on the lower extremities. Symptoms begin with vomiting, diarrhea, and dizziness as the worm makes its way through the body. The area produces a blister and the patient, seeking relief, turns to bathing the area. When the lesion comes in contact with water, the female worm emerges, rupturing the blister and discharging a milky white fluid containing thousands of larvae into in water. Only water will cause her to deposit her eggs. Upon release, they go on to be ingested by a crustacean called a ‘cyclops’ (a copepod) and two weeks later, the cycle begins again. In an October, 1995 People Magazine article, the guinea worm was reported to have emerged from the back of a child’s head and from under the tongue of a man who eventually starved to death because the area was too painful to permit eating. Native medicine men remove the worms slowly by winding them onto a stick. It is a long process, requiring only a turn or two a day. It is not uncommon to see people walking around with a stick taped to their legs and good-sized worms coiled around them. If the procedure is not done properly, bacterial infections develop. After serious efforts towards hygiene and purified water, the disease is being eradicated. Where once several million people were affected, the numbers are now fewer than 200,000.