14/8/2015

CDCEnterobiasisGeneralInformationFrequentlyAskedQuestions

PinwormInfectionFAQs
Whatisapinworm?
Apinworm("threadworm")isasmall,thin,whiteroundworm(nematode)calledEnterobius
vermicularisthatsometimeslivesinthecolonandrectumofhumans.Pinwormsareaboutthe
lengthofastaple.Whileaninfectedpersonsleeps,femalepinwormsleavetheintestinethrough
theanusanddeposittheireggsonthesurroundingskin.

Whatarethesymptomsofapinworminfection?
Pinworminfection(calledenterobiasisoroxyuriasis)causesitchingaroundtheanuswhichcan
leadtodifficultysleepingandrestlessness.Symptomsarecausedbythefemalepinwormlaying
hereggs.Symptomsofpinworminfectionusuallyaremildandsomeinfectedpeoplehaveno
symptoms.

Whoisatriskforpinworminfection?
Pinworminfectionoccursworldwideandaffectspersonsofallagesandsocioeconomiclevels.Itis
themostcommonworminfectionintheUnitedStates.Pinworminfectionoccursmostcommonly
among
schoolagedandpreschoolagedchildren,
institutionalizedpersons,and
householdmembersandcaretakersofpersonswithpinworminfection.
Pinworminfectionoftenoccursinmorethanonepersoninhouseholdandinstitutionalsettings.
Childcarecentersoftenarethesiteofcasesofpinworminfection.

Howispinworminfectionspread?
Pinworminfectionisspreadbythefecaloralroute,thatisbythetransferofinfectivepinworm
eggsfromtheanustosomeonesmouth,eitherdirectlybyhandorindirectlythrough
contaminatedclothing,bedding,food,orotherarticles.
Pinwormeggsbecomeinfectivewithinafewhoursafterbeingdepositedontheskinaroundthe
anusandcansurvivefor2to3weeksonclothing,bedding,orotherobjects.Peoplebecome
infected,usuallyunknowingly,byswallowing(ingesting)infectivepinwormeggsthatareon
fingers,underfingernails,oronclothing,bedding,andothercontaminatedobjectsandsurfaces.
Becauseoftheirsmallsize,pinwormeggssometimescanbecomeairborneandingestedwhile
breathing.

Canmyfamilybecomeinfectedwithpinwormsfromswimmingpools?
Pinworminfectionsarerarelyspreadthroughtheuseofswimmingpools.Pinworminfections
occurwhenapersonswallowspinwormeggspickedupfromcontaminatedsurfacesorfingers.
Althoughchlorinelevelsfoundinpoolsarenothighenoughtokillpinwormeggs,thepresenceofa
smallnumberofpinwormeggsinthousandsofgallonsofwater(theamounttypicallyfoundin
pools)makesthechanceofinfectionunlikely.

Mylittlekidsliketocobathecouldthisbehowtheyarebecoming
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CDCEnterobiasisGeneralInformationFrequentlyAskedQuestions

infected?
Duringthistreatmenttimeandtwoweeksafterfinaltreatment,itisagoodideatoavoidco
bathingandthereuseorsharingofwashcloths.Showeringmaybepreferredtoavoidpossible
contaminationofbathwater.Carefulhandlingandfrequentchangingofunderclothing,night
clothes,towels,andbeddingcanhelpreduceinfection,reinfection,andenvironmental
contaminationwithpinwormeggs.Theseitemsshouldbelaunderedinhotwater,especiallyafter
eachtreatmentoftheinfectedpersonandaftereachusageofwashclothsuntilinfectioniscleared.

Didmypetsgivemepinworms/canIgivepinwormstomypets?
No.HumansareconsideredtobetheonlyhostsofE.vermiculariswhichisalsoknownasthe
humanpinworm.

Howispinworminfectiondiagnosed?
Itchingduringthenightinachildsperianalareastronglysuggestspinworminfection.Diagnosisis
madebyidentifyingthewormoritseggs.Wormscansometimesbeseenontheskinneartheanus
oronunderclothing,pajamas,orsheetsabout2to3hoursafterfallingasleep.
Pinwormeggscanbecollectedandexaminedusingthetapetestassoonasthepersonwakesup.
Thistestisdonebyfirmlypressingtheadhesivesideofclear,transparentcellophanetapetothe
skinaroundtheanus.Theeggssticktothetapeandthetapecanbeplacedonaslideandlookedat
underamicroscope.Becausewashing/bathingorhavingabowelmovementcanremoveeggsfrom
theskin,thistestshouldbedoneassoonasthepersonwakesupinthemorningbeforetheywash,
bathe,gotothetoilet,orgetdressed.Thetapetestshouldbedoneonthreeconsecutive
morningstoincreasethechanceoffindingpinwormeggs.
Becauseitchingandscratchingoftheanalareaiscommoninpinworminfection,samplestaken
fromunderthefingernailsmayalsocontaineggs.Pinwormeggsrarelyarefoundinroutinestool
orurinesamples.

Howispinworminfectiontreated?
Pinwormcanbetreatedwitheitherprescriptionoroverthecountermedications.Ahealthcare
providershouldbeconsultedbeforetreatingasuspectedcaseofpinworminfection.
Treatmentinvolvestwodosesofmedicationwiththeseconddosebeinggiven2weeksafterthe
firstdose.Allhouseholdcontactsandcaretakersoftheinfectedpersonshouldbetreatedatthe
sametime.Reinfectioncanoccureasilysostrictobservanceofgoodhandhygieneisessential(e.g.
properhandwashing,maintainingcleanshortfingernails,avoidingnailbiting,avoidingscratching
theperianalarea).
Dailymorningbathinganddailychangingofunderwearhelpsremovesalargeproportionofeggs.
Showeringmaybepreferredtoavoidpossiblecontaminationofbathwater.Carefulhandlingand
frequentchangingofunderclothing,nightclothes,towels,andbeddingcanhelpreduceinfection,
reinfection,andenvironmentalcontaminationwithpinwormeggs.Theseitemsshouldbe
launderedinhotwater,especiallyaftereachtreatmentoftheinfectedpersonandaftereachusage
ofwashclothsuntilinfectioniscleared.

Shouldfamilyandotherclosecontactsofsomeonewithpinwormalsobe
treatedforpinworm?
Yes.Theinfectedpersonandallhouseholdcontactsandcaretakersoftheinfectedpersonshould
betreatedatthesametime.
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Whatshouldbedoneifthepinworminfectionoccursagain?
Reinfectionoccurseasily.Preventionalwaysshouldbediscussedatthetimeoftreatment.Good
handhygieneisthemosteffectivemeansofprevention.Ifpinworminfectionoccursagain,the
infectedpersonshouldberetreatedwiththesametwodosetreatment.Theinfectedpersons
householdcontactsandcaretakersalsoshouldbetreated.Ifpinworminfectioncontinuestooccur,
thesourceoftheinfectionshouldbesoughtandtreated.Playmates,schoolmates,closecontacts
outsidethehome,andhouseholdmembersshouldbeconsideredpossiblesourcesofinfection.Each
infectedpersonshouldreceivetherecommendedtwodosetreatment.

Howcanpinworminfectionandreinfectionbeprevented?
Strictobservanceofgoodhandhygieneisthemosteffectivemeansofpreventingpinworm
infection.Thisincludeswashinghandswithsoapandwarmwaterafterusingthetoilet,changing
diapers,andbeforehandlingfood.Keepfingernailscleanandshort,avoidfingernailbiting,and
avoidscratchingtheskinintheperianalarea.Teachchildrentheimportanceofwashinghandsto
preventinfection.
Dailymorningbathingandchangingofunderclotheshelpsremovealargeproportionofpinworm
eggsandcanhelppreventinfectionandreinfection.Showeringmaybepreferredtoavoidpossible
contaminationofbathwater.Carefulhandling(avoidshaking)andfrequentlaunderingof
underclothes,nightclothes,towels,andbedsheetsusinghotwateralsohelpsreducethechanceof
infectionandreinfectionbyreducingenvironmentalcontaminationwitheggs.
Controlcanbedifficultinchildcarecentersandschoolsbecausetherateofreinfectionishigh.In
institutions,massandsimultaneoustreatment,repeatedin2weeks,canbeeffective.Hand
hygieneisthemosteffectivemethodofprevention.Trimmingandscrubbingthefingernailsand
bathingaftertreatmentisimportanttohelppreventreinfectionandspreadofpinworms.
Moreon:Handwashing(/handwashing)
Thisinformationisnotmeanttobeusedforselfdiagnosisorasasubstituteforconsultation
withahealthcareprovider.Ifyouhaveanyquestionsabouttheparasitesdescribedaboveor
thinkthatyoumayhaveaparasiticinfection,consultahealthcareprovider.
Pa g ela st r ev iew ed:Ja n u a r y 1 0 ,2 0 1 3
Pa g ela st u pda t ed:Ja n u a r y 1 0 ,2 0 1 3
Con t en t sou r ce:Globa lHea lt h Div ision ofPa r a sit icDisea sesa n dMa la r ia
Not ice:Lin k in g t oa n on feder a lsit edoesn ot con st it u t ea n en dor sem en t by HHS,CDCor a n y ofit sem ploy eesoft h e
spon sor sor t h ein for m a t ion a n dpr odu ct spr esen t edon t h esit e.

CentersforDiseaseControlandPrev ention1600CliftonRd.Atlanta,GA
303294027 ,USA
800CDCINFO(8002324636)TTY :(888)2326348ContactCDCINFO

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