What Are Roundworms

Overview

Roundworms (also known as nematodes) are organisms with a long round body that live in your intestine. They vary in length and are commonly seen in tropical countries. Children are more affected than adults.

Roundworms are small organisms that can live in your digestive system for a long time. These worms mature from larvae or eggs to adult worms in your body. They commonly get into the body when a person gets them on their hands and transfers them to the mouth. Some worms can also get through the skin. They can be harmful and cause symptoms like abdominal pain, fever and diarrhoea.

Most are mild cases with no symptoms, but in case of heavy infestation, it can lead to serious symptoms and complications. Mostly, it affects the children from areas with poor sanitation and hygiene.

Key characteristics

Roundworms are parasites which live on or in another creature to survive; this can cause problems for the host (the creature the parasite depends on). Roundworms need the human body or other animals to survive, lay eggs, and mature them. Roundworms can infect anyone at any time. Entering into the body varies with each type of roundworm. Commonly, they enter through the mouth. Infection often happens by touching the stool (poop) or soil that is infected with eggs and using it without washing the hands (faecal-oral route). Roundworms are in different types, but most commonly, they end up in the intestines, causing infection.

The life cycle of a worm

• Ingestion

They are very tiny and can only be seen through a microscope. They are seen in stool (poop) and the soil which comes in contact with it. People can accidentally ingest the roundworm by hand-to-mouth contact and by eating fruits or raw vegetables that have been grown in the contaminated soil.

• Migration

Once ingested, larvae hatch the eggs in the small intestine, travel through the intestinal wall and reach up to the heart and lungs through the bloodstream or lymphatic system. After surviving in the lungs, it causes infection where the larva breaks into the airway and travels up to the throat, where the infected person coughs and swallows the phlegm (sputum) back into the intestine.

• Maturation

Once they reach the intestine, they grow and transform into male or female worms. Female worms are longer than the male worms.

• Reproduction

Female worms can lay 200,000 eggs per day; they leave the body through the faeces. Then, the fertilised eggs reach the soil, and they can survive for at least 2 to 4 weeks in the soil before they come in contact with a body.

Causes

Roundworms are mostly affected by poor sanitation and hygiene. Most of them are found in the soil and come in contact with hands and they travel into the mouth, some kind of roundworm can pass through the skin also. There are different types of roundworm, and the causes and symptoms are : 

• Ascaris lumbricoides: Ascaris lumbricoides is the most common roundworm infection that affects people worldwide. This spreads through poor hygiene, and it often lives in human stool (poop). People get infected by hand-to-mouth contact and having unwashed fruits and vegetables grown in contaminated soil. It can cause symptoms like :
  • Cough
  • Fever
  • Abdominal pain
  • Diarrhoea
  • Disturbed sleep
  • Vomiting
  • Malnutrition
  • Growth retardation

• Guinea worm disease (dracunculiasis): People get infected by guinea worm by drinking contaminated water. The larva grows and matures in the small intestine, and they travel into other areas of the body and come out through the skin like a painful blister; they lay eggs in the water when the blister comes in contact with the water.^1,2 Some of the symptoms are : 
  • Fever
  • Swelling
  • Pain in the area affected
  • Redness

• Hookworm: Hookworm infection occurs when the larva comes in contact with the human skin through contaminated soil or faeces. At the same time, walking barefoot in the dirt mixed areas with infected stool (poop). Children are mostly affected. The worms go through the skin to the lungs and reach the small intestine where they mature and lay more eggs, they feed on the blood of the infected person.³ Some symptoms that may appear are : 
  • Anaemia
  • Abdominal pain
  • Diarrhoea
  • Nausea
• Pinworm: Pinworm is the most common infection that occurs in children, and it is commonly seen in schools and daycare centres. The female pinworms lay eggs in and around the anus, and without realising it, people touch them with their fingers; for example, children may scratch their bottom or not wash their hands after using the bathroom; in the case of parents, they may not wash their hands properly after changing the diaper of a child. After touching the affected area, people may put their fingers in or near the mouth or touch surfaces like cloths, toys, doorknobs, furniture and faucets; the pinworm may exist for up to 2 weeks. Some of the symptoms are : 
  • Itching around the anus
  • Difficulty in sleeping
  • Restlessness
  • Teeth grinding

• Strongyloidiasis: Strongyloidiasis enters through the skin and reaches the small intestine. People get infected by touching the contaminated soil. This usually happens when people walk barefoot on contaminated soil, and the larvae get into the body through skin.⁵ Some of the symptoms are : 
  • Abdominal pain
  • Nausea and vomiting
  • Diarrhoea
  • Anaemia
  • Weight loss

• Trichinellosis: People get infected by eating undercooked meat like pork, sausage and bear meat. In this type, the larvae mature in the small intestine, and they move into the muscle cells and affect them; they live for months and years.⁶ Some of the mild symptoms are : 
  • Diarrhoea
  • Abdominal pain
  • Eye infection
  • High fever
  • Muscle pain
  • Swelling in the face

• Whipworm: Whipworm is affected when the person eats contaminated food that grows in the soil, which contains the egg of the worm. Some of the  symptoms are : 
  • Blood in the stool (poop)
  • Diarrhoea
  • Abdominal pain
  • Weight loss
  • Anaemia

Symptoms

Symptoms vary depending on the type of roundworm causing the infection. Commonly, people may not show any symptoms, but in severe cases, some of the common symptoms are : 

• Malnutrition (in children)
• Fever
• Tiredness
• Abdominal pain
• Wheezing: Difficulty in breathing
• Vomiting
• Diarrhoea
• Itching around the anus

Risk for roundworms

Anyone can be affected by roundworms, but they are more common in children, and people who are at risk are : 

• People living in undeveloped areas where there is no proper hygiene
• People living in prison and mental health facilities
• People living in a tropical climate
• Weakened immunity
• Malnutrition
• Eating uncooked meat and unwashed fruits and vegetables
• Children playing in the playground
• People who come in contact with animal faeces

Diagnosis

Proper diagnosis helps identify the worm-causing infection and provides the proper treatment. The health provider takes a complete medical history of the patient and does the physical examination; other tests are : 

• Blood test: A complete blood count is done; if eosinophils are elevated, it may be due to any infection present.
• Stool and urine analysis: Urine analysis is done to determine the presence of microorganisms. Healthcare providers may advise for stool examination, where a small piece of stool is examined under a microscope to see any eggs or larvae.
• Muscle or skin biopsy: A small tissue of skin in the affected area is taken to examine under a microscope to find the causative factor.
• Ultrasound: These sound waves help to create images of the internal organs. Ultrasound helps in showing any worm affection in the pancreas or liver.
• X-ray: X-ray helps in identifying the area affected and shows whether any worms are present in the abdomen. A chest x-ray shows if any larvae are present in the lungs.
• Tape test: This test is particularly used to identify pinworm infection. In this test, the doctor pastes a sticky tape around the anus, and then the tape is taken to be examined under a microscope.⁴

Treatment and management

Roundworm infection is controlled or treated by proper medications, improved sanitary methods and health education.

Medications

Anti-parasite medications are used to treat roundworm infection; the most commonly used medicines are albendazole, ivermectin and mebendazole. Pregnant women and children should consult the doctor before taking medications. Some people may experience mild side effects of the medicine, such as abdominal pain and diarrhoea.

Surgery

In severe cases of roundworm infection, surgery may be needed to remove worms from the affected area and repair the damage it has caused. In some cases, it may obstruct the intestine or other organs.

Preventive measures

Roundworm infection can infect anyone at any time; they can be prevented by following certain things: 

• Maintain a proper personal hygiene
• Pet safety by cleaning the animal poop immediately from the place and then washing the hands
• Having cooked meat
• Taking washed fruits and vegetables
• Drink boiled or bottled water
• Practise washing hands before having food
• Taking a proper balanced diet food
• Proper exercise

FAQs

When should I consult a doctor

Roundworm infection may not have any symptoms in some cases, but in case of severe infection, there will be symptoms like itching in the anus, rashes on the skin, diarrhoea for more than a week, unexplained weight loss and presence of worms in the stool (poop). If these symptoms are present it is advised to consult the doctor immediately.

How do roundworms enter the human body?

Roundworms can infect humans if the person has contaminated food or water. It is also possible that some roundworms can enter through the skin when it comes in contact with contaminated stool (poop) or soil.

Are roundworms easy to treat

Roundworms are usually easy to treat and will take 3 to 4 days after deworming. In some severe cases, there may need surgery to remove the worms.

What should I do at home if I have a roundworm infection

Take the prescribed medicines properly. Maintain personal hygiene, wash hands properly before eating, and wash clothes and bedding in hot water.

Summary

Roundworms (also known as nematodes) are organisms with a long round body that live in your intestine. Roundworms need the human body or other animals to survive,  lay eggs, and mature. Roundworms can infect anyone at any time. Entering into the body varies with each type of roundworm. Commonly, they enter through the mouth. Infection often happens by touching the stool (poop) or soil that is infected with eggs and using it without washing the hands (faecal-oral route). They commonly get into the body when a person gets them on their hands and transfers them to the mouth. Some worms can also get through the skin. They can be harmful and cause symptoms like abdominal pain, fever and diarrhoea. Deworming is the treatment used in treating roundworms.