Roundworms: what are they? how are they transmitted?

Roundworms are very thin black worms that can reach a length of 30 centimeters in female specimens and 20 in male specimens. The scientific name is Ascaris lumbricoides  and they are quite common parasites in tropical areas, where in addition to children , who are still the preferred guests, these worms also infect adults to a greater extent than in countries with a temperate climate.

Poor hygienic conditions also play an important role in the transmission of this parasitosis.

These black worms do not need an intermediate host to infect humans or other animals. Transmission is faecal gold, i.e. the roundworms lay their eggs in the intestine of the person affected by the infestation. They are disseminated in the surrounding environment mostly thanks to the faeces.

Once ingested, the eggs hatch releasing larvae that begin to develop also from a reproductive point of view and then spread to other organisms as well.

Before reaching the adult specimen, two weeks will have to pass from the infection. In a single day, an adult female can lay thousands of eggs which are released outside, where they manage to survive for a long time, especially in precarious hygienic conditions and in hot and humid climates.

Once ingested, the eggs take from 10 days to two weeks to hatch and begin a life cycle in the new host.

What are the symptoms of ascariasis?

Roundworms, or the black worms of today’s driving, give rise to a parasitosis characterized by quite varied symptoms, but in most cases it presents itself with a completely asymptomatic course. Sometimes disturbances may appear immediately or arrive after a few weeks.

The immediate symptoms, when they appear, affect the upper airways and are manifested by cough, dry throat, difficulty breathing. I’ll explain why.

When the ingested eggs hatch in the intestine, the larvae pass through the intestinal wall and reach the bloodstream, through which they reach the airways to then be swallowed and arrive in the intestine in their adult form. It can therefore be said that the maturation of roundworms takes place around the body. This explains why, if there are symptoms in the initial phase, these concern the respiratory system and not the intestine.

Symptoms that occur after the incubation period only affect the intestinal tract, and are very common to other types of parasitosis or other intestinal pathologies. There is persistent diarrhea, pain, abdominal cramps, nausea and vomiting.

Diagnosis

When these symptoms are observed, one should never proceed with self-medication as there is a risk of creating further damage. The first thing to do is to contact your doctor or pediatrician immediately in order to report all the disturbances and allow him to proceed with a diagnosis to establish the right treatment.

Live black worms are often visible inside the feces that move and it is this phenomenon that alarms mothers and prompts them to contact the pediatrician, who after a careful anamnesis will recommend a parasitological examination to identify the worm.

Treatment

We have several anthelmintic drugs available for the treatment of ascariasis, which are the same ones used in pinworm disease as well. The therapeutic scheme consists in the administration of an anthelmintic drug in a single dose, to be repeated in the same way after two weeks, time in which any eggs, on which these drugs have no effect, take time to hatch.

Family members and anyone who has been in contact with the patient are also subjected to the treatment, but not because a contagion between individuals is possible, but because the eggs are concentrated in the tissues, on objects and in the whole environment shared by several subjects.

The drugs in question are:

• Vermox® whose active ingredient is mebendazole. It is a well tolerated drug as only a minimal part of the administered dose is absorbed, and almost all of this is bound by plasma proteins and rapidly metabolized to inactive metabolites by the liver. However, absorption increases if the administration is accompanied by a meal rich in fat, decreasing the amount of mebendazole which acts on the parasites in the intestine. This is why it is convenient to administer it away from the meal. Furthermore, the efficacy of the drug is linked to the intestinal transit time and the entity of the infestation.

The dosage should be adjusted according to the weight of the child for which the drug is formulated in oral solution, while for adults it is present in tablets.

• Combantrin® , whose active ingredient is pyrantel pamoate. It is a broad spectrum anthelmintic, which works by paralyzing the worm until it dies.
• Zentel® , whose active ingredient is albendazole. It is a broad spectrum drug, in fact it is also used in other types of parasitosis as well as in ascaridiasis.

Naturally, the doctor will decide which drug is most appropriate for the individual case. It should be remembered that pinworms are parasites and not bacteria, so antibiotics are not absolutely effective.

How to prevent them?

As already specified, for roundworms, as well as for all intestinal parasites, hygienic conditions are really very important. Since eggs are often concentrated on the hands, and especially under the nails, it is always a good habit to wash your hands before putting them on food, wash fruit and vegetables, especially if eaten raw, avoiding consuming uncooked dishes especially when travelling. .

Furthermore, once ascaridiosis in a child has been ascertained, the structures frequented by the latter must be notified, so that the parents of all children who have been in contact can have their children subjected to checks to find out if they have been infected and, if so, start a cure immediately, naturally referred by their doctor.