Author: Daniel Jun Yi Wong, Medical Student, University of Melbourne, Australia, 2013.
What are whipworms?
Whipworms, or Trichuris trichiura, are nematodes, a type of parasitic worm that infects the intestines of humans. Whipworm infection is also known as trichuriasis. The worm is named after its whip-like shape and buries its threadlike anterior half into the intestinal wall to feed on tissue secretions.
Whipworm infection occurs commonly in tropical areas of Asia and, less commonly in Africa and South America.
What are the symptoms of trichuriasis?
The symptoms of trichuriasis vary depending on the severity of infection. Some individuals with light infections may be asymptomatic. More severely infected individuals can experience diarrhoea and painful defaecation. Stools can become loose and contain blood with mucus. Moderate to severe infections may cause vague abdominal pain and the need to pass stools at night. Infected people tend to feel tired. In very severe infections patients may show symptoms of anaemia.
Worms can sometimes become directly visible on the irritated anus.
Who is at most risk of trichuriasis?
Children are particularly vulnerable to trichuriasis. Infection in children can cause growth retardation and impair normal development.
How does trichuriasis spread?
Trichuriasis is associated with poor hygiene. Children are particularly vulnerable to infection, particularly in developing countries. It is thought that partial immunity to whipworms develops with age.
How is trichuriasis confirmed?
Trichuriasis is diagnosed by looking under the microscope for whipworm eggs in the stool. Sometimes, the adult worms can be seen on proctoscopy or colonoscopy. A female whipworm produces up to 20,000 eggs per day.
How is trichuriasis treated?
Treatment of trichuriasis is with anthelminthic medication such as mebendazole or albendazole.
Prevention of infection is equally important. Children and adults should wash hands before handling food, and wash, peel, and cook food fully before eating. Improving sanitation is the best way to eradicate trichuriasis.
Are anti-worm medications safe in pregnancy?
Mebendazole and albendazole are best avoided in pregnancy. The doctor will weigh up the benefits of treatment for the mother and risk to the fetus. Mild trichuriasis is asymptomatic and delaying treatment until after delivery is an option.