What are threadworms and how do you get rid of them?

If your child is extra wriggly on their seat or complaining about an itchy bum, they may have threadworms. Here are the facts on these intestinal parasites.

Threadworms are often harmless but can cause your child to experience some discomfort.

And while threadworms are easy to treat, they are also very easy to catch.

Anyone can get a threadworm infection, but it’s common in kids.

“Even in a country like Australia with pretty good health services and hygiene, anywhere between 10 to 15 per cent of kids will get threadworms at some point,” The House of Wellness TV co-host Dr Nick Carr says.

From recognising the symptoms of an infection to preventing the threadworms from spreading and getting rid of them, here is how to keep yourself and your kids healthy.

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What are threadworms?

Threadworms are a common parasite that live in the intestine and around the bottom.

“Threadworms, otherwise called pinworms, are tiny parasitic worms that commonly infect the human intestine and are particularly prevalent in children,” paediatrician Dr Sarah Arachchi, of @kidsdoctorsarah, says.

The infection and spread of threadworms come down to eggs — if a child scratches their bottom and touches a surface, microscopic eggs can be picked up on another child’s hands.

Once ingested, eggs travel to the intestine and anus where they hatch and rapidly reproduce.

It’s estimated that one female threadworm can lay up to 16,000 eggs.

What do threadworms look like?

True to their name, threadworms look a bit like thread.

“Threadworms lay eggs around the bottom, which are too tiny to see, but the worms themselves do look like little cotton threads,” Dr Carr says.

“They’re white or sometimes yellow in colour, and about 1cm in length.

“They’re also pretty thin, only about 1mm in width, and generally quite tiny.”

How do you know if you have threadworms?

An itchy bottom is the main symptom of a threadworm infection.

“If a child has a persistently itchy bum, then it’s likely they have worms,” Dr Carr says.

“Kids often have redness or irritation in that area too because they’ve been scratching.

“Girls will sometimes get irritation around the front as well, which is what we call vulvovaginitis, and it’s commonly associated with threadworms.”

Threadworms are active at night, which can make for more intense itchiness and disrupted sleep.

“Kids can get a bit itchy and irritable, and can get a bit out of sorts because they’re not sleeping well,” Dr Carr says.

This also means night-time is the best time to confirm any threadworm suspicions and look for worms around a child’s bottom.

“Parents can have a look at their child’s bottom at night-time because that’s when the worms come out, and you’ll sometimes see them wriggling around near the anus,” Dr Carr says.

“Sometimes you can see threadworms on toilet paper, in the poo or around the bottom.”

Alternatively, sticky tape can catch eggs and confirm a case of threadworms.

“If you’re not sure or suspicious of threadworms, you can place a bit of sticky tape around your child’s bottom overnight to try and pick up any threadworm eggs,” he says.

“You can take that into your doctor to get looked at under a microscope.”

Why are kids more likely to get threadworms?

Threadworms are easily spread, which makes them common among preschool and school-aged children.

“Children are predisposed to threadworm infections due to their frequent interactions with contaminated surfaces, less stringent hygiene practices, and closer proximity to peers in communal settings like schools and daycare centres,” Dr Arachchi says.

And while thorough handwashing can limit the spread, Dr Carr says threadworms shouldn’t be associated with poor hygiene or other factors.

“There tends to be a bit of a stigma around this,” he says.

“Threadworm infections can happen to families in every circumstance, and it’s often a normal part of growing up.”

How do you get threadworms?

Threadworms can affect children and adults, and infection comes down to the spread of small eggs we can’t see.

The Royal Children’s Hospital notes that these eggs can survive up to two weeks outside the body and contaminate surfaces, food and even dust.

While threadworms can start with one child, Dr Carr says it’s easy for infection to spread within a household.

“You should treat the whole house even if they don’t have symptoms, because chances are at least one other member of the family will have picked up threadworms,” he says.

And before you point your finger at your pet, the Victorian Government notes that threadworms from animals can’t be transferred to humans.

How do you treat threadworms?

Over-the-counter medication is an easy and effective way to treat threadworms, and comes in a tablet or even a chocolate form that is easy for kids to take.

“Treatment for threadworms typically involves anthelmintic medications, which effectively eliminate the parasites,” Dr Arachchi says.

But treatment doesn’t stop at one tablet. Dr Arachchi suggests all family members take medication even if they do not have symptoms to prevent spread and reinfection.

“Recurrence is common, especially if preventive measures and hygiene practices aren’t diligently followed post-treatment,” she says.

Dr Arachchi recommends the following preventative measures:

  • Shower the night after taking the medication and the next morning, to help remove eggs laid overnight
  • Wash bedding, clothing and toys in warm water
  • Vacuum floors
  • Clean high-traffic surfaces such as benchtops, remote controls and door handles.

A threadworm infection is often mild and, at most, an uncomfortable experience, but Dr Arachchi says follow-up is still important.

“It’s important to follow up with your GP to ensure your child’s symptoms do improve,” she says.

“Always take them for a medical review if there are other symptoms such as nausea, vomiting, low energy levels, abdominal pain or if they pass a large worm.”

Can threadworms go away without treatment?

If you adhere to strict hygiene measures, threadworms can die off on their own.

However, Dr Arachchi says treatment is always advised.

“The lifespan of a worm is around six weeks so it is possible (to get rid of threadworms) by adhering to strict hygiene; however, there is a risk — rare but possible — of UTIs and vaginitis that may occur,” she says.

“Treatment is advised over a watch-and-wait approach to minimise the risk of transmission to others and prevent potential complications.”

Medication will kill the worm but not the eggs, which is why good hygiene is still important.

“Whilst medication will treat the worm, it will not kill the eggs and so strict hygiene measures are necessary in order to prevent reinfection,” Dr Arachchi says.

“Some people will need to take a second course of the treatment two weeks later.”

If you are unsure about treatment for you or your child, consult your doctor for advice.

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 Written by Hayley Hinze.