YIKES! HAVE I GOT WORMS?
From worms to scabies, could unwanted guests be what’s making you itch? THREADWORMS — so-called because they look like tiny pieces of white thread, about 1cm long — are parasites that infect the large intestine and are the most common worm infection in the UK. They are harmless — if unpleasant. The main symptom is an itchy bottom and you may see the white worms in stools or on bedsheets.
‘Threadworms are unusual in adults because they are due to poor hygiene [scratching the bottom and putting your fingers in the mouth], and usually we only see them in children,’ says Dr Ana Wilson, a consultant gastroenterologist at St mark’s Hospital, Harrow. ‘But if someone is infected in a family, it’s best to treat everyone.’
Threadworms eggs can easily be transferred to bedsheets, towels and clothing — and then can be picked up by others.
‘A course of the antibiotic mebendazole will get rid of them,’ adds Dr Wilson.
If you’re planning an exotic holiday, beware of catching a ROUNDWORM infection. roundworm is often picked up through eating unwashed salads and fruit in developing countries in Africa and parts of Asia, explains Professor Chuka Nwokolo, a consultant gastroenterologist at Spire Parkway Hospital in Solihull.
‘Anyone who doesn’t pay careful attention to washing their hands or making sure the food they eat is either boiling hot — or in the case of fruit and vegetables washed carefully — is at risk.’
It’s also possible for eggs to be transferred from your hands to your mouth after touching contaminated soil — roundworm is common in cats and dogs and its eggs are released in faeces of infected animals.
A parasite which lives in the gut, roundworm rarely causes symptoms at first.
‘often the first anyone will know they have one is when they see a worm which looks like a piece of string and can be up to three or four inches long in their stool,’ adds Professor Nwokolo.
Left untreated, the condition can start to cause diarrhoea, says Dr richard Pollok, a consultant gastroenterologist at St George’s Hospital and medical School, London. ‘It can also cause asthmatype symptoms such as wheezing or coughing because the roundworm switches on a side of the immune system which produces this kind of reaction.’
It’s treated with a three-day course of the drug mebendazole, which stops the roundworms using glucose, without which they die.
A serial offender when it comes to itchy infections is
RINGWORM. The first thing to say about ringworm is that it’s a misnomer. It’s not actually a worm at all, it’s a fungus.
Different branches of the tinea family, to give ringworm its formal name, colonise different parts of the body. For example, tinea pedis, better known as athlete’s foot, is a form of the fungus that thrives in sweaty trainers and between toes.
Tinea cruris — affecting the groin, and sometimes called jockstrap itch — has equally dubious tastes, while tinea capitis colonises the scalp, tinea barbae likes bearded regions and tineas manus and faciei are at home on our hands and faces, respectively. ringworm infections such as these show themselves in roughly circular ‘fairy rings’ of red or silvery inflamed skin, often as large as a 50p piece. Different symptoms, though, crop up in different parts of the body. ringworm on the face lacks the rings but appears as a collection of small red spots, often pusfilled. Likewise, there are no rings between the toes in athlete’s foot (see cover). ringworm won’t kill you, but it can be infuriatingly itchy. It’s important not to selfdiagnose, says Walayat Hussain, a consultant dermatologist at Leeds Teaching Hospitals NHS Trust. ‘one of the problems we have is that people over-diagnose themselves with fungal infections of the skin,’ he says, when, in fact, it’s eczema or some other skin condition. ‘If you are worried you have one, go to your GP first. You can have circular patches of eczema, which get labelled ringworm simply because they are circular.’
A rash of tiny red, intensely itchy spots and silvery lines on the
skin can be a sign of SCABIES, caused by tiny eight-legged para sitic mites that burrow into human flesh.
Smaller than the point of a needle, and all but invisible to the naked eye, the silvery tracks the females leave as they eat and
tunnel their way under the top layer of skin to lay their eggs can be seen — and most certainly felt.
‘This creates a very, very itchy rash,’ says consultant dermatologist Juber Hafiji, a spokesman for the British Skin Foundation.
‘I see patients absolutely at the end of their tether with scabies.’ Although over-crowding and poor hygiene make it more likely, scabies is ‘no discriminator’, says Dr Hafiji.
‘Anybody can get it any time because it is highly infectious, usually through close contact — children in nurseries often pass it on.’ It is also common in care homes.
Creepily, victims rarely become aware of the mite until about a month after it has moved in, which is when the itching usually starts.
Resisting the urge to scratch is almost impossible and the infected skin can end up covered in crusty sores, which can become infected.
The mites are found mainly in the folds of skin between fingers and toes, the palms of the hands, the wrists, ankles and soles of the feet, groin and breasts.
THe good news is that scabies can be dealt with using over-thecounter treatments, including permethrin cream and malathion liquid. The bad news is that this is a major undertaking, and many people fail to see it through, says Walayat Hussain.
Because the mites can lurk anywhere, treatment must be applied to all areas of skin below the neck in adults, and all areas of skin in children, including the scalp.
And all treatments must be left on for at least 12 hours before they can be washed off. If you wash any part of your body during that time, you’ll have to re-apply the treatment there.
And once is never enough — the whole procedure has to be repeated a week later, to make sure you’ve caught any mites that have hatched out since the first treatment.
‘Not infrequently, I see students who have just started at university, and I have to convince them that they have to get a room-mate or one of their best mates to apply this in the areas they cannot reach,’ says Mr Hussain.
‘Proper application of scabies treatment needs someone else to help you.’
Infected clothing and bed linen should be washed at the highest possible temperature.