Ascariasis

• An infection that is caused by the roundworm Ascaris lumbricoides, many cases of which remain asymptomatic.
• During the transient larval migratory phase, shortness of breath, fever, and eosinophilia can occur.
• Depending on the intestinal worm burden, a spectrum of gastrointestinal tract symptoms can occur

Ascariasis Life Cycle

About ascariasis

• Ascaris is an intestinal parasite of humans.
• It is the most common human worm infection.
• The larvae and adult worms live in the small intestine and can cause intestinal disease.

Transmission

• Ascaris lives in the intestine and Ascaris eggs are passed in the feces of infected persons.
• If the infected person defecates outside (near bushes, in a garden, or field), or if the feces of an infected person are used as fertilizer, then eggs are deposited on the soil.
• They can then mature into a form that is infective.
• Ascariasis is caused by ingesting infective eggs.
• This can happen when hands or fingers that have contaminated dirt on them are put in the mouth or by consuming vegetables or fruits that have not been carefully cooked, washed or peeled.

Unfertilized Ascariasis Egg

Risk factors

• Infection occurs worldwide in warm and humid climates, where sanitation and hygiene are poor, including in temperate zones during warmer months. Persons in these areas are at risk if soil contaminated with human feces enters their mouths or if they eat vegetables or fruit that have not been carefully washed, peeled or cooked.
• Ascariasis is now uncommon in the United States.

Symptoms of ascariasis

• People infected with Ascaris often show no symptoms. If symptoms do occur they can be light and include abdominal discomfort. Heavy infections can cause intestinal blockage and impair growth in children.
• Other symptoms such as cough are due to migration of the worms through the body.

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Ascaris lumbricoides

Diagnosis

• Health care providers can diagnose ascariasis by taking a stool sample and using a microscope to look for the presence of eggs.
• Some people notice infection when a worm is passed in their stool or is coughed up.
• If this happens, bring in the worm specimen to your health care provider for diagnosis.

Prevention of infections

• Avoid contact with soil that may be contaminated with human feces, including with human fecal matter (“night soil”) used to fertilize crops.
• Wash your hands with soap and warm water before handling food.
• Teach children the importance of washing hands to prevent infection.
• Wash, peel, or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure.

Roundworm

Transmission of infection to others can be prevented by:

• Not defecating outdoors, and by
• Effective sewage disposal systems.

Treatment

• Anthelminthic medications (drugs that rid the body of parasitic worms), such as albendazole and mebendazole, are the drugs of choice for treatment. Infections are generally treated for 1-3 days. The recommended medications are effective.
• In developing countries, groups at higher risk for soil-transmitted helminth infections (hookworm, Ascaris, and whipworm) are often treated without a prior stool examination.
• Treating in this way is called preventive treatment (or “preventive chemotherapy”).
• The high-risk groups identified by the World Health Organization are preschool and school-age children, women of childbearing age (including pregnant women in the 2nd and 3rd trimesters and lactating women) and adults in occupations where there is a high risk of heavy infections.

Mass drug administration (MDA)

• School-age children are often treated through school-health programs and preschool children and pregnant women at visits to health clinics.
• The soil-transmitted helminths (hookworm, Ascaris, and whipworm) and four other “neglected tropical diseases” (river blindness, lymphatic filariasis, schistosomiasis and trachoma) are sometimes treated through mass drug administrations.
• Since the drugs used are safe and inexpensive or donated, entire risk groups are offered preventive treatment.
• Mass drug administrations are conducted periodically (often annually), commonly with drug distributors who go door-to-door.
• Multiple neglected tropical diseases are often treated simultaneously using MDAs.

Ascariasis Resources
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