Trichuriasis

Other Names: Whipworm infection; Trichocephaliasis

An infection that is caused by the nematode trichuris trichiura, a soil-transmitted helminth, which is transmitted via food and/or water contaminated with the eggs of the worm. Symptoms are usually mild and include abdominal pain, diarrhea, fatigue, and possibly anemia secondary to blood loss in diarrhea.

Cause

The nematode (roundworm) Trichuris trichiura, also called the human whipworm causes Trichuriasis.

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Epidemiology & Risk Factors

Whipworm is a soil-transmitted helminth (STH) and is the third most common roundworm of humans. Whipworm causes an infection called trichuriasis and often occurs in areas where human feces is used as fertilizer or where defecation onto soil happens. The worms are spread from person to person by fecal-oral transmission or through feces-contaminated food. Worldwide, infection occurs more frequently in areas with tropical weather and poor sanitation practices, and among children. In 2002, the estimated number of persons infected with whipworm was 1 billion. Trichuriasis also occurs in the southern United States.

Life Cycle

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The unembryonated eggs are passed with the stool The number 1. In the soil, the eggs develop into a 2-cell stage The number 2, an advanced cleavage stage The number 3, and then they embryonate The number 4; eggs become infective in 15 to 30 days. After ingestion (soil-contaminated hands or food), the eggs hatch in the small intestine, and release larvae The number 5 that mature and establish themselves as adults in the colon The number 6. The adult worms (approximately 4 cm in length) live in the cecum and ascending colon. The adult worms are fixed in that location, with the anterior portions threaded into the mucosa. The females begin to oviposit 60 to 70 days after infection. Female worms in the cecum shed between 3,000 and 20,000 eggs per day. The life span of the adults is about 1 year.

Symptoms

People infected with whipworm can suffer light or heavy infections. People with light infections usually have no symptoms. People with heavy symptoms can experience frequent, painful passage of stool that contains a mixture of mucus, water, and blood. Rectal prolapse can also occur. Heavy infection in children can lead to severe anemia, growth retardation, and impaired cognitive development. Whipworm infections are treatable with medication prescribed by your health care provider.

Diagnosis

The standard method for diagnosing the presence of whipworm is by microscopically identifying whipworm eggs in a stool sample. Because eggs may be difficult to find in light infections, a concentration procedure is recommended.

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 3 days. The recommended medications are effective. Health care providers may decide to repeat a stool exam after treatment. Iron supplements may also be prescribed if the infected person suffers from anemia.

Prevention & Control

The best way to prevent whipworm infection is to always:

Avoid ingesting soil that may be contaminated with human feces, including where human fecal matter (“night soil”) or wastewater is 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.

Trichuriasis Resources
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