Helminthiases in children

Helminthiases in children and adults - chronic types of infectious diseases caused not by microorganisms, but by worm-parasites. The group of pathogens includes more than 400 species, dangerous for humans. In the Russian Federation, 20 types are singled out of them, most often found in different territories and affecting children.

Medical statistics note in recent years the growth of helminthiases( especially enterobiasis and ascariasis).The pediatric service associates with helminths the problem of increasing the spread among children of diseases of the digestive system and allergic mood.

The main groups of parasites

Worms-parasites differ in structure, habitat, life cycle, the choice of an intermediate host. The most common:

• round parasites( nematodes) - pinworms, roundworms, whipworm;
• tapes( cestodes) - pork and beef chains, wide ribbons;
• Flukes( trematodes) - hepatic and cat's fluke.

Accordingly, the diseases caused by them, refer to the type of helminthiasis to nematodes, cestodias, trematodes. And the name of a particular species determines the Latin name of the parasite. The child is more often affected by the defeat of roundworms( nematodes).Cestodoses and trematodes are much less common.

Differences in structure:

• Nematodes - have an elongated filiform form, a round body in diameter, from 1 mm to 1 m in length. There are individuals up to 10 m.
• Cestodes - reach a length of up to 10 m, have a tape structure with a head, neck andseparate segments. The number of segments can reach up to a thousand.
• Trematodes - flat in shape, resembling a leaf, have suckers. Dimensions are much smaller than previous species( from 1 mm to 10 cm).

By the method of transmission it is customary to allocate:

• contagious helminthiases - if the infection of the child occurs on contact with the patient, through toys, dishes, bed linen;
• biogelmintozy - before the invasion( ingression) of the human helminth requires an intermediate host-carrier, in which he develops from the stage of the larva or the egg to the sexually mature form, is transmitted when nursing, playing with pets( cats, dogs, hamsters);
• geogelmintoses - do not need an intermediate host, as eggs or larvae are sufficiently resistant to environmental factors, tolerate drought and frost, live well in the soil, develop here to the stage of infectiousness, children get unwashed vegetables, fruits, dirty hands.

Cows - representatives of carriers in case of infection with bovine chain

How does infection occur?

We are not able to place a child in an aseptic world. The kid must meet with the infection. Gradual acquisition of hygiene skills reduces the possibility of infection. A sick animal or man secretes eggs of parasites with feces. If the rules of washing hands after the toilet are not respected, they remain under the fingernails, on the skin, underwear, pet paws.

Sufficient conditions of infection are created in kindergarten, at home, at school. Children play together on the site, in the sandbox, they use only toys, sports equipment, swimming pools in the summer, they help at the dacha.

The causes of helminthiasis are caused by:

• by the transfer of eggs to the child's hands, then swallowing if there is no timely washing with soap;
• the habit of children to nail;
• spread in indoor flies, with dust;
• drinking unboiled water;
• using common linen, towels;
• by the use of unwashed vegetables, fruits from the bed;
• close contact of the child with infected animals.

In the organized collectives, special attention is paid to cooking according to the rules of technological processing, prohibition of salted products and cold smoking( fish), checking of persons having access to cooking and storing food, distributing, feeding children.

The anatomical and functional properties of the child's organism contribute to infection: insufficient formation of protective barriers, a lower level of acidity of gastric juice than in adults, a pronounced desire to touch everything and try everything with their own hands.

What happens when helminths get into the body of a child?

In pediatric practice, any complaints of the child are checked for the presence of helminthic invasion. This is due to the variety of forms of damage and the influence of helminthiases as a significant risk factor in the course of pathology.

Worms are not easily nourished by the blood( red blood cells) of a child, they capture a significant part of the incoming energy from food, but also gradually poison the body with their living products. After the first encounter with parasites, the body begins to produce specific antibodies to toxins of worms.

This is manifested in children in different ways from skin rash and itching, pronounced diathesis to anaphylactic shock. The reaction is determined by the individual sensitivity of the child. If the intestinal wall is damaged, the conditions for digestive disorders are created: the ability to assimilate the products entering the intestine is lost, the composition of the intestinal flora is disrupted.

Pancreatic enzymes do not fulfill their function. The blood does not receive the necessary amount of protein and vitamins to ensure growth, mental development of the child. Some parasites living in the intestine, overlap the lumen and cause signs of obstruction. And getting into the bile ducts, promote the formation of stones and bile colic attacks.

A very important contemporary problem of pediatrics is the inadequate level of post-vaccination titres of antibodies caused by helminthiases( 2-3 times lower than in children without parasitic infection).This indicates the uselessness of the entire vaccination work and increases the sensitivity to various infections.

A child often combs the skin around the anus

How does helminthiosis manifest in children?

Symptoms of helminthiasis in children are most often manifested in the autumn-winter period. This is caused by a predominant infection in the spring and summer. Before the appearance of initial symptoms, the incubation period passes. On the street, kids spend enough time playing with animals, eating dirty hands with unwashed vegetables and berries from the garden.

Attentive parents notice the first symptoms:

• on the manifestation of weakness, fatigue in a child;
• increased irritability, whims;
• sleep disturbance;
• complaints of unclear abdominal pain;
• headaches;
• changes the child's appetite( the decrease alternates with an increase);
• attacks of nausea, sudden vomiting;
• diarrhea and constipation.

Perhaps an incomprehensible slight increase in temperature, the occurrence of itching and rashes on the skin, muscle and joint pain. The child changes externally: there is pallor and swelling of the face, dark circles under the eyes. Less often there are signs of catarrhal sinus, enlarged lymph nodes, jaundice of the skin, cough.

The sign of helminthiosis in this period is the growth of eosinophils in the blood, a decreased level of hemoglobin and red blood cells. This indicates the allergic mood of the child's body. When X-ray examination, migrating infiltrates in the lung tissue are detected, a suspicion of pneumonia.

These symptoms determine the acute phase of the disease. With ascariasis, it occurs 2-3 days after infection. With other helminthiasis it will take from two weeks to several months. The incubation period is determined by the type of parasites and their number.

Transition to the chronic phase is accompanied by the manifestation of syndromes( a certain set of symptoms) indicating the defeat of a particular organ or system. Allergic reactions contribute to the development of bronchial asthma, urticaria, atopic dermatitis. Glistnye diseases are recognized by WHO as one of the causes of secondary immunodeficiency.

Negative action of worms causes sensitization of the body( increased sensitivity) and decreased immunity. These reasons provide convenient conditions for the development of various pathologies, the attachment of infection.

A child is more likely to have SARS, influenza, and other infectious diseases. Phthisiologists note a false turn of tuberculin samples( expansion of the papule from the Mantoux sample compared to the previous study).

Disturbance of digestion is accompanied by nausea, vomiting, unstable stool, loss of appetite, belching, drooling

Asthenic syndrome is manifested by increased irritability, insomnia, mood swings, inability to concentrate, schoolchildren - decreased learning achievement, increased fatigue. Slows down the growth and physical development of the child.

Metabolic syndrome consists of metabolic disorders: protein content, concentration of vitamins, folic acid, trace elements decrease, metabolism of fats and carbohydrates changes. The organs of the child manifest the effects of iron deficiency anemia, there is oxygen deficiency in the tissues. The condition in children without treatment of helminthiosis can go to the stage of irreversible pathology.

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See also:

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asbestos smear.

For the acute phase are typical:

• from the blood - leukocytosis and severe eosinophilia, the growth of biochemical hepatic tests( alanine and aspartic transaminases, alkaline phosphatase, bilirubin, thymol test);
• uses serological methods to detect an increase in antigens( ELISA, RIF, RNGA, RSK);
• skin tests can help to establish a specific allergy;
• pathogens of helminthiases are detected in children in feces, bile, sputum;
• pinworm eggs are detected by scraping on enterobiasis with the surrounding anal opening of the skin, using a sticky tape;
• in the diagnosis of echinococcosis is given the most importance to instrumental methods( contrast radiography, fibrogastroscopy, ultrasound, computer and magnetic resonance imaging), they can detect echinococcal cysts in the liver, lung tissue, in the brain;
• trichinosis is diagnosed with a biopsy of the skin and muscles, the larvae of the parasite are searched in the tissues;
• for opisthorchiasis requires examination of the contents of the duodenum, therefore, duodenal sounding is performed.

What helminthiases most often affect children?

Conversations with parents suggest information about the most common helminthiases in the children's environment. We give brief information that is useful to know.

Askaridoz

The disease is caused by a round worm - ascaris. The females have sharpened both ends, the tail is bent in the males. The parasite resembles a earthworm. Females reach a length of 25-40 cm, males - 15-25.Live in the small intestine, feed on the contents and mucous membrane. The only source is a sick person.

Fecundated eggs are excreted into the external environment, covered with a thick protective shell. The disease refers to geohelminthiases. Eggs ripen in the ground. Of these, larvae appear. Infection occurs when in contact with the soil, unwashed vegetables, through dirty hands.

Paths of infection with ascaridosis

Eggs and larvae enter the baby through the mouth and stomach into the small intestine, penetrate into the wall, through it enter the bloodstream.

They pass the liver, the chambers of the heart, reach the lungs. So, inflammation develops with coughing, shortness of breath, fever.

With saliva and sputum they are again swallowed by the baby and returned to the small intestine. Now the sexually mature specimens develop from the larvae. Ascariasis is asymptomatic. But more often the child has nausea, vomiting in the morning, drooling, colic in the upper abdomen, appetite decreases.

Enterobiosis

The disease is caused by the pinworm. It is a small parasite, no more than 5-12 mm long. Infection occurs only from a sick person through dirty hands, food. Helminth lives in the final section of the small intestine and in the caecum. Here, larvae hatch from eggs, in two weeks they become sexually mature.

The diagnosis is not based on the analysis of feces, but in the study of scrapings of skin folds or washings

Eggs are laid, crawling at night from the anus in the skin, on the laundry. They become infectious after 6 hours. Children are worried about severe itching around the anus. Combing leads to contamination of the nails and repeated self-infection. Pinworms give the clinic acute appendicitis when crawling into the vermiform appendage, vulvitis in girls. Epileptiform seizures are possible.

Trichocephalus

Called by a parasitic vagal head. It also refers to roundworms, reaching a length of up to 5.5 cm. It has a characteristic structure: a thin head-like hair. A favorite habitat is the large intestine, more often the caecum.

Secured by the front end behind the wall of the intestine, it feeds on blood. Dedicated eggs "reach" in the ground to the stage of invasiveness. Infection does not differ from ascaridosis and enterobiosis. The clinical course is accompanied by all the common signs of helminthiases.

TENIARINHOSH

Helminthiasis caused by a bull chain-representative of a group of flatworms. It differs in huge sizes( in length up to 7 m).Lives in the small intestine of a person. Has a head with four suckers, flat segments. Each produces eggs. The parasite needs an intermediate host.

The larval stage( Finns) should develop in the body of cattle. Larvae with blood are introduced into muscles, other tissues. For a child, dangerously unprocessed meat( veal, beef).In the clinical course, attention is paid to perversion or increased appetite, abdominal pain, nausea, dizziness. The eggs of the parasite are revealed in the stool of the patient.

How to treat a child?

Before treating a child, it is necessary to identify a specific causative agent of the disease. It can be hard for mothers to take the analysis on time. Therefore, the inclusion in the nursing duty, the process of sampling smears and tests at home is important. It has already been shown that with such organization of work, the detection of helminths has significantly increased.

The basis of treatment is the achievement of complete dehelminthization of the child's body. The choice of a particular drug is determined by the form and type of the parasite, the presence of a concomitant disease. Medicines are not always prescribed. They tend to have high toxicity. Natural biologically active complexes help.

Stages of treatment. The first - Preparation of the body for the excretion of worms using pumpkin and linseed oil, Allocha, Enterosgel. Binding and removal from the intestine of toxic substances synthesized by worms.

Pumpkin oil - one of the tested folk remedies for helminths

Second - The use of anthelmintic agents of concrete and wide action, herbal preparations. The remedy should destroy the larvae, eggs and adult parasites. Albendazole, Mebendazole is prescribed for ascaridosis, trichinosis, enterobiasis, trichocephalosis. Pyrantel treat enterobiasis and ascariasis. Praziquantel is a necessary preparation for schistosomiasis, opisthorchiasis, diphyllobothriasis, theniasis.

Third - After completion of the course of therapy, control is necessary by repeated parasitological examination. To be confident in the effective de-worming of children, doctors recommend simultaneously treating the entire children's group( a group in a kindergarten, a class in school), family members. To prevent re-invasion, control over the hygiene regime is necessary.

Children with allergic mood and manifestations are prescribed antihistamines.

With severe intoxication and severe child is hospitalized. Intravenous fluids are injected to relieve intoxication. With symptoms of myocarditis, inflammation of the meninges, vasculitis is prescribed glucocorticosteroids.

Prevention

Prevention of helminthiosis infection of children requires strict adherence to sanitary and hygienic rules, control of epidemiologists over the situation in the territory, timely detection and sanitation of infected people.

The child needs to explain the obligation:

• washing hands with soap after returning from a walk and before eating;
• regular haircut and cleanliness of nails;
• erosion after stool;
• daily rinsing of the external genitalia;
• regular change of cowards;
• use only a personal towel.

Parents should know about prevention measures and provide for the child:

• once a week change of linen on the bed;
• obligatory washing with powder and ironing pants, towels and bed linen;
• catering dishes after sufficient heat treatment, thorough washing of fruits and vegetables;
• drink only boiled or filtered water.

If you are allowed to keep pets, then you need to consult a veterinarian about deworming and hold it regularly, prohibit licking the face of the child, sleeping with a cat or dog.

. It is necessary to wean the child from the habit of biting nails, pencils, licking fingers, scratching the external genitalia and the zoneanus. Daily cleanliness in the house is maintained by cleaning, disinfectants should be used in the toilet.

Physicians register a high risk of helminth infection. Therefore, in addition to strict compliance with personal hygiene requirements, conducting a survey of children's groups and staff, they offer periodic courses of preventive de-worming in pre-school institutions, among children 3-6 years old.