How does infection occur?
Ascaris eggs mature in the soil and remain there for a long time, especially in warm, humid climates. A person swallows them with poorly washed vegetables, fruits and herbs, with water from unreliable sources, or by putting them into his mouth with dirty hands after working in the garden or playing in the sand. The parasite is not transmitted from person to person through normal contact because the eggs need time to mature outside the body. Children become infected more often than adults due to their hygiene habits.
- Unwashed vegetables, fruits and herbs
- Contaminated soil and sand
- Water from unreliable sources
- Dirty hands after working in the garden
- Using undisinfected feces as fertilizer
- Flies as carriers of eggs onto food
Two phases of the disease
The early, pulmonary phase occurs one to two weeks after infection, when the larvae migrate through the lungs. A dry cough appears, sometimes streaked with blood, shortness of breath, wheezing, low fever, and there may be hives and itching. In a blood test, eosinophils are increased, and on an x-ray, volatile infiltrates are visible, which quickly change location. The late, intestinal phase develops after 2–3 months: pain around the navel, nausea, loss of appetite, unstable stool, and in children - irritability and poor sleep.
- Early phase: dry cough and shortness of breath
- Allergic rash and itching
- Increased eosinophils in the blood
- Volatile infiltrates in the lungs on x-ray
- Late phase: pain around the navel
- Nausea, loss of appetite, unstable stool
- Weight loss and fatigue
Complications
With a large number of parasites, a ball of roundworms can block the intestinal lumen and cause intestinal obstruction - a condition requiring emergency surgical care. An individual can crawl into the bile ducts and pancreatic ducts, causing obstructive jaundice, cholangitis or acute pancreatitis. Less commonly, the parasite penetrates the appendix. In children, prolonged infection affects nutrition, causing vitamin deficiencies and stunted growth. This is why treatment cannot be delayed.
- Intestinal obstruction
- Obstructive jaundice and cholangitis
- Acute pancreatitis
- Appendicitis
- Bowel perforation (rare)
- Nutritional deficiencies in children
- Bronchoobstruction in the pulmonary phase
Diagnostics
The main method is to examine stool for helminth eggs. An important subtlety: in the early, pulmonary phase, eggs do not yet appear in the stool, because the parasite has not reached maturity, and the analysis will be negative. During this period, they focus on the clinic, high eosinophils, sometimes general IgE and x-rays of the lungs. In the intestinal phase, stool analysis is usually informative; it is repeated if necessary. Abdominal ultrasound is used when complications are suspected, and adults are sometimes detected by endoscopy or fluoroscopy with contrast.
- Feces for helminth eggs, three times if necessary
- Complete blood count with eosinophil assessment
- Coprogram
- Total IgE in the early phase
- Chest x-ray for cough
- Abdominal ultrasound for pain and jaundice
Treatment and prevention
Ascariasis is treated with anthelmintic drugs, which are selected by the doctor taking into account age, weight and concomitant conditions; The schemes are different for pregnant women and small children. Self-medication is dangerous: the wrong dose can provoke the migration of parasites into the bile ducts. After the course, monitoring of stool tests is mandatory. Folk remedies like garlic, pumpkin seeds and wormwood are not a substitute for treatment. Prevention is simple and effective: wash your hands and food, drink safe water, cultivate the soil in the area, do not fertilize the garden with fresh feces.
- Anthelmintic drugs as prescribed by a doctor
- Considering age, weight and pregnancy when choosing a regimen
- Monitoring stool analysis after treatment
- Examination and treatment of family members according to the doctor’s decision
- Refusal of self-medication and traditional methods
- Washing hands with soap and keeping nails short in children
- Thorough washing of vegetables, fruits and herbs
- Boiled or bottled water