Dear Alice,

My wife is a teacher and developed pinworms from her students (we think). Our HMO could not diagnose it (or lost the test results). We felt sure that the symptomology was that of pinworms and proceeded to take 100 mg of Vermox (mebendazole). It seemed to work since the itching started to subside and a cluster of "dental-floss looking" worms was "delivered" in the john. Since the delivery she has taken the Vermox again to destroy the eggs and plans to do it again in 3 weeks. The question is:

"How hard is it to get rid of these worms once you've had them for over a year? Should she repeat the dosage every 2-3 weeks if itching returns???"

Thank you in advance for any help you might give us.

Dear Reader,

It is estimated that close to one-fifth (20%) of all children in the United States have pinworms at any given time. In fact, pinworms are probably the most common of all worm infestations in humans. Infective pinworm eggs can live indoors for up to two weeks, presumably in hope of being taken in by a human host. Young children tend to be most effective at ingesting and spreading pinworm eggs. You are most likely correct in guessing that your wife picked up these little buggers in her classroom.

The length of time that a person has pinworms should not affect the treatment or make it more difficult to get rid of them. It's not as if the pinworms will erect an entire city in a year's time, but only a squatter settlement with only a few weeks. That is, they should be equally easy to treat, no matter the length of the infestation. Mebendazole (also known by its brand name, Vermox) is an over the counter drug that is effective for getting rid of pinworms, as well as other helminth relatives of the pinworm. To treat pinworms, you first take one 100 mg tablet. Then two weeks later, you take one more tablet. After that, it's best to wait about three weeks before deciding whether or not to take a third dose. If symptoms do not reappear, you probably got rid of them and don't require any further treatment.

If the symptoms persist after two or three doses of Vermox, it is recommended that your wife to see a health care provider. The test for the presence of pinworm eggs is very effective and relatively simple — scotch tape is applied to the anal area (preferably in the morning before bathing), and then what is picked up on the tape is put on a slide and viewed under a microscope. This is usually done a few mornings in a row to be absolutely certain that eggs are present. Many people who think they have pinworms actually end up finding out that the anal itching they've been experiencing is caused by something else, such as an allergy to perfumes and dyes in toilet paper, hemorrhoids, and other conditions which are difficult to diagnose and define. Of course, in your wife's case, it sounds like you had some pretty hard evidence indicating the presence of the worms.

Keep in mind, too, that it's possible for your wife to be reinfected with pinworms. One step she can take to prevent this from happening is to inform the parents about pinworms — how they're transmitted, what symptoms to look for (primarily, itchiness and/or a tickling sensation in the anal area), and ways to try to prevent infection with pinworms, such as keeping fingernails short, and being vigilant about washing hands after each trip to the bathroom. Your wife can also make sure that the classroom, including desks, toys, and other surfaces the children come in contact with frequently, is thoroughly cleaned on a regular basis.

Beyond being annoying and uncomfortable, pinworms are a benign parasite that will not compromise your wife's health. Hope that you're successful in treating the problem!


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