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,

Beyond being annoying and uncomfortable, pinworms are a benign parasite that most likely won't compromise your wife's health. They are also incredibly common — the most common of all worm infestations in humans! Young children tend to be most effective at ingesting and spreading pinworm eggs, and it's estimated that close to one-fifth (20 percent) of all children in the United States have pinworms at any given time. So, you may be correct in guessing that your wife picked up these little buggers in her classroom. The length of time that a person has pinworms doesn't affect the treatment or make it more difficult to get rid of them — they're equally easy to treat regardless of the length of the infestation.

Luckily, the treatments for pinworms can be pretty simple. Mebendazole is a prescription drug that is effective for getting rid of pinworms. If the symptoms persist after two or three doses of mebendazole, your wife might consider consulting with a health care provider again. The test for the presence of pinworm eggs is very effective and easily done at home — a sticky piece of tape is applied to the anal area (preferably in the morning before bathing), brought to a health care professional, and examined under a microscope. This is typically done for a few mornings in a row to be absolutely certain that eggs are present. Doing this is key as 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, or other conditions which are difficult to diagnose and define.

Keep in mind, too, that it's possible for your wife to be reinfected with pinworms. There are several steps within the school setting she might take to prevent infection, starting with informing parents about pinworms — how they're transmitted, what symptoms to look for (primarily, itchiness 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 might also consider making sure that the classroom, including desks, toys, and other surfaces the children come in contact with frequently, is thoroughly cleaned on a regular basis. What can you both do in your home to prevent pinworms? Consider the following:

  • Shower in the morning. Because pinworms lay their eggs at night, washing and cleaning the anal area is crucial.
  • Change underwear and bed linen daily. Pinworm eggs can survive on clothing and bedding, among other surfaces, for two to three weeks.
  • Wash clothes in hot water. Wash bedsheets, nightclothes, underwear, washcloths, and towels in hot water and dry on the highest heat setting.
  • Avoid scratching the anal area. It might be tempting, but scratching can lead to the collection of eggs under the fingernails, which can transfer them to other surfaces.
  • Wash your hands. Handwashing prevents infection and is particularly key after bowel movements and diaper changes.

List adapted from Mayo Clinic.

Your wife might be uncomfortable right now, but there is hope for a pinworm-free future.

Alice!

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