ENTEROBIUS VERMICULARIS

Prof. Walter Jaoko

Department of Medical Microbiology
University of Nairobi
Learning Objectives
At the end of this lesson, the learner should be able to:

Classify the parasite Enterobius vermicularis
Outline geographical distribution of E. vermicularis
Describe morphology of key stages of E. vermicularis
Describe the life cycle of E. vermicularis
Describe clinical manifestations of E. vermicularis
Describe the tests used to diagnose E. vermicularis
Outline treatment of E. vermicularis
Describe control of E. vermicularis
1.0 Introduction
Intestinal nematode, found in the large intestines
Also known as pinworm
Worldwide distribution, more in temperate climates
More common in overcrowding places
Orphanages, boarding schools etc
Children most affected high prevalence & intensity
Cause disease known as enterobiasis
2.0 Morphology
Adults
Females 9-12 mm, Males 2-3 mm
Thick lips (cervical alae)
Eggs
Planocovex in shape
Transparent wall
Embryonated


Adult, Enterobius vermucularis

Egg in Iodine stained preparation
Egg in wet saline preparation
3.0 Life cycle
Adults mate in LI, females get out of anus, lay eggs
Eggs passed embryonate within a few hours
Itchiness of perineum, scratching, stick to fingers &
nails, ingested accidentally (self or others), reach SI,
hatch, larvae move to LI, attach to mucosa, adults
May be transmitted through clothing, beddings, food
etc contaminated with eggs, dustborne by inhalation,
retroinfection
Life cycle 4-6 weeks

4.0 Clinical presentation
Light infection mostly asymptomatic
Clinical presentation includes
Pruritus ani (scratching the anus) usually at night
Sleep disturbance
Irritability & lack of concentration in school
Poor class performance
Loss of appetite
Complications include
Appendicitis
Salpingitis in females (rare)
5.0 Laboratory Diagnosis
Microscopic identification of eggs must be done in the
morning, before defecation and washing by
Adhesive scotch tape test - Press transparent adhesive
tape on the perianal skin & then examining tape
placed on a slide
Anal swabs Press a swab coated with adhesive
material on the perianal skin
Camel hair brush
Eggs occasionally found in stool, urine, vaginal smears
Adult worms may also be found in perianal area



Enterobius vermicularis eggs in a cellophane tape preparation
6.0 Treatment
Mebendazole
Albendazole
Pyrantel Pamoate
* In institutional outbreaks treat all the household
members
7.0 Prevention & Control
Proper hygiene
Daily bathing
Frequent changing of clothes & beddings
Keeping short nails etc,
Avoiding overcrowding, opening of windows for
ventilation etc
Health education
Washing of hands before eating of a meal
Treatment of infected persons with antihelminthes