Threadworms

Question 1

What are threadworms?

Answer 1

threadworms are a parasite infection in which worms come out in faeces

Question 2

Treatment timescale of threadworms

Answer 2

With treatment should resolve within 2-3 weeks but can go on for months or years

Question 3

Referral criteria for threadworms

Answer 3

medication failure
signs of a bacterial infection
recent travel abroad

Question 4

Symptoms of threadworms

Answer 4

• perianal itching caused by an allergic reaction to the substances in and surrounding the worms’ eggs, which are laid around the anus
• itching might not happen in someone infected for the first time as sensitisation takes a while to develop
• itching is worse at night - as this is when female thread worms lay their eggs on the surrounding skin around the anus along with a sticky irritant fluid
• persistent scratching may lead to a secondary bacterial infection - refer if skin is broken and there are signs of weeping
• loss of sleep due to itching at night, tiredness and irritability during the day
• appearance of worms in faeces: they are about 10mm long and less then 0.5mm in width. White or cream coloured threadlike objects. Some may be protruding from the anus itself

Question 5

lifestyle advice for thread worms

Answer 5

• infection doesn’t signify a lack of care and attention to personal hygiene
• all family members must be treated at the same time. Other members may be in the early stages of infection and thus asymptomatic
• transmission and reinfection of threadworms can be prevented by:
• cutting fingernails short to prevent large numbers of eggs being transmitted. Eggs remain viable for about 1 week.
• children wearing pyjamas to reduce the scratching of bare skin at night
• bath or shower each morning to wash away the eggs that were laid at night

Question 6

Name 3 treatments for threadworms

Answer 6

Mebendazole
Piperazone
Ovex suspension/tablets

Question 7

Describe the use of mebendazole for thread worm treatment

Directions for use

Answer 7

one tablet once only
Single 100mg tablet crushed/chewed whole.
Single 5mL dose if liquid - good compliance

Question 8

Mebendazole side effects

Answer 8

GI disturbances

Question 9

Mebendazole warnings

Answer 9

Do not give to children under 2 years of age
Do not take at the same time as metronidazole or cimetidine
Do not use if prengnant

Question 10

Mebendazole counselling

Answer 10

• one dose can be repeated after 2-3 weeks to make sure the infection is completely gone
• can be chewed or swallowed
• whole of family must do a course

Question 11

Piperazone directions for use

Answer 11

3 months or older: one dose followed by another 2 weeks later, to get rid of remaining eggs

Question 12

Piperazone side effects

Answer 12

Uncommon: Nausea, vomiting, diarrhoea, colic

Adverse effects on CNS (rare): headaches, dizziness (

Question 13

Piperazone warnings

Answer 13

Not for patients on neuroleptic therapy
Not for those with impaired renal function
Not for pregnant women

Question 14

Piperazone counselling

Answer 14

Laxative (senna) can be incorporated into sachets to eliminate worms

Question 15

Ovex suspension 
treats?
Directions
side effects
warnings 
counselling

Answer 15

Threadworms
2 years+ 5mL dose or 1 tablet chewed/crushed/taken whole. 2nd dose after 2 weeks if needed.
SEs: GI disturbances
Warning: Not for use in pregnancy
Counselling: taken either with or without food