Worms( helminthiases) - Causes, symptoms and treatment. MF.

Worms or, scientifically, helminths - a large group of representatives of lower worms, capable of living in the human body, causing parasitic diseases - helminthiases. Helminths are divided into three classes: roundworms, tapeworms and flukes. Almost 200 species of helminths can affect the human body, however, only about 20 species are found on the territory of Russia. The prevalence of helminths is primarily affected by climatic conditions and the level of socio-economic development of the territory - therefore, in developed countries the incidence of helminthiases is much lower than in the countries of the tropical and subtropical belt.

In our time, the importance of helminthiasis is underestimated. Nevertheless, only in our country there are more than half a million infected worms each year from which more than 80% are children( and according to some data about 15 million people are infected every year!).In connection with a higher degree of contamination by eggs of helminths of the environment, the prevalence of helminthiases in rural areas is higher than in urban areas.

Depending on the route of transmission, helminthiases are divided into three groups: biohelminthoses( transmitted to humans through animals), geogelmintoses( part of the development of helminth occurs in the soil) and contagious( transmitted from the infected person).

The manifestations of the disease will depend on the way the helminth penetrates the body, the number of worms in the body, and the degree of their adaptation in the body.

The most destructive effect on the body is provided by larval and developing forms of worms. While the adult helminth has, as a rule, a stable location in the body - the larva is able to make difficult trips to the organs, leaving them painful changes. The preferred habitat for worms is the gastrointestinal tract, with different species preferring certain parts for their habitation, for example, ascarids - the initial sections of the small intestine, pinworms - in the lower parts of the small and primitive parts of the large intestine, the withered head - in the initial section of the large intestine. Depending on the location of the parasite, helminthiases can be divided into luminary( the parasite lives in the lumen of the hollow organ) and the tissue( the parasite is in the thickness of the tissues).Some helminthiases( for example, ascariasis) in different stages can have both tissue and luminal forms.

Symptoms of helminths

The development of helminthiasis usually takes place in two stages: acute - from two, three weeks to two months and chronic - from several months to many years.

The acute stage coincides with the time of introduction and development of the parasite and is manifested, mainly by the immune response to foreign antigens, by allergic reactions. Symptoms of this stage of helminthiosis are similar when introducing various types of parasites.

Chronic stage differs in a great variety: depending on the location of worms, their number and way of life, there are violations in the work of a variety of organs and systems. Embedded in the metabolic system, consuming the necessary substances for themselves, the parasite leads to disturbances, manifested by disorders of digestion, absorption of vitamins, proteins, fats, carbohydrates, minerals. Worm products of worms not only lead to suppression of normal intestinal microflora, but also reduce immunity, contributing to the development of chronic bacterial infections, reducing the effectiveness of preventive vaccinations. The increased risk of malignant tumors is associated with a negative effect on the immune system and enhanced processes of cell division( repair) in damaged tissues.

The first signs of the development of helminthiosis may occur from 2-3 days( with ascariasis), up to 1.5 years( with filariasis).More often this period is 2-3 weeks. At the beginning of the disease, rashes appear on the skin, enlargement of the lymph nodes, enlargement of the liver and spleen, pain in the muscles and joints. Some helminthiases are characterized by specific signs, for example jaundice for opisthorchiasis( hepatic fluke) or fever, muscle pain, facial edema and eyelids for trichinosis.

In the chronic phase, the presence of single specimens of the helminths proceeds practically without any symptoms, the exception may be the presence of large specimens, for example, the broad-ribbon, ascarids. In the case of a more massive infection, the symptoms of helminthiasis are composed of digestive disorders( nausea, bloating, abdominal pain, loose stools) and some specific signs. With enterobiasis, for example, it is an itch in the area of ​​the anus, intensifying in the evening and night.

When trichocephalosis is a hemorrhagic( with hemorrhages) colitis. With ankylostomiasis - iron deficiency anemia. With ascariasis, mechanical obstruction of the intestine and bile ducts can occur. In helminthiases with liver damage, chronic hepatitis, inflammation of the biliary tract( cholecystitis, cholangitis) develops. A special place is occupied by helminthiases with the development of cysts( fluid formations in the membrane): echinococcosis, alveococcosis, cysticercosis. Even large-sized cysts may not manifest themselves at all, but their suppuration or rupture leads to severe consequences such as anaphylactic shock, peritonitis, purulent pleurisy.

Helminthiases may be accompanied by symptoms of vegetovascular asthenia with neurotic conditions.

Let's consider in more detail the most widespread special cases of helminthiases.

Types of

helminths pinworms are small, slightly more than a centimeter, thin round worms, gray-white in color. The disease that occurs when they are infected is called enterobiosis. Infection with these worms occurs when eggs of the parasite enter through the mouth with poorly washed vegetables and fruits, from unwashed hands, after contact with soil or infected domestic animals. In addition, self-infection, leading to the prolonged existence of pinworms in the body, is possible. The development of worms occurs in the gastrointestinal tract, the larva develops into an adult specimen for 2 weeks. Adult individuals parasitize in the lower parts of the thin and upper parts of the large intestine.

Being still larvae, pinworms already harm the body: secreting enzymes that have an irritating( destructive) effect on the intestinal wall, lead to the appearance of inflammation sites. Adult individuals, having a mechanical effect on the intestinal wall, lead to the formation of small hemorrhages in it and promote the penetration of pathogenic bacteria into the mucosa. The processes of digestion and absorption of food are disrupted, in 30% of people the acidity of gastric juice decreases. The composition of normal intestinal microflora changes. A specific symptom of enterobiasis is itching in the anus, which increases in the evening and night;at this time pinworms crawl out of the anus, in order to lay eggs on the skin around it. Itching leads to the appearance of scratching, in the future in the area of ​​combing there may be foci of staphylococcal infection. Itching often persists after the release of the body from parasites. The appearance of itching explains the mechanism of repeated self-infection: when combing under the fingernails, eggs of pinworms enter, which then, with unwashed hands, get safely into the mouth.

Most often, self-infection with worms is noted in children.

In addition to impairing the function of the gastrointestinal tract, pinworms can cause inflammation of the urogenital system: more often in girls, due to penetration of the parasite into the genital tract and the attachment of a secondary infection. Disease enterobiosis in children can lead to a lag in the psycho-physical development, become a cause of nervous disorders.

Ascarids are large round worms, red-yellow in color, reaching the length up to 40 cm in the adult state. The disease caused by them is called "ascariasis".The development of the parasite begins after the eggs enter the intestine through the mouth, the hatched larvae enter the bloodstream through the intestinal wall. Passing along the migration path through the intestinal wall, the liver into the lungs, ascaris larvae have a traumatic effect on the tissue, causing hemorrhages and inflammatory changes in them. At the end of its path, in the lungs, the ascarid larva grows to 2 mm. In the lungs, the larva penetrates into the alveoli, from them into the bronchi and, together with sputum, again enters the gastrointestinal tract, where it develops into an adult.

In the intestinal phase of existence, the ability of ascarids to spiral forward movements and the desire to penetrate into narrow apertures is an important factor leading to serious complications( mechanical jaundice, pancreatitis).Frequent symptoms of ascaridosis are: abdominal pain, nausea, vomiting, loose stools, headache, fatigue. Allergens released by ascarids are among the most powerful parasitic allergens and can cause severe, severe allergic reactions. With ascariasis, the structure of the intestinal wall changes, absorption of vitamins A, C, B6 is impaired, and the composition of the intestinal microflora changes.

Often, people infected with such worms get into the hospital with erroneous diagnoses of pneumonia, asthmatic-like conditions, cholelithiasis. A ball of adult ascarids can cause an obstruction of the intestine, and at perforation of the intestinal wall - peritonitis. There are cases of penetration of ascarids from the intestine into the abdominal cavity through the postoperative suture. Penetration of adult individuals in the respiratory tract can cause mechanical asphyxia( suffocation).

The whitewashed is a round worm 30-50 mm long, named after the shape of the body: the front part is long and narrow, like a hair, and the back is short and wide. The disease caused by the vaginal head is called "trichocephalosis".After enterobiosis and ascariasis, trichocephalosis is the third most frequent in frequency. Infection occurs by food, through objects contaminated with soil and parasite eggs. Signs of trichocephalosis: abdominal pain, unstable stool, anorexia, anemia.

Often, with the diagnosis of "acute appendicitis", infected with vaginal head fall on the operating table.

A wide tapeworm - a large tapeworm, reaching a length of about 10 meters, can be found individuals over 20 meters long. The disease caused by these worms is called diphyllobothriasis. In the process of its development, before entering the human body, the lentian changes two hosts: freshwater crustaceans( the development cycle begins with them) and freshwater fish. Man is the ultimate master of the parasite. With meat, caviar of infected ripples, the larva enters the human body, where it is attached to the wall of the small intestine and develops into an adult. After 20-25 days, the helminth is able to excrete the eggs.

Symptoms of diphyllobothriasis include disorders in the functioning of the gastrointestinal tract and a specific for this disease B12 deficiency anemia - increased absorption by the parasite of vitamin B12 leads to its lack in the body.

Ankylostoma is the combined name of two types of worms: hookworms of the duodenum, and a non-cage, roundworms 10-15 mm in length. The larvae enter the human body through the skin, on contact with contaminated soil, then the larvae migrate to the lungs and through the bronchi, with sputum enter the gastrointestinal tract. In the intestine, the parasite attaches to the wall, beginning to feed on the host's blood.

Symptoms of ankylostomiasis consist of symptoms of lung damage, the same as with ascariasis, but less pronounced, abdominal pain, various disorders of the digestive tract and specific diseases - iron deficiency anemia and a decrease in the number of certain proteins in the blood.

Trichinella - small round worms 2-5 mm long, causing severe disease - trichinosis. The infection of a person with these worms occurs after eating meat that contains the parasite's larvae. Most often this meat is pork, but the "champions" of infection are wild animals - a bear and a wild boar, their meat hunters often get trichinosis.

The larva, caught in the meat in the intestines for 3-4 days, ripens into an adult. Female Trichinella in a period of 10 to 40 days produces more than 2,000 eggs, after which it dies. Hatching larvae enter the bloodstream through the intestinal wall and are carried with the current through the organs, settling in the muscle tissue. The muscles of the face, flexors of the limbs, respiratory muscles are most affected.

Symptoms of trichinosis: abdominal pain, nausea, loss of appetite, loose stool - in the first days after infection. One to two weeks after infection, there is an increase in body temperature to 39-40 °, facial swelling, pain in the muscles of the limbs, itching and rashes on the skin. During this period, with a massive infestation of larvae, a lethal outcome is possible. After about three to four weeks, recovery occurs, during this period, the larvae fixed in the muscles are covered with a capsule - the organism isolates the parasite. In fact, a person is a biological impasse in the cycle of development Trichinella.

Flukes( Cat Fluke) is a flat worm from the flailer class 7-20 mm in length. The disease caused by this parasite is called "opisthorchiasis".More than half of the world's incidence of opisthorchiasis occurs in Russia. The development of the parasite begins after the eggs hit the water. Larvae develop in the body of snails swallowed eggs. From the body of the snails, the larvae go into the water, where the carp family( carp, crucian carp, roach, bream) are introduced into the body of freshwater fish. Infection occurs when eating meat from infected fish. From the intestine, the larva of the parasite penetrates the gallbladder and bile ducts, where it develops into an adult. To keep in the biliary tract the parasite is helped by two suckers on the body.

Symptoms of opisthorchiasis: the acute phase of the disease lasts up to two months after infection and is manifested by the severity and pain in the upper abdomen, increased body temperature, aching muscles and joints, nausea, loose stool, allergic reactions to the skin and lungs. The chronic phase can last a lifetime and is manifested by the symptoms of hepatitis, cholecystitis, cholangitis( inflammation of the bile ducts), abnormalities in the work of the stomach and intestines, increased fatigue, weakness, nervous disorders.

Terrible complications of opisthorchiasis are cirrhosis and liver cancer. After the expulsion of the parasite in the liver, irreversible changes remain in the form of chronic inflammatory processes and functional disorders.

Swine and bovine tapeworm - similar in structure to tapeworms up to 6 meters long. In humans, they parasitize in the small intestine. Infection occurs with the use of meat of pigs or cattle, containing one of the intermediate forms of chain-finns( whitish vesicles up to 0.5 cm in size).In the small intestine the embryo is attached to the wall and in three months it turns into a mature parasite.

The worm consists of segments( up to 2000), the terminal segments contain up to 150,000 eggs. Almost daily the terminal segments come off and through the rectum enter the external environment, while the length of the parasite does not decrease, since in the growth zone more and more new ones are formed. Breaking off, the segments are capable of independent movement outward, crawling out of the anus, which is the main sign of the disease - teniarinhoza. In addition, the disease is characterized by digestive disorders and the work of the stomach and intestines.

Echinococcus parasitizes in the human body not in an adult form, but in the form of an intermediate form - Finns. The echinococcus itself is a ribbon worm 3-5 mm in length. He parasitizes in the body of a dog, a wolf, less often a cat. When a person comes in contact with infected animals contaminated with environmental objects, eggs of the parasite enter the intestine, where intermediate forms, oncospheres, appear from them. From the intestine, the oncospheres penetrate into the bloodstream and are carried throughout the body with blood flow, most often settling in the liver and lungs. Once in the body, the oncosphere turns into a Finn( a bubble surrounded by two shells).Finn( echinococcal cyst) begins to grow, destroying the affected organ. Manifestations of the disease depend on the location of the cyst, its size. Often echinococcosis is initially taken for a malignant or benign tumor. Of the complications, apart from the destructive mechanical effect on the organs, blood vessels, it is deadly dangerous to break the echinococcal cyst, leading to the development of multiple new cysts or toxic shock from the toxic contents of the cyst.

Alveococcus is a worm-like echinococcus, with a similar structure and mechanism of development. The difference is in the features of the structure and development of the cyst, making its symptoms very similar to a malignant tumor. Often the diagnosis of alveococcosis is put too late for a single treatment - operative.

Complications of helminthiases

Complications of helminthiases are associated, first of all, with the mechanical action of the parasite on the organ, the destruction of tissues sometimes leads to fatal disturbances in the function of the affected organ. Attachment of bacterial infections in places of mechanical damage is a frequent complication, masking the presence of the parasite in the body. Impressive people, the type of parasite( for example, during expulsion) can cause a serious psychological trauma requiring prolonged restorative treatment.

Diagnosis of helminthiases

Due to the variety of species and manifestations of the disease, careful attentiveness and careful questioning of the patient, which help to identify possible causes of infection, are of great importance. Investigation of biological materials( feces, rectal mucus, bile, contents of duodenum, blood, sputum from the lungs, muscle tissue) is carried out in order to identify whole or fragments of parasites, their eggs. When carrying out simple clinical blood tests, the idea of ​​parasites may be caused by an increased amount of one of the leucocyte types - eosinophils. In a number of cases, more complex immunological studies of blood are carried out, in order to detect antibodies to some parasites. X-ray and ultrasound studies, computed tomography, and endoscopy can be of great help in diagnosis.

Treatment of helminthiases

The basis for the treatment of helminthiases is specific anthelmintic agents. The line of anthelmintic drugs, not differing in variety, nevertheless, includes a number of highly effective agents. To treat enterobiasis and ascariasis( nematodes), pyrantel, mebendazole, albendazole, carbendacim are used. In diseases caused by tapeworms, praziquantel is used. Often, for the treatment of helminthiosis, a single dose of the drug is sufficient, but often the treatment is prescribed in the form of a regimen, with repeated administration of the medication in a few days. Effective specific treatment of echinococcosis and alveococcosis has not yet been developed, in these cases the treatment is selected individually according to the parasite disturbances.

Some helminthiases( for example, enterobiosis) recommend the treatment of all family members. Strict observance of personal hygiene during the treatment period is an indispensable condition, excluding the possibility of re-infection.

As ancillary, antiallergic agents( suprastin, diazolin), which help to restore intestinal microflora( bifidumbacterin, bactisubtil, linex) are used.

Folk remedies for the treatment of helminths

Folk methods of treatment include medicinal plants that have a helminthic, laxative effect. In ancient times for the expulsion of worms healers recommended the use of juice of elecampane and celandine. Carrots and carrot juice also have an anthelmintic effect. Often in the recipes of traditional medicine, you can find a walnut, pomegranate, mint, even more often - garlic as a component of nutrition or enemas. Broth wormwood bitter used in the form of enemas or inside. Pumpkin seeds are an official medicine against worms. In folk medicine, the intake of medicinal plants is often combined with salt laxatives. Although the effect of medicinal plants is not so high - they can quite serve as a preventive measure or supplement to the traditional treatment of helminthiases.

Prevention of helminthiases

Prevention of helminthiosis includes strict observance of personal and public hygiene, observance of cooking technology, carrying out measures to improve the environment aimed at reducing the number of eggs of worms that enter the soil. Examination and timely treatment of pets will help to avoid serious forms of helminthiosis in family members, communication with domestic animals is many times more dangerous, since almost 100% of them are infected with different forms of helminths. Compulsory washing of fresh vegetables and herbs is mandatory, since organic fertilizers containing eggs of parasites can be used for their fertilization. Proper processing of fish( especially river), the exclusion of eating raw, dried, salted fish will help avoid infection with tapeworms.

By purchasing products of animal origin from unworthy sources of trust, it is necessary to realize that the risk of infection, including worms, is much higher than when buying the same products in stores and in organized markets.

Frequently asked questions about worms:

Can I get rid of worms without specific treatment?
Theoretically it is possible. Methods without specific treatment are possible, for example, with enterobiosis( pinworm), but most helminths require expulsion with specific means, the use of which is necessary, considering the harm that the helminth can cause before it "leaves" itself.

What are the main symptoms of a suspected presence of worms?
This: frequent nausea, vomiting, abdominal pain, gastrointestinal tract disorders, irritability, fatigue, anxious sleep, creaking in the sleep with teeth, frequent allergic reactions for no apparent reason, itching in the anus, inflammation of the vulva( vulvovaginitis)in girls, an increased level of eosinophils in the blood, a decrease in body weight, in children - a lag in growth.

Can anthelmintics be used as a prophylaxis?
Rather yes. Nevertheless, before using the drug as a prophylaxis, it is necessary to carefully study its possible side effects and evaluate the ratio of possible harm and the desired effect.

You can often hear opinions about the benefits of worms: they help to lose weight, and the drugs from them have a rejuvenating effect. Is it worth it to believe?
Of course not! If cohabitation with at least one kind of higher organism will be beneficial to the human body, it will be a new kind of person( symbiosis).Man learned to get on well with only some bacteria. Most other species are foreign to the body and their interactions often have the form of a pathological process( disease).

Therapist doctor Sokov S.V.