Trichuriasis is an intestinal nematode infection. Light infections are asymptomatic. Heavy infection cause blood in stool, diarrhea, anemia, and growth retardation in children. Infection occurs after eating contaminated soil or vegetables, especially in warm, moist climates.
CASES/YEAR
400 (US); 604,000,000 (Global)
OTHER NAMES
Trichuris trichiura; Whipworm infection;
INCUBATION
Indefinite; Eggs appear in stool 70-90 days after ingestion of embryonated eggs; Symptoms may appear much earlier; [CCDM]
INITIAL SYMPTOMS
Light infection: asymptomatic; Heavy infection: blood in stool, diarrhea, anemia, and growth retardation in children;
PRECAUTIONS
No direct person-to-person transmission; [CCDM]
COMMENTS
Light infection: asymptomatic; Heavy infection: blood in stool, diarrhea, anemia, and growth retardation in children;
Trichuriasis is a nematode infection of the large intestines. Infection occurs after eating contaminated soil or vegetables. [CCDM, p. 627-8] Eggs passed in the feces are not infective until maturing (becoming embryonated) for 2-3 weeks in warm, moist soil. [Guerrant, p. 791] Some patients develop Trichuris dysentery syndrome with tenesmus and bloody, mucoid diarrhea. [PPID, p. 3441] Heavy infections can cause acute dysentery. Chronic trichuriasis can cause impaired growth and anemia. [Cecil, p. 2131] Very heavy infections in children can cause weight loss, anemia, and rectal prolapse. [Merck Manual, p. 1681] Eosinophilia is uncommon. [ID, p. 2355] Most patients have no symptoms and no eosinophilia. [Harrison ID, p. 1135]
DIAGNOSTIC
Microscopic exam for ova in stool; Identification of worms attached to wall of lower colon or prolapsed rectum; One fecal smear is usually sufficient for diagnosis because of heavy egg production by female worms. [PPID, 8th Ed, p. 3203]
SCOPE
Global, especially in warm, moist climates; [CCDM]
SIGNS & SYMPTOMS
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G abdominal pain
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G blood in stool
-
G diarrhea
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G nausea, vomiting
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H anemia
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H eosinophilia
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*weight loss
SOURCE
Fecally Contaminated Soil, Soil or Dust (Ingesting or Inhaling), Eating Contaminated Food, Eating Contaminated Produce
RISK FACTORS
- Eat soil containing infective eggs
- Ingest infectious agents in food/water
TREATMENT
Mebendazole or albendazole are effective. [CCDM]
REFERENCES FOR CASES/YEAR
1. (US) Prevalence from 1% (US) to 80% (developing world); [ID, p. 2355] Most common in poor children in tropics and subtropics; [Harrison ID, p. 1224) 1% x 300 million = 3 million which is probably way too high; Guesstimate: 400 (same as Ascariasis);
2. (Global) 1.5 billion (Ascariasis, Trichuriasis, and hookworm infections (N. americanus & A. duodenale); [Fact sheets from WHO 2013] Global prevalence 604 million; [Harrison ID, p. 1132t] Prevalent in communities with poor sanitation; [Gorbach, p. 346] Prevalence from 1% (US) to 80% (developing world); [ID, p. 2355]