Ascariasis

Introduction

Ascariasis is a kind of roundworm infection. These worms are parasites that use our body as a host and develop from larvae or eggs into grown-up worms. Adult worms, which reproduce, are sometimes more than a foot (30 centimeters) long.

It is one of the most common worm infections in people globally. Most infected people have mild cases without any signs or symptoms. But heavy infestation can cause severe signs and symptoms, as well as headaches.

Ascariasis happens frequently in children in the tropical and subtropical regions of the world, especially in regions with poor sanitation and hygiene.

Causes of Ascariasis lumbricoides

Ascariasis cannot be directly transmitted from one person to another. It spreads when a person comes into contact with soil that is mixed with human or pig feces that contain ascariasis eggs. In some developing regions of the world, human and animal feces are still used as natural fertilisers for crops. If infected feces are mixed with the soil, then the disease can spread through the ingestion of soil, vegetables, or even infected water. It can also be transmitted by eating uncooked pig or chicken liver that is infected.

Roundworm Life Cycle

If a person gets infected with Ascariasis, the roundworm will mature through its life cycle within the host’s body. The stages of a roundworm’s life cycle are as follows: Eggs hatch into larvae within the host’s intestine. The larvae then flow through the body via the bloodstream into the lungs. The larvae will mature inside the lungs before entering the throat. A person will either swallow or cough out the larvae. If swallowed, the larvae pass into the intestine and mature into adult roundworms. A female roundworm may produce about 200,000 eggs per day. The eggs will leave the body through a person’s stool.

Characteristics of Ascaris lumbricoides

  • Roundworms’ length varies from less than 1 millimeter to over 7 meters. As suggested by their name, roundworms have a round body

  • Roundworms have a tough covering of cuticles on the surface of their bodies. It prevents their bodies from expanding

  • Roundworms reproduce sexually. Sperm and eggs are produced by male and female worms, respectively

  • Roundworms are free-living or parasitic. Free-living parasites and worms are mainly found in freshwater habitats, and some are also found living in the soil

  • They generally feed on bacteria, fungi, or organic matter. By breaking down organic matter, they play an important role in maintaining ecological balance

Ascariasis Symptoms 

In populations wherever worm infections are widespread, it is commonly found that most people are infected by a small number of worms, whereas only a few people are heavily infected by worms. This is often the characteristic of the many varieties of worm infections. People infected only with a small number of worms usually have no symptoms.

  • Migrating larvae

As the larvae mature and travel through the body, they can cause damage to the visceral nervous system, inflammation, enlargement of the liver or spleen, and can also cause inflammation of the lungs.

  • Intestinal blockage

The worms may sometimes cause internal organ blockage once a large number of them get mixed up in the bolus or when they migrate from the small intestine. Surgery might be needed for the removal of the worms causing intestinal blockage.

  • Bowel obstruction

Bowel obstruction due to Ascaris is very rare, about 0.02% per year. A worm might block the ampulla of Vater or enter the main pancreatic duct, leading to inflammation of the pancreas with raised blood serum levels of amylase and lipase. Sometimes, a worm may travel through the biliary tree and even into the gallbladder, inflicting acute inflammation of the bile duct.

  • Malnutrition

The worms in the intestine might cause abnormalities in the absorption of food nutrients along the digestive tract. The abnormality in absorption is also because of a loss of brush border enzymes, erosion and flattening of the villi, and inflammation in the digestive tract.

Treatment

Antiparasitic medicines are used to treat most instances of ascariasis. For serious infestations, they may explore further treatment options. A doctor’s goal may not be to cure the infestation, but rather to lower the number of worms and eggs in a person’s body to alleviate symptoms. Surgery may be recommended by a doctor to properly remove excessive numbers of worms. If the infestation has blocked a section of the intestine, surgery may be a possibility.

Medications

Ascaricides are medicines that are used to kill roundworms. The World Health Organization recommends albendazole, mebendazole, levamisole, and pyrantel pamoate for ascariasis. Ascariasis may be treated with a single dosage of albendazole, mebendazole, or ivermectin. They’re efficient at eliminating parasites and eggs from the intestines.

Piperazine is a flaccid paralyzing agent that prevents Ascaris muscles from responding to acetylcholine, immobilizing the worm. When mild medications like thiabendazole are used to treat it, it stops the migration of the worms. When administered alone, it causes the worm to flow out of the stool and may be used to treat worms that have blocked the intestinal or bile duct.

Some of the symptoms, such as inflammation, may be treated with corticosteroids.

Surgery

Worms may induce intestinal blockage in certain instances of severe infestation, demanding emergency surgery. Bowel obstruction might be caused by worms or bowel twisting. The worms may be manually removed during surgery.

Prevention

  • Ascariasis is very rare in people who live in areas with adequate sanitation. However, it is essential to carefully wash food and wash our hands after using the restroom

  • After each usage, all utensils and cooking surfaces should be washed

  • When visiting a place with few sanitary facilities, the following steps must be taken to prevent being infected

  • Observe and check the cleanliness of the food preparation areas

  • Filter and boil the water before drinking it

  • Hands should be washed with soap and hot water before handling or eating food

  • Avoid public bathing locations, particularly if they seem to be dirty

  • Any vegetables or fruit growing in unhygienic surroundings should be peeled and cooked

  • After playing outdoors, make sure that the kids wash their hands with soap and water

Conclusion

Ascariasis is a prevalent illness in underdeveloped nations where sanitation is inadequate. People may prevent acquiring ascariasis by utilizing proper food handling procedures, appropriate sanitation equipment, and avoiding travel to areas where the disease is prevalent. People infected only with a small number of worms usually have no symptoms. Ascariasis may be treated with a single dosage of anti-treatments such as antifungal medicines.