The problem of worms worries parents no less than vaccinations and teething. Any symptom, ranging from abdominal pain and ending with bad behavior invokes thoughts of worms. How a wrong diagnosis leads to incorrect treatment? We’ll try to understand it in our new article refuting the most common myths.
1. Worms may cause atopic dermatitis
Atopic dermatitis is a chronic skin disease, caused, as scientists assume, by the genetically programmed predisposition (often the patient’s relatives also suffer the same problem) to the violation of its barrier function and quick drying, making it much easier for the majority of external irritants and allergens to cause inflammation. Simply put, this disease has its own reasons for the development and treatment methods, and worms have nothing to do with it. Moreover, modern “hygiene hypothesis” suggests that a closer contact with bacteria, viruses, parasites and allergens may reduce the frequency of allergic diseases, which is clearly seen on the example of developing countries.
2. You can feel worms move throughout the body
This is not true. Even migrations of skin parasites cannot be felt, although some patients complain that they feel worms move in the intestine, lungs or blood vessels. This phenomenon even has a name – visceral hallucinations. However, this is treated by psychotherapists rather than parasitologists.
3. Parasites living in the intestine can be diagnosed by a blood test
Medicine also developed its trends. Modern people easily believe in expensive and advertised methods of diagnosing diseases, including parasitic infestations. One striking example is the diagnosis of typical intestinal helminths and protozoa (mainly of Ascaris and Giardia) using ELISA (enzyme-linked immunosorbent assay). This method defines antibodies to parasites. Unfortunately, it has a lot of disadvantages:
- It cannot determine if the person is sick now or the infection occurred a few years ago;
- it has poor sensitivity and specificity, that leads to a high probability of false-positive and false-negative results;
- in the end, it’s not cheap.
For the diagnosis of intestinal parasites, only microscopic evaluation of stool sample is used. Blood test is only useful for toxoplasmosis, toxocariasis, trichinosis, fascioliasis, opisthorchiasis, and echinococcosis. With other parasites, a blood test is unreliable!
4. If you keep a dog, you need to be sure all family members take preventive anthelmintic drugs
Dogs and humans have two common parasites: toxocara and echinococcus. The latter can be caught by contact with stray dogs, which are, fortunately, absent in many countries. As for toxocariasis, dog owners have the same chances of getting infected as non-owners because infection occurs mainly through street dust containing particles of animal feces (and children, as a rule, get it while playing in a sandbox). So dog owners need to simply clean up after their pets on the street, bathe them often and give anthelmintic drugs – this is the best prevention of toxocariasis. Dog owners need no preventive measures.
5. All children should take anthelmintics 1-2 times a year for prevention
Partly true, but we should consider the details. The World Health Organization actually recommends helminths prophylaxis in children, but it only concerns endemic zones: once a year, if the prevalence of soil-transmitted helminth infections reaches more than 20%, and twice a year if this figure is more than 50%.
6. Dietary supplements can cure intestinal worms no worse than standard drugs
Supplements are positioned as regular food additives to replenish vitamins and minerals in the body, but savvy marketers started promoting them as a medicine for all diseases. According to the legislation, products labeled “dietary supplements” require no medical research, as with medicines. Therefore, if you see an ad of another super-product against worms on the internet, TV, in newspapers or television, be aware that the manufacturer of this “miracle” does not really know how it works and whether it works at all, because their main task is to make money, not to cure you. To date, none of the dietary supplements has officially passed all the necessary tests or proven its anthelmintic action.
7. Giardia can penetrate into the gallbladder or liver and cause inflammation there
Giardia are parasites living in the small intestine only, because they like the alkaline environment. They cause corresponding symptoms: diarrhea, indigestion, fatigue, and fever. Prolonged exposure to bile kills giardia quickly, and their advancement, not to mention living in the gall bladder, is highly improbable,
8. Little children eat sand and earth while playing on the street, so they should be given anthelmintic products from time to time
There is nothing good in eating sand, of course. Especially, if you are not sure that it is not used as a dog toilet, because they are carriers of toxocariasis, as we discussed above. Alas, if the child has swallowed the eggs of toxocara, preventive dosages of drugs will not work, as they are too small for the destruction of worms and will do more harm than good. Parents just need to look after their children carefully (try to avoid public sandboxes and not to let the child take the objects from the ground into his or her mouth) and to seek medical help at the first symptoms of the disease. Only a doctor can diagnose the disease properly and select appropriate treatment.
9. Sorbents are used to treat intestinal worms
None of the modern treatment protocols on helminthisms contains such recommendations. Multiple studies have shown that virtually 100% of cases require only anthelmintic products for treatment. You have probably heard about them: albendazole, mebendazole, pyrantel, metronidazole, etc. And nothing more is needed. Everything else will only add side effects, but will not help in the treatment.