What are pinworms?

Pinworms are small, white, threadlike worms (0.25–0.5 inches long) that live in the large intestine. Pinworms are found in about 5% to 15% of the US population and are not dangerous.

What are the signs or symptoms?

• Most people have no signs or symptoms.

• Itching and irritation around the anal or vaginal area.

• Secondary bacterial infections can result from scratching and breaking the skin.

What are the incubation and contagious periods?

• Incubation period: 2 to 6 weeks or longer from the time of ingesting the pinworm egg until an adult worm migrates to the anal area

• Contagious period: As long as the female worms are laying eggs onto the skin around the anus

How are they spread?

• Fecal-oral route: Contact with feces from an infected person, typically when the person contaminates their fingers and touches an object another person then touches. Children who have contact with the contaminated surface may place their fingers into their own or another person's mouth.

• By sharing toys, bedding, clothing, toilet seats, or baths. The eggs are light and float in the air.

• Pinworm eggs remain infective for 2 weeks in indoor environments.

• Infestation with pinworms commonly clusters within families.

• Pinworms are relatively common among preschool and school-aged children and easily shared within these groups. The rate of reinfection can be high.

How do you control them?

• Use good hand-hygiene technique at all the times listed in Chapter 2 of Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 7th Edition .

• Keep the child's fingernails short.

• Treatment with oral medication once or repeated in 2 weeks may be necessary for the whole family and the group of children who share a common environment.

Adult pinworm in the area around the anus. Inspection 2 to 3 hours after the child goes to sleep may reveal pinworms that have migrated outside of the intestinal tract to lay their eggs on the skin around the anus.

GARY WILLIAMS, MD

Fingers spread open a buttocks to reveal the anus. An arrow points to a white, threadlike worm, about as fine as a piece of hair and a couple centimeters in length, at the top of the anal opening.

What are the roles of the educator and the family?

• Report the infection to the staff member designated by the early childhood education (ECE) program or school for decision-making and action related to care of ill children and staff members. That person, in turn, alerts possibly exposed family and staff members to watch for symptoms.

• Suspect pinworms if a child has intense itching around the anal or vaginal area.

• Refer the person with the infection to a health professional for treatment recommendations. Several different medications can treat pinworms. Treatment is effective and often completed with a single dose of medication which may be repeated in 1 to 2 weeks to prevent reinfection. Children do not need to be excluded from ECE programs or school during treatment.

• Bathe the child in the morning to remove a large proportion of eggs that are laid at night.

• Avoid shaking bedding or underwear to prevent spreading eggs through the air.

• Wash children's hands directly after using the toilet and before hands are involved with putting something into their mouths.

• Wash toys frequently.

• Clean or sanitize surfaces that are touched by hands frequently, such as toys, tables, and doorknobs, according to the Routine Schedule for Cleaning, Sanitizing, and Disinfecting in Chapter 8 of Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 7th Edition .

Exclude from educational setting?

No.