(Whipworm)

 Whipworm is a soil-transmitted helminth (STH)

and is the third most common roundworm of
humans. This roundworm infects human hosts and
reproduces within the large intestine.
 Humans are the primary host
 Trichuris trichuria
 Whipworm causes an infection called trichuriasis
and often occurs in areas where human feces is
used as fertilizer or where defecation onto soil
happens. The worms are spread from person to
person by fecal-oral transmission or through
feces-contaminated food.
 Fecal-Oral route
 Ingestion of embryonated
Trichuris eggs from
vegetables or soil that is
contaminated with
human feces
 The incubation period is 2 to 3 months
 1. In the soil, the eggs
develop into a 2-cell
stage
 2. an advanced
cleavage stage
 3. and then they
embryonate
 4. eggs become infective in 15 to 30 days. After ingestion
(soil-contaminated hands or food), the eggs hatch in the small
intestine, and release larvae
 5. that mature and establish themselves as adults in the colon
 6. The adult worms (approximately 4 cm in length) live in the
cecum and ascending colon. The adult worms are fixed in that
location, with the anterior portions threaded into the
mucosa. The females begin to oviposit 60 to 70 days after
infection. Female worms in the cecum shed between 3,000
and 20,000 eggs per day. The life span of the adults is about 1
year.
 Manifestations of infection depend on the worm
burden, with most infection light and asymptomatic.
Burden and symptomatology tend to be heaviest in
school-age children.
 Large number of worms either trichuris alone or
combined with other parasites can cause abdominal
pain, nausea, vomiting flatulence chronic diarrhea
(with blood and mucus ), weight loss, and anemia.
 Very heavy worm burdens sometimesresult in rectal
prolapse. Children with severe chronic infection may
have clubbing, growth retardation, and possible
cognitive delays
 Hookworm infection
 Acute abdomen
 Amebiasis
 Human to human transmission of T. trichuria does NOT
occur because part of the worm’s life cycle must be
completed in soil before becoming infectious. Soil
contamination is perpetuated by fecal contamination
from infected individuals. An infected person may shed
eggs for as long as they are infected with an egg laying
adult which may be several years.
 MEBENDAZOLE 100 mg, PO, BID for 3 days
 ALBENDAZOLE 400 mg, PO for 3 days

-5 to 7-days regimen of albendazole produces an improved

cure rate
 NITAZOXANIDE -100 mg , BID, PO for 3 days (children age 1 to
3)
 - 200 mg PO, bid, for 3 days (children ages 4-11)
 Wash hands after defecating and before contact with food
 Wash vegetables before eating
 Prevent infants and children from ingesting soil
 When a sanitary water supply is unavailable, periodic deworming of
school-age children with mebendazole or albendazole has been shown
to decrease overall worm burden in the community