Human Whipworm (Trichocephalosis) is a disease from the group of anthropomorphous helminthiases – nematodes, which has a pathological effect on the organs of the digestive tract in the form of a dyspeptic syndrome, and also has neurotic manifestations. The disease is widespread, like other helminthiases in tropical and subtropical zones; children from poor families are most often infected.
Adult whipworms parasitize in the lumen of the blind and colonic intestines, deeply penetrating into the mucous membrane by the front long threadlike parts of the body. They secrete a specific secret that converts enterocytes into a semi-liquid substrate. In this case, the intestinal wall is traumatized, which has an additional pathogenic effect:
- a local inflammatory reaction develops, as well as edema, erosion and necrosis;
- hemorrhages and damage to small vessels of the intestinal wall occur, and as a result – anemia;
- the creation of favorable conditions – a gateway for the penetration of infections, various pathogenic microflora, which leads to the secondary attachment of infectious diseases.
In addition, the intoxication of the body occurs as a result of the release of toxins and metabolites that poison the human body, which leads to functional disorders of the reflex order.
Types of Human Whipworm (Trichocephalosis)
According to the form of the course, trichocephalosis is chronic (usually in children 3-5 years old), manifest, severe, compensated or, most often, sub clinical.
The causative agent of trichocephalosis is the whipworm, a nematode of the species Trichocephalus trichiurus, therefore, in some sources, another name for the disease may be indicated – trichurosis. The main route of infection is fecal-oral and is caused by the consumption of vegetables, berries, fruits, herbs and other plants, as well as water and household items contaminated with eggs.
Structure and Life Cycle
From the photo of the parasite, it is clear that the helminth got its name due to the unusual structure of the body. Its front part is filamentous, in the form of a hair, it contains only the esophagus, the rest is the posterior, wider part of the body, inside which all other organs are located. The shape is somewhat reminiscent of a whip, the size of males is 30-45 mm, and females can be slightly larger and reach 55 mm. The structure of the eggs: barrel-shaped, with caps at the ends. Their color is light, yellowish-brownish. Dimensions do not exceed 50 microns. A sexually mature female lays thousands of eggs every day, which go out together with the feces and continue to ripen in the soil like a geohelminth. For the development of larvae in eggs, moist soil with a temperature of 25-30 °C is necessary and after 3-4 weeks they become capable of invasion.
The Life Cycle of a Human Whipworm
When a person swallows an egg with matured larvae, then upon reaching the duodenum, they hatch (the membrane dissolves under the action of digestive enzymes) and the larva emerges, which matures for several weeks and then migrates into the colon. The full cycle of helminth development lasts about 3 months. The worm can live up to 6 years and parasites only in the human body, feeding on blood (up to 0.005 ml of blood per day) and tissue fluid.
Symptoms of Human Whipworm (Trichocephalosis)
Usually, trichocephalosis is characterized by an asymptomatic course of the disease, since the body’s response to the introduction of helminths is weak. The first clinical manifestations after about 1-1.5 months are:
- decreased or perverted appetite;
- general malaise;
- progressive emaciation;
- nausea, sometimes with vomiting;
- sleep disorders;
- violation of the defecation regime;
- paroxysmal pain in the epigastric region and the right half of the abdomen.
Severe invasions can cause anemia and violations of the integrity, functioning of the gastrointestinal tract, peritonitis, as well as inflammatory changes in the appendix – the appendix.
Symptoms of severe invasion are manifested in the form of abdominal pain, loss of appetite, diarrhea mixed with mucus and blood. Thus, the diagnosis of ulcerative colitis or Crohn’s disease can be misdiagnosed. General intoxication causes headaches and dizziness, children may develop neuroses or epileptoid states.
Whipworm in children who suffer from malnutrition and chronic diarrhea in severe cases can provoke rectal prolapse. Moderate infestations can cause stunting of the child.
Analysis and Diagnostics
To confirm the diagnosis of trichurosis, it is necessary to conduct an analysis and microscopically detect the eggs of the pathogen in the feces, which are 50 to 20 microns in size and resemble a lemon in shape. In some cases, it is possible to detect sexually mature whip-worms 3-5 cm long during rectoscopy, which shows the edematous, hyperemic mucous membrane of the large intestine with invaded whip worms.
When studying the hemogram, it is possible to reveal eosinophilia in 10-20% of patients and, possibly, microcytic anemia.
People who have had trichocephalosis should be under dispensary supervision for at least 3 months. After 12-14 days after anthelmintic therapy, repeated studies of feces are carried out twice with a break of 2 weeks.
Treatment is usually medication. Human whip worm turns out to be sensitive to antiprotozoal agents (for example, containing such active substances as albendazole , mebendazole), capable of selectively suppressing β-tubulin polymerization, which causes destruction and blocking of the movement of cytoplasmic microtubules, secretory granules and other organelles of intestinal tract and muscle cells helminth cells, as well as a result of irreversible disruption of glucose utilization and inhibition of ATP synthesis, which generally causes the death of parasites.
The most effective anthelmintic drugs that help with trichocephalosis include:
Albendazole is a broad-spectrum anthelmintic drug, which should be taken orally after meals, the daily dose is 400 mg at a time, the course is 3 days.
Mebendazole is an effective anthelmintic drug that must be taken orally by mouth 25–30 minutes after a meal, the daily dose is 200 mg, should be divided into 2 doses, the duration of treatment is 3 days.
Carbendacim – The drug is used for swelling due to its activity against intestinal nematodes. Assign orally by mouth after meals at a dose of 10 mg per 1 kg of the patient’s body weight for 3-5 days.
When using the above listed drugs, laxatives or cleansing enemas are not prescribed.
The most effective are the following prevention methods:
- timely identification of patients and the conduct of anthelmintic therapy;
- constant maintenance of personal hygiene and adherence to the rules;
- drinking only boiled drinking water;
- scrupulous washing of greens, vegetables, fruits and berries;
- prevention of contamination of surrounding areas with feces due to the arrangement of sanitary devices and sewerage;
- regular cleaning of cesspools and decontamination of feces;
- sanitary and educational work.
Diet Plan for Human Whipworm (Trichocephalosis)
During therapy, it is recommended to follow a diet that limits consumption:
- salty, fatty and fried foods;
- sugar and various sweets;
- smoked products;
- foods that disrupt the digestive tract (margarine, bacon, baked goods, canned foods with dyes).
You need to enrich the diet with seafood, sauerkraut, salad and spinach, carrots, bananas, boiled potatoes, lactic acid drinks, rye bakery products.
Consequences and Complications
- intestinal prolapse;
If no serious complications have arisen, then after conducting anthelmintic therapy, the prognosis is favorable.