Ascariasis: Treatment & Epidemiology

Instructor: Artem Cheprasov
Hundreds of millions of people are infected with parasitic worms! One condition where this occurs is called ascariasis. Find out more about this condition's treatment and epidemiology.

Ascariasis

Do you have a cough? Maybe it's just the flu. Or maybe it's a sign of something straight out of a horror film. A cough is one potential sign of ascariasis, the disease caused by parasitic worms known generally as ascarids. Long story short, a person might swallow parasitic (and microscopic) worm eggs as they eat. These eggs hatch in the person's intestines and, from there, the little worms move to the lungs, where they might cause a person to cough! From the lungs, the worms eventually make it back down into the intestines and grow into large adult worms inside the person's gut.

But this lesson isn't about the pathophysiology nor signs of this condition. Instead, it's about some of the possible treatment options for ascariasis as well as some tidbits about its epidemiology.

Ascaris lumbricoides, a type of ascarid.
Ascaris lumbricoides

Treatment

So let's just say you've been unlucky enough to swallow these eggs and develop a case of ascariasis. What to do? Well, the answer sort of depends on exactly what's going on.

See, if you have a cough or difficulty breathing as a result of ascariasis, then it's possible little parasitic worms are inside of your lungs right now. You'd think that killing them ASAP is a good idea. However, the problem is that if you were to kill these worms while they're in the lungs, the dying worms put you at risk of developing a serious inflammatory reaction in the lungs known as pneumonitis. So, the worms inside the lungs aren't targeted directly. Instead, a person may be given bronchodilators. Bronchodilators work by opening up the airways of the lungs, helping the person breathe.

Now, the intestinal infection itself is treated via anthelmintics. An anthelmintic is a drug that targets parasitic worms. Here are some possible treatment options:

  • Albendazole. Albendazole works by, in the end, depleting the parasitic worm of life-sustaining sugar and biochemical energy. This, obviously, causes the worm to die.
  • Mebendazole, as an alternative to albendazole.
  • Pyrantel pamoate for pregnant women.

Not all treatment options for ascariasis are based on medications. See, sometimes there is a tangled mess of worms inside a person's gut. This could cause a potentially serious intestinal obstruction, one that would require surgery to remove the obstruction.

Epidemiology

So should you be really worried about getting infected with ascarids and having to go through all of that? Well, this is where knowledge of the epidemiology surrounding ascariasis comes in. It can help us answer this question.

Ascariasis is most common in children between the ages of 2-10. This could be, in part, because they are more likely to put dirty hands into their mouths.

Additionally, as of 2005, the following regions had a lot of cases of ascariasis:

  • China, at 86 million cases
  • India, at 140 million cases
  • Sub-Saharan Africa, with 173 million cases

Recent figures for the United States are hard to come by, but they are likely around a few million cases per year and most of those cases are likely limited to recent immigrants.

And so, a combination of environmental, hygienic, and sanitary reasons influences your chances of getting infected. For example, warm and wet climates are far more ideal for transmission of these worms than a tundra.

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