From the Research
Recurrent Enterobius vermicularis (pinworm) infections are primarily caused by repeated cycles of reinfection, particularly autoinfection, due to poor personal hygiene, inadequate sanitation, and overcrowding, as well as the short life span of adult pinworms. The main transmission route occurs when someone touches a contaminated surface and then touches their mouth, allowing eggs to be ingested 1. Children are particularly susceptible due to their tendency to put fingers in their mouths and their close contact with other children in schools or daycare settings. Poor hand hygiene significantly increases infection risk, especially after using the bathroom or before eating. The pinworm life cycle contributes to reinfection, as female worms crawl out of the anus at night to lay eggs on surrounding skin, causing itching that leads to scratching and further egg dispersal under fingernails.
Some key factors that contribute to recurrent pinworm infections include:
- Poor socioeconomic conditions
- Inadequate sanitation
- Poor personal hygiene
- Overcrowding
- Age, with children aged 5 to 14 years having the highest prevalence of enterobiasis
- Autoinfection, where eggs are ingested after being deposited on the perianal skin
- Household transmission, where entire families can become infected simultaneously
To prevent frequent infections, it is essential to practice thorough handwashing with soap and water, keep fingernails short, avoid touching the face, wash bedding and underwear in hot water regularly, and clean bathroom surfaces and toys frequently 1. Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections, as reinfection is common even when effective medication is given. The drugs of choice for the treatment of pinworm infestation are mebendazole, pyrantel pamoate, and albendazole, all of which are given in a single dose and repeated in two weeks 1.