The wriggly topic of worms

How common are worms in children and adults in Singapore?

Very common!

Pinworms, also known as threadworms (because they look like thin white threads) are one of the most common worm infections worldwide, including affluent countries like Singapore. They affect primarily families with preschool aged and school aged children of all socio-economic backgrounds.

How do you contract worms?

Pinworms can only be transmitted from human to human through the fecal-oral route. It is most commonly transmitted by children to their families. Female pinworms lay their eggs around the human anus at night. This can cause an intense peri-anal itching causing the host to scratch and transmit the eggs through contaminated hands and fingernails. The transmission continues with contaminated hands in contact with underclothing, bedding, surfaces, toilet seats, toys and even food.  Pinworms eggs can survive up to 3 weeks. Eggs are transmitted with contaminated hands and objects through the mouth. Once inside the human small intestine, the female worms will mature, move to the colon and lay eggs around the anus. The life cycle continues with the contaminated host re-infecting themselves and others.

Other worms like hookworms, roundworms and whipworms are transmitted to humans by contact of soil contaminated faeces of dogs, cats and even humans. This is more prominent in poorly sanitised countries in tropical and subtropical areas.

What are the symptoms of worms?

Symptoms can range from none to severe itching around the anus at night. Girls may only complaint of itch in their front private parts. Children may show poor disturbed sleep, behavioural issues, irritability, tiredness and poor concentration. They may complain of tummy aches, have change of stools and exhibit a poor appetite. They may even show signs of vitamin and mineral deficiencies.

With hookworms and other worms, there may be bleeding through the stools and poor growth.

How can I check whether my child has them? 

It is important to check your young child’s bottom regularly with a torch, 2 to 3 hours into their sleep. You will find moving thin white thread-like worms that range from 5-15mm long. It is not possible to see pinworm eggs. The “tape test” is a clear sticky tape placed on the anus of the child once awake. The tape will collect the pinworm eggs and can be sent for microscopic examination. It is not necessary to perform the “tape test” as the treatment is usually not harmful.

What is the treatment?

Pinworm medicine can be prescribed by your doctor. Treatment usually extends to those in close contact with the infected person and then repeated 2 weeks later.

Do you have any recommendations as to how to avoid them?

Regular hand washing especially after using the toilet and before meals. Avoiding nail biting. Wash food, fruits and vegetables well before eating. Avoid drinking poorly sanitised water when travelling to underdeveloped countries. Wash bedding and underwear in a hot wash, especially a few days following the deworming treatment. Remember to regularly deworm pets.

If you would like to discuss with a DR about worming treatments, please make an appointment by calling: 6733 4440 or online:

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