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Whipworm

Authors: Robert W. Tolan, Jr, MDAuthor Information and Disclosures

Editors: Ashir Kumar, MBBS, MD, FAAP; Mary L. Windle, PharmD; Martin Weisse, MD; Daniel Rauch, MD, FAAP; Russell W. Steele, MDEditor Information

Last Updated: March 19, 2008

Synonyms and related keywords ›

Introduction

Background: Trichuris trichiura (whipworm) is a roundworm of the phylum Nematoda. It is one of the most common human parasites. The common name is derived from the worm's distinctive whiplike shape. The adult worm usually reaches 3-5 cm in length and has a lifespan of 1-3 years.

Pathophysiology: Humans are the only known host of T trichiura. The organism is spread via the fecal-oral route. Potential hosts ingest the embryonated (mature) eggs. The eggs hatch in the small intestine, and the larvae attach to and penetrate the small intestinal mucosa, where they begin to mature. After approximately one week, the immature worms move passively to the large intestine and proximal colon. The worms' anterior portions penetrate the mucosal epithelium, and the worms can imbed over one half of their length into the mucosal surface.

Once the worms are sexually mature, mating begins. Egg production occurs 2-3 months after initial ingestion. The female worm is capable of producing 3,000-20,000 eggs a day. Once the eggs are passed in the feces, they develop in a warm humid environment. Egg maturation occurs in approximately 2-6 weeks. The embryonated egg can maintain viability for several months under suitable conditions. Destruction occurs with exposure to direct sunlight for more than 12 hours and to temperatures of less than -8°C or higher than 40°C for one hour.

Frequency:

  • In the US: Prevalence of whipworm infestation is less than 0.1%. The most common areas of infection are the southern Appalachian range and Gulf coast states.
  • Internationally: Whipworm infections are among the most common of all human parasites, with an estimated 750-800 million infections worldwide. The most affected regions are rural areas with poor sanitation and tropical climates, including Southeast Asia, Africa, the Caribbean, and Central and South America. Prevalence rates as high as 80% exist in these regions. In contrast, prevalence in areas of Western Europe and Japan is similar to that in the United States.

Mortality/Morbidity: Most infections are asymptomatic. Symptoms are related to the worm load or number of worms involved in an infection. Heavy infections (hundreds to thousands of worms) can lead to death secondary to GI and hematologic complications.

Age: Although infections are observed in all age groups, most heavy infections are observed in the pediatric population. This probably reflects the increased likelihood of children to have poor hygiene and to play in soil that carries the worms' mature eggs.

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Synonyms And Related Keywords

Nematoda, parasite, parasite infection, parasitic disease, trichuriasis, Trichuris trichiura, T trichiura, whipworm, rectal prolapse, Trichuris dysentery syndrome, ascaris, anemia

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Author Information and Disclosures

Author: Robert W. Tolan, Jr, MD, Chief of Allergy, Immunology and Infectious Diseases, The Children's Hospital at St Peter's University Hospital, Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Coauthor(s): Tina Slusher, MD, Assistant Professor, Department of Pediatrics, Section of Pediatric Critical Care, West Virginia University; Steven L. Lanski, MD, Assistant Professor, Department of Pediatrics, Division of Pediatric Emergency Medicine, Emory University and Children's Healthcare of Atlanta at Egleston

Robert W. Tolan, Jr, MD, is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Disease Society, Phi Beta Kappa, and Physicians for Social Responsibility

Editor Information

Editor(s): Ashir Kumar, MBBS, MD, FAAP, Professor, Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University; Consulting Staff, Department of Pediatrics, EW Sparrow Hospital; Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc; Martin Weisse, MD, Program Director, Associate Professor, Department of Pediatrics, West Virginia University; Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine; and Russell W Steele, MD, Professor and Vice Chairman, Department of Pediatrics, Head, Division of Infectious Diseases, Louisiana State University Health Sciences Center

 
 
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