Chapter 286 Enterobiasis (Enterobius vermicularis)
Etiology
The cause of enterobiasis, or pinworm infection, is Enterobius vermicularis, which is a small (1 cm in length), white, threadlike nematode, or roundworm, that typically inhabits the cecum, appendix, and adjacent areas of the ileum and ascending colon. Gravid females migrate at night to the perianal and perineal regions, where they deposit up to 15,000 eggs. Ova are convex on 1 side and flattened on the other and have diameters of ∼30 × 60 µm. Eggs embryonate within 6 hr and remain viable for 20 days. Human infection occurs by the fecal-oral route typically by ingestion of embryonated eggs that are carried on fingernails, clothing, bedding, or house dust. After ingestion, the larvae mature to form adult worms in 36-53 days.
Epidemiology
Enterobiasis infection occurs in individuals of all ages and socioeconomic levels. It is prevalent in regions with temperate climates and is the most common helminth infection in the USA. It infects 30% of children worldwide, and humans are the only known host. Infection occurs primarily in institutional or family settings that include children. The prevalence of pinworm infection is highest in children 5-14 yr of age. It is common in areas where children live, play, and sleep close together, thus facilitating egg transmission. Because the life span of the adult worm is short, chronic parasitism is likely due to repeated cycles of reinfection. Autoinoculation can occur in individuals who habitually put their fingers in their mouth.
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