Whipworm Infection

Last updated March 17, 2017

What are the other Names for this Condition? (Also known as/Synonyms)

  • Infection by Trichuris
  • Trichocephaliasis Trichuriasis
  • Trichuris Trichiura Infection

What is Whipworm Infection? (Definition/Background Information)

  • Whipworm Infection is caused by the presence of the roundworm Trichuris trichiura in the intestines, most commonly in the large intestine
  • The disease is acquired by ingestion of soil containing the eggs of the roundworm. Vegetables may also contain eggs of T. trichiura, when grown in contaminated soil
  • The signs and symptoms may be mild or severe depending on the infestation by the worm. These may include abdominal pain, bloody diarrhea, and rectal prolapse in severe cases
  • Whipworm Infections respond well to treatment with appropriate medications. The prognosis is generally excellent with appropriate treatment
  • Ensuring proper hygiene and sanitation facilities, especially in regions where open defecation is practiced can reduce/prevent the incidence of Whipworm Infections

Who gets Whipworm Infection? (Age and Sex Distribution)

  • According to  U. S. Centers for Disease Control and Prevention (CDC), over 700 million people are infected globally by T. trichiura resulting in Whipworm Infections
  • Children are more likely to be exposed to the disease, based on their increased contact with infected soil
  • There is no gender predilection, both males and females are at equal risk for Whipworm Infection

What are the Risk Factors for Whipworm Infection? (Predisposing Factors)

The risk factors of Whipworm Infection include:

  • Individuals living in the tropical regions of the world have a higher probability of being affected by Whipworm Infection
  • Exposure to contaminated soil
  • Soils treated with fertilizer made of waste such as sewage
  • Individuals living in unhygienic settings with poor sanitary conditions
  • Living or travelling to areas with poor sanitation facilities
  • Eating food contaminated with ‘egg-carrying’ soil, eating raw or uncooked fruits and vegetables

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Whipworm Infection? (Etiology)

Whipworm Infection is caused by the roundworm Trichuris trichiura. Humans are the main reservoir of whipworm (roundworm).

  • Upon ingestion of the roundworm (T. trichiura) eggs, the eggs travel through the gastrointestinal tract (food tract), until they reach the small intestine, where they hatch and mature. This causes a Whipworm Infection
  • Adult roundworms travel to the large intestine, where they can reproduce and live for up to a year, or even longer in untreated cases
  • Eggs laid by the adult whipworms are passed into fecal matter to embryonate (develop as an embryo) in the local soils. The eggs found in the soil are resistant to cold temperature, but not to desiccation (dry conditions); therefore, the frequency of infection is greater in moist, tropical areas
  • The human whipworms are long ‘whip-like’ worms with flattened posterior end (30-50 millimeters in length), classified as roundworms. Female whipworms can lay about 10,000 eggs per day through human feces that get deposited in soils, mostly in areas where people practice ‘open (outside) defecation’

What are the Signs and Symptoms of Whipworm Infection?

The common signs and symptoms of Whipworm Infection are:

  • Abdominal pain
  • Bloody diarrhea
  • Tenesmus: Feeling of incomplete defecation
  • Anemia: Decreased amount of hemoglobin in blood
  • Fecal incontinence during sleep
  • Vitamin A deficiency
  • Children with light Whipworm Infections usually may have no symptoms.

How is Whipworm Infection Diagnosed?

The diagnosis of Whipworm Infection may include the following:

  • Physical examination with thorough evaluation of medical history (and recent travel history)
  • Presence of ova or parasites in stool detected through lab tests

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Whipworm Infection?

Whipworm Infections can cause the following complications:

  • Rectal prolapse can occur in severe cases , in which the rectum falls or slides down and projects out of the anal opening
  • Severe blood loss can lead to iron-deficiency anemia
  • Nutritional deficiencies resulting in growth retardation and weight loss, especially with severe infection in children

How is Whipworm Infection Treated?

Whipworm Infections may be treated through antimicrobial medications and proper nutrition:

  • Mebendazole and albendazole are used as first line drugs
  • Iron and vitamin supplementation are also added to the diet

How can Whipworm Infection be Prevented?

Possible preventive measures for Whipworm Infection may include:

  • Maintaining proper hygiene
  • Washing hands with soap before meals
  • Avoiding food contact with infected soil
  • Washing vegetables and fruits before consumption
  • Following basic rules while cooking food, such as carefully washing food items, washing food vessels/cutting boards before use, cooking food to the required temperatures to kill any pathogens, refrigerating cooked food to avoid it being spoiled, and keeping food items covered
  • Always drink water that is clean and from a reliable source

A decreased frequency of Whipworm Infection has been observed by ensuring the proper disposal of human feces and by improving sanitation methods, especially in tropical areas with high risk of infection.

What is the Prognosis of Whipworm Infection? (Outcomes/Resolutions)

The prognosis of Whipworm Infection is excellent with suitable treatment.

Additional and Relevant Useful Information for Whipworm Infection:

  • Roundworms, also known as nematodes, cause a variety of human parasitic infections. Common roundworms include whipworms, hookworms, and ascaris, grouped together as soil-transmitted-helminths (worms that spread through infected soils)
  • The US FDA has published a book titled, ‘Bad Bug Book’, which contains information about Trichuris trichiura and other infectious diseases
  • The ova and parasites stool test (O & P test) is used to detect the presence of specific parasites within the human digestive tract

The following article link will help you understand the ova and parasites stool test:

http://www.dovemed.com/common-procedures/procedures-laboratory/ova-and-parasites-stool-test/

What are some Useful Resources for Additional Information?

World Health Organization (WHO)
Avenue Appia 20, 1211 Geneva 27, Switzerland
Telephone: + 41 22 791 21 11
Fax: + 41 22 791 31 11
Website: http://www.who.int

Centers for Disease Control and Prevention (CDC)
1600 Clifton Rd.  Atlanta, GA 30333
Phone: (404) 639-3534
Toll-Free: 800-CDC-INFO (800-232-4636)
TTY: (888) 232-6348
Email: cdcinfo@cdc.gov
Website: http://www.cdc.gov

References and Information Sources used for the Article:

http://www.nlm.nih.gov/medlineplus/ency/article/001364.htm (accessed on (11/13/2014)

http://www.fda.gov/Food/FoodborneIllnessContaminants/CausesOfIllnessBadBugBook/ucm070828.htm (accessed on 11/13/2014)

http://www.cdc.gov/parasites/whipworm/ (accessed on (11/13/2014)

Helpful Peer-Reviewed Medical Articles:

Herman, M. A., Ukawa, K., & Sugawa, C. (2000). Diagnosis and removal of cecal whipworm infection: case report and review. Dig Dis Sci, 45(8), 1639-1643.

Davis, M., Matteson, R., & Williams, W. C. (1986). Radiographic and Endoscopic Findings in Human Whipworm Infection (Trichuris trichiura). Journal of clinical gastroenterology, 8(6), 700.

Baddeley, A. (1992). Cognitive function and whipworm infection. Parasitology Today, 8(12), 394-395.

Joo, J. H., Ryu, K. H., Lee, Y. H., Park, C. W., Cho, J. Y., Kim, Y. S., ... & Shim, C. S. (1997). Colonoscopic diagnosis of whipworm infection. Hepato-gastroenterology, 45(24), 2105-2109.

Ma, X. B., Cai, L., Zhang, B. X., Fu, Y. H., & Huang, D. S. (1999). The relationship between whipworm infection and children’s development. Chinese Journal of Parasitic Disease Control [in Chinese], 12(4), 310-311.

Lin, A. T. C., Lin, H. H. H., & Chen, C. L. (2005). Colonoscopic diagnosis of whipworm infection. Journal of gastroenterology and hepatology, 20(6), 965-967.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 18, 2015
Last updated: March 17, 2017

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