TRICHURIASIS (Trichocephalo-sis) — the helminthosis from group of nematodoses which is characterized by dysfunction of digestive tract and a nervous system.
T. J. Morganyi in 1761 is for the first time described. It is widespread everywhere, especially in wet zones of a moderate, subtropical and tropical belt; places it infected about 90% of the population. More often children and teenagers aged from 5 up to 15 years are ill.
The activator — a threadworm — Tri-chocephalus trichiurus (L., 1771)
Blanchard, 1895 from this. Trichoce-phalidae Baird, 1853; parasitizes only at the person. The nematode white, sometimes slightly reddish, front department of a body thin, long, back — is shorter and is thickened; at a male the back department is bent in the form of a spiral, at a female — will bend dugoobrazno (fig.). Length of a male is 30 — 45 mm, females — 35 — 55 mm. Eggs of helminth of 50 in size —
54x22 — 23 microns, yellow or brown color, a bochonkovidny form with pro-barrels on poles. The female of a threadworm lays eggs, in to-rykh process of their maturing (formation of a larva) comes to the end in the environment. At t ° 30 ° and high relative humidity in eggs in 25 — 29 days the mobile larva then eggs become invasive (see Inva-
of Fig. develops. Adult individuals of a threadworm of the person (Trichocephalus trichiurus): 1 — males;
2 — females; full size.
ziya). Invasive eggs of threadworms can a long time (up to 3 years) to remain viable in the soil what their accumulation and long existence in the centers of T is connected with. Eggs are resistant to influence of desinfectants. During the swallowing invasive eggs by the person they in intestines leave larvae, to-rye are implemented into fibers of a mucous membrane of a gut where there are from 3 to 10 days. After this term of a larva leave in a gleam of a gut again and are fixed by the head end on its wall. Through i1! 2 — 2 months parasites become puberal and females begin to lay eggs. Threadworms are localized in a caecum, an appendix, the ascending colon, and at an intensive invasion — throughout a large intestine, occasionally in a lower part of a small bowel. Parasitizing of threadworms can last 5 — 6 years. One patient can have one parasite, several tens, hundreds and even thousands are more rare.
Source of activators of an invasion threadworms is only the person. Infection of the person with a trichuriasis happens at a proglatyvaniye of invasive eggs of a threadworm to the contaminated food stuffs and water. Especially often it occurs at consumption of the crude vegetables and berries which are grown up on the soil fertilized by excrements of the person. Infection through the hands contaminated by invasive eggs is possible. Most often T catch. during processing of the soil, gathering early vegetables and strawberries, i.e. in the spring and in the summer. Children because of a shortcoming at them a gigabyte are exposed to the greatest risk of infection. skills.
Usually reaction of a human body to implementation of threadworms is a little expressed, but sometimes in a wall of a large intestine there are infiltrates consisting preferential of eosinophils, plasmocytes and partially lymphoid elements. Small hemorrhages and erosion on a mucous membrane of a gut can be noted, and at a gnezdny arrangement of parasites — to form tumorous granulematozny growths. Metabolic products of helminths cause a sensitization of an organism of the patient. Traumatization of a wall of a gut can promote penetration of bacteria into it (e.g., colibacillus, etc.) with development of local inflammatory process: colitis (see), appendicitis (see), a typhlitis (see), iroktosigmoidit (see Colitis). The irritation of interoretseptor causes emergence patol. the nervous impulses causing disorders of functions of intestines and a stomach.
Durable immunity after transferring of T. does not arise what repeated infections of T testify to., especially children.
In a wedge, a current of T. the significant role is played by intensity of an invasion and reactivity of an organism of the patient. Infection with single parasites usually does not cause the expressed painful phenomena. Sick T. usually complain of a febricula, increased fatigue, decrease (increase is more rare) appetite, hypersalivation, nausea, occasionally vomiting, dull aches in a stomach, is more often in the right ileal and epigastric areas. Approximately at a half of patients locks or their alternation from ponosa are noted. At ponosa in excrements there can be an impurity of slime. At an intensive invasion (in 1 g of excrements to 20 thousand eggs) cases of a trikhotsefalezny hemocolitis meet, at the same time the prolapse of the rectum can be observed at children, on a mucous membrane a cut it is possible to see hundreds of attached threadworms. Sometimes there are attacks of appendicular or intestinal colic (is more often at children). At a palpation of a stomach morbidity in the right ileal area, on the course of a large intestine, in epigastric area and occasionally on all stomach is noted; headaches, dizzinesses, irritability, an uneasy dream, a short-term loss of consciousness, faints and even epileptiform attacks, Menyer's syndrome are observed.
Diagnosis of T. is established at detection in excrements of eggs of a threadworm. Changes from blood are expressed unsharply, anemia, an eosinophilia can be observed. Sometimes at a research of excrements reaction to the occult blood is noted (see. The benzidine test, Guaiac test).
For treatment use diphezyl, Mebendazolum, Naftamonum, oxygen. Diphezyl appoint in a daily dose 5 g, to children up to 5 years — 2,5 g (at two-or triple reception on an empty stomach) within 5 days. It has easy aperient effect. Mebendazolum (Vermoxum) appoint on 0,1 g during food one or twice a day within 3 — 4 days. Naftamonum is accepted on an empty stomach, in 3 hours prior to food. A single dose of 5 g, to children up to 5 years 2 — 2,5 g. Drug is stirred in 30 — 50 ml of sweet tea and drunk in one step then the patient shall lie 3 hours. Course of treatment of 5 days. Naftamonum in a half dose can be combined with oxygen. Oxygen is entered through a rectum. Previously sick give an enema cleansing. In an hour at position of the patient on the left side through a rubber enema cannula enter oxygen on 200 — 250 ml with an interval of 1 — 2 min. After administration of oxygen of the patient shall lie on spin 2 hours. Dose of oxygen on a session: to children at the rate of 100 ml for a year of life, adult — 1500 ml. Cycle of treatment of 5 — 7 days. After oxygen therapy appoint laxative within
1 — 2 days.
The forecast at T. favorable.
Prevention consists in mass inspection of the population and treatment of the revealed patients. Fertilizer of the soil of kitchen gardens, berry-pickers excrements should be produced after their composting. It is recommended to wash and scald carefully boiled water vegetables, berries. It is necessary to observe personal hygiene — washing of hands before food, after work in a kitchen garden, etc.
See also Nematodoses.
Bibliography: Karnaukhov V. K. and
L and with to about in e N to about A. I. K to treatment of a trichuriasis, in book: Vopr. medical gelmintol., under the editorship of L. I. Prokopenko, etc., page 43, M., 1976; The multivolume guide to
microbiology, clinic and epidemiology of infectious diseases, under the editorship of N. N. Shu-kova-Verezhnikov, t. 9, page 574, M., 1968; Intestinal protozoan and helminthic infections, Geneva, WHO, 1981.
V. K. Karnaukhov.