Trichuriasis (Whipworm)

Complications /Information to beware of/General tips:

Medical Emergency Condition

And/or do not wait, phone for an ambulance if  have or develop:

• Liver disease
• Bowel obstruction
• Neurocysticercosis (cysts form in brain and eyes and that can affect sight)
  • Encephalitis
  • Severe headaches and/or confusion and/or poor coordination and/or seizures (fits)
  • High temperature (fever) of 40°C (104°F) or over
  • Blurred vision
  • Floaters (small shapes floating in your field of vision)
  • Reduced vision or loss of vision
  • Slurred speech
• Cysts form on heart:
  • Heart arrhythmias
• Cysts form on muscles:
  • Muscle weakness and disorders
• Cysticercosis (cysts form in the intestines and burst causing secondary infection)
  • Anaphylaxis
  • Meningitis
  • Epilepsy
  • Dementia
  • Hydatid disease (echinococcosis)

This condition can lead to due to Diphlylobotium latum (fish):

• Anaemia (vitamin B12 deficiency)

General tips

• Always wash your hands (when preparing and after eating food)

Meat

• Meat should be cooked until the centre is no longer pink and the juices run clear. Further, letting meat rest for at least three minutes before serving it will also help kill any tapeworms because the meat continues to cook while it is resting.

The FDA recommends these guidelines:

• Refrigerate or freeze meat within 2 hours of cooking or purchasing. Refrigerator temperature should be 40 degrees F or below; freezer temperature 0 degrees or below
• Cooking ground meat and poultry to an internal temperature of at least 160 degrees F (71 degrees C)
• Cooking whole cuts of meat to an internal temperature of at least 145 degrees F (approximately 63 degrees C)

Fish

• Fish should be cooked until it is flaky and is a solid colour. The FDA recommends that fish should also be cooked to an internal temperature of 145 degrees F (approximately 63 degrees C)
• Freezing at least -4 degrees (-20 degrees C) for a week (7 days) will also kill tapeworms.
• Lower temperatures can be used for a shorter time to kill tapeworms, including:
  • Freezing until solid at -31 degrees F (-35 degrees C) or below, and storing at this temperature or below for 15 hours
  • Freezing until solid at -31 degrees F (-35 degrees C) and then storing for 24 hours at -4 degrees (-20 degrees C)

Further General tips

• If one has this condition phone the medical doctor practice rather than visiting the practice as one may spread it to others.
• An infected person should stay away from work or school at least 48 hours after last attack of vomiting or diarrhoea.
• Do not touch your face with unwashed hands
• Avoid close contact with infected people
• Avoid close contact with people who are already ill
• Do not share towels and utensils, dishes , drinking glasses
• Clean and disinfect frequently touched objects and surfaces
• After an illness, clean surfaces that may have the virus on them with detergent and chlorine bleach.
• Don’t prepare any food for other people until at least 2 or 3 days after diarrhea/vomiting stops.
• Don’t eat food that is prepared by someone who is ill with diarrhea/vomiting.
• Stay home and away from other people when ill.
• One should reconsider to keeps pets if one has a weak immune system this includes when there are young children, pregnant women and elderly persons over 65 years old.
• How to wash Hands
• Diarrhoea advice
• How to prevent food poisoning

Take the following steps to avoid passing the illness on to others:

• Wash your hands thoroughly with soap and water after going to the toilet.
• Stay away from work or school until you’ve been completely free from any symptoms for at least 48 hours.
• Help young children to wash their hands properly.
• Don’t prepare food for others until you’ve been symptom free for at least 48 hours.
• Don’t go swimming until you’ve been symptom free for at least 48 hours.
• Where possible, stay away from other people until your symptoms have stopped.
• Wash all dirty clothes, bedding and towels on the hottest possible cycle of the washing machine.
• Clean toilet seats and toilet bowls, and flush handles, taps and sinks with detergent and hot water after use, followed by a household disinfectant.
• Avoid sexual contact until you’ve been symptom free for at least 48 hours.

NHS choices 

Travel

If you’re travelling to a country where there’s a high risk of getting the condition, the Information below can help prevent infection:

• Don’t drink the local water unless you’re sure it’s clean (sterile) – drink bottled water or drinks in sealed cans or bottles.
• If the water isn’t sterile, boil it for several minutes or use chemical disinfectant or a reliable filter.
• Don’t clean your teeth with tap water.
• Don’t have ice in your drinks because it may be made from unclean water.
• Avoid fresh fruit or vegetables that can’t be peeled before eating.
• Avoid food and drink sold by street vendors, except drinks in properly sealed cans or bottles.

NHS choices

Future advise especially when travelling to an infectious country:

• Fresh foods: those that are peeled or cooked are the safest
• Avoid high risk foods like shellfish
• Boiling water is the best method of sterilisation
• Chemicals are useful for preparing safe drinking water but have their limitations
• Chlorine-based tablets are widely available and will be appropriate for most travellers
• More intrepid travellers and those planning to use surface waters as a drinking water source should use an iodine-based product.

• Iodine or chlorine used for water purification (as discussed later) can also be used for soaking and manufacturers of food products give recommendations for the appropriate concentrations.

There are three methods by which the traveller can prepare clean drinking water:

• Boiling:
  • Boil water for a full five minutes at any altitude.
• Chemical disinfection:
  • Iodine, chlorine, katedyne silver.
• Filtration

The Pharmaceutical Journal, PJ, January 2000;():DOI:10.1211/PJ.2000.20000218

H.I.V Test

• A H.I.V test should be offered if one has this condition if symptoms are ongoing.

This condition may show similar symptoms to:

• Bacterial gastroenteritis
• Tapeworm
• Viral gastroenteritis

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice