What is the treatment for threadworms?

The common treatment is to take a medicine to kill the worms in your gut AND hygiene measures to clear eggs which may be around your anus or in your home.

Medication
You can buy the following medicines from pharmacies. You can also get them on prescription. (The medicines below are not recommended if you are pregnant or breastfeeding. Hygiene measures alone may be sufficient.)

• Mebendazole is the usual treatment for people aged over two years. All household members, including adults and those without symptoms, should take a dose at the same time. This is because it is common to have worms in the gut with little or no symptoms. Just one dose kills the worms. A second dose two weeks after the first is sometimes needed if the infection has not cleared (which may occur if you swallow some eggs after taking the medication).
   
• Piperazine is an alternative medicine, and can be used in children under two years (but over three months). You need to take two doses, 14 days apart.

Hygiene measures
Medicine will kill the worms in the gut, but not the eggs that have been laid around the anus. These can survive for up to two weeks outside the body on underwear, bedding, in the dust, etc (as described above). So, hygiene measures aim to clear any eggs from the body and the home, and to prevent any eggs from being swallowed. This will then break the cycle of 're-infection'. Every member of the household should do the following for two weeks after the first dose of medicine.

• Wear underpants or knickers at night. This is so that if you scratch in your sleep, you will not touch the skin near the anus.
• Keep fingernails short. Wash hands and scrub nails each morning. Wash hands before meals or snacks, before preparing food, and after going to the toilet or changing nappies.
• Every morning have a bath, or wash around the anus, to get rid of any eggs laid overnight. You must do this straight away after getting up from bed.
• Change and wash underwear, nightwear (and bed linen if possible) each day. Avoid shaking clothes and linen as any eggs on them may be wafted into the air and become part of the dust.
• Keep toothbrushes in a closed cupboard. Rinse well before use.

Also, on the day when you take the medicine, it is best to have a 'blitz' around the home which aims to clear any eggs which may be part of the dust. This should include:

• Vacuum and dust all household carpets, particularly those where children play.
• Damp-dust smooth surfaces with a cloth rinsed in hot water. Again, particularly in places where children play, and in bedrooms and the bathroom. Throw out the cloth after use.

After an initial thorough cleaning blitz, some people suggest that you vacuum and damp-dust every day for 14 days.

However, it may not be your home which is a main source of threadworm eggs. Your children may come into contact with eggs in schools or nurseries, particularly in the toilets if they are not cleaned properly. If your child has recurring threadworms, it may be worth checking that toilet facilities at schools, nurseries, etc, are regularly cleaned in a way that will remove any threadworm eggs which may be present.

If you are pregnant you should not take medicines which kill worms. The worms die after about 6 weeks. Provided that you do not swallow any new eggs, then no new worms will grow to replace them. So, if you continue the hygiene measures described above for 6 weeks, then this should break the cycle of 're-infection', and clear your gut of threadworms.

Can a child with threadworms go to school?

Yes. There is no need to keep a child with threadworms off school, nursery, etc. The hygiene measures described above will mean that children will not have any eggs on their fingers when they go out from the home each day and so cannot infect others.