Roundworm disease - Ascariasis

Japanese: 回虫症 - かいちゅうしょう（英語表記）Ascariasis
Roundworm disease - Ascariasis

What kind of infection is it?

Roundworms are worms that are found all over the world, and in Japan, people of all ages, genders, and places of residence can become infected with them. Infection occurs when people swallow roundworm eggs along with food.

Eggs in the small intestine hatching ( Deep ) The emerging larvae burrow into the mucous membrane of the intestine, and travel via the blood and lymph to the liver and lungs. From there, they travel up the trachea and down to the small intestine, where they mature.

Two to three months after infection, eggs are excreted in the feces. Fully matured adults are 20 to 30 cm long and 0.5 cm wide, with females being larger. They live for one to two years.

How symptoms manifest

Roundworms are huge compared to other nematodes, but as long as they remain calm in the small intestine, they do not cause any symptoms. However, they can sometimes enter the bile duct or pancreatic duct, causing sudden, severe abdominal pain.

Also, even if you don't have any symptoms at all, your pet may suddenly spit roundworms out of its mouth or have roundworms come out of its anus.

Testing and diagnosis

Roundworms are often discovered by chance during endoscopic examinations of the stomach or duodenum. When worms are vomited or expelled from the anus, they are diagnosed as roundworms based on their appearance. When a large, slightly reddish milky white worm like worm is found in the stomach or intestines, it is safe to assume that it is a roundworm.

In addition, by chance, blood tests such as health checkups may Eosinophils ( Thank you ) When an increase in white blood cells is found, antibody and stool tests are performed. However, recently, there have been an increasing number of cases where there is only one roundworm, and in many cases, stool tests fail to detect eggs.

Treatment methods

Once the insect is removed with an endoscope, it can be used for both diagnosis and treatment. Anthelmintics ( English: ) It can be cured by taking (Comvantrin) orally.

What to do if you notice an illness

Even if roundworm eggs are excreted in feces, they are not immediately infectious. The eggs mature to the point where they can infect people over a period of 2 to 4 weeks in a warm, moist environment. Since roundworm eggs are not transmitted directly from person to person, there is no need to worry about disposing of feces.

However, people who eat the same food may also be infected. Family members living in the same household should also visit an internal medicine doctor and have their blood and stool tested to check for infection.

Haruhiko Maruyama

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな感染症か

　回虫は、もともと世界中どこにでもいる虫で、日本でも年齢や性別、住んでいる場所に関係なく感染することがあります。感染は、食べ物といっしょに回虫の卵を飲み込んで起こります。

　卵は小腸で孵化(ふか)し、出てきた幼虫は腸の粘膜にもぐり込んで、血液やリンパ液の流れに乗って肝臓、そして肺にたどり着きます。そこから気管をさかのぼって今度は小腸におりてきて、そこで成熟します。

　感染してから2～3カ月で、便のなかに卵が排出されます。十分に成熟した成虫は長さが20～30㎝、太さが0.5㎝ほどで、メスのほうが大きくなります。寿命は1～2年です。

症状の現れ方

　回虫は、線虫類のなかでは巨大といってもいい大きさですが、小腸のなかでおとなしくしているうちはあまり症状はありません。ただし時々、胆管や膵管のなかに入り込むことがあり、この時は突然の激しい腹痛に襲われます。

　また、何の症状もなかったのに、突然、口から回虫を吐き出したり、お尻から回虫が出てくることもあります。

検査と診断

　胃や十二指腸の内視鏡検査で偶然、回虫を発見することが多くなっています。虫を吐き出したり肛門から排出した時は、虫の形態で回虫と診断します。胃や腸のなかから、うっすらと紅い乳白色でミミズのような大きな虫が出てきた時には、まず回虫と考えて間違いありません。

　また、健康診断などの血液検査で偶然、好酸球(こうさんきゅう)という白血球が増えていることがわかった時には、抗体と便の検査を行います。ただし、最近は回虫が1匹だけという例が増えており、検便しても卵を検出できないことが多くなっています。

治療の方法

　内視鏡で虫をつまみ出したら、それで診断と治療を兼ねることになりますが、基本的に駆虫薬(くちゅうやく)（コンバントリン）の内服で治ります。

病気に気づいたらどうする

　回虫卵は便とともに排出されても、すぐには感染能力がありません。卵は暖かく湿った環境で2～4週間かけて、感染可能なまでに成熟します。ヒトからヒトへ直接伝染することはないので、排泄物の処理などに気を使う必要はありません。

　ただし、同じ食事をしている人は、同様に感染している可能性があります。同居の家族も内科を受診し、血液や便を検査して感染の有無を確かめることが必要です。

丸山　治彦

出典　法研「六訂版 家庭医学大全科」六訂版 家庭医学大全科について　情報

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