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Two young children have contracted roundworm, a parasitic infection usually found in pigs – with one child discovered to have had a 16cm-long worm inside her.
The rare cases of autochthonous ascariasis (roundworm) infection have been highlighted in an article published in the New Zealand Medical Journal today.
The authors say roundworm is usually associated with overseas travel, but the children lived on farms and had not been outside New Zealand.
They say the most likely explanation is that the infection was passed from pigs via the soil, raising the prospect of “under-recognised” roundworm transmission within New Zealand.
Ascariasis is a roundworm infection that can be picked up by drinking water or eating food contaminated with roundworm eggs. It can also be ingested through contaminated soil and is an infection often found in tropical and subtropical countries.
Ascariasis lumbricoides primarily infects people, whereas the other kind of infection, Ascariasis summ, primarily infects pigs. Some experts believe, however, that cross-infection between people and pigs is possible.
The report describes how eggs can hatch in a person’s small intestine, releasing larvae, then migrating to the lungs before returning to the small intestine to grow into adult worms.
The 16cm adult worm retrieved from a 3-year-old. Photos / NZ Medical Journal
One of the two children identified in the report is a 14-month-old girl who presented at hospital with diarrhoea.
“One month later, her mother noted the presence of a worm in her nappy.”
The other child was a 3-year-old girl who presented with abdominal pain and diarrhoea.
“She subsequently passed a worm,” the report reads.
Both children were treated with Mebendazole – medication used to treat intestinal worm infections.
Three photos were also released as part of the New Zealand Medical Journal report, showing an ochre-coloured adult worm with a tapered end.
The first image shows the whole worm – a specimen of the parasite worm that measured a spine-tingling 16cm long.
The other two photos show the unique horizontal patterns on the worm, as well as the “protuding mouth parts”, as described in the report.
Clinicians urged to consider roundworm
The authors of the article - Shivani Fox-Lewis, Sushmir Sen, Jane Hunter and Mary N De Almeida - noted a link between the two girls.
“Both children lived in Northland on farms, housing cows and pigs. Neither child had direct contact with pigs, but both had contact with soil around the farm.
“Neither child had travelled overseas.”
As a result of that link, the authors say Ascariasis infection can be locally acquired, particularly in light of the fact one of the species is known to be present in pigs in New Zealand.
They also called on healthcare providers to consider the infection when treating patients.
“The two cases described here raise the possibility of under-recognised autochthonous ascariasis in Aotearoa.
“This report serves as a reminder to clinicians to consider Ascariasis, even in cases without overseas travel, particularly if there is exposure to pigs or contaminated soil.”
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