The Extremely Contagious Kid Stomach Bug No One's Talking About

kid feet toilet

I used to think the worst thing I'd hear screamed from the bathroom was "come wipe me, Mommy!" Now it's "Mommy, there's something on my toilet paper, and it's moving!" This is how I was introduced to pinworms, which the Mayo Clinic calls "the most common type of intestinal worm infection in the United States."


If you haven't heard of them, you're living in the dark -- but you've got a lot of company. Schools regularly send home letters about lice infestations and bed bugs. But while the CDC estimates as much as 50 percent of children under 18, people who are institutionalized, and people who take care of infected children could be infected by pinworms, it's pretty rare that schools notify parents of an outbreak.

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The reason is simple, says Dr. Charles Shubin, director of pediatrics at Mercy Family Care in Baltimore, Maryland: Most parents don't even know their kids (or they) have it. That means schools and/or daycares don't often know about an infestation going on either. 

In some ways, that's for good reason.

"You don't get diarrhea. You don't get sick from it," Shubin says of an infestation. "You do get an itchy bottom."

Serious infestations do happen -- a girl in the UK made headlines last year when doctors found a nest of pinworms wriggling around her abdomen, causing severe pain and nausea. But by and large, if you're going to get a parasite, pinworms tend to sit on the "disgusting nuisance" end of the spectrum versus scary or dangerous.

Pinworms are typically transmitted via the "fecal/oral route" -- i.e., kids unknowingly swallow something with infected poop on it. Pinworms deposit their eggs in the intestines, and they're excreted. Because they can last up to three weeks in the open air (and they're microscopic), if a kid doesn't practice good handwashing, they can easily transmit the microscopic eggs to someone else. Sandboxes are often blamed for being ground zero. 

Once swallowed, the eggs end up in another kid's intestines, where they hatch into worms, which crawl out of the anus at night -- hence the itching. 

Which brings us back to my kid screaming that something was moving on her toilet paper. She was up late that night, and her night-owl tendencies turned out to be a good thing for our family ... at least in terms of catching the bugs.

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Most kids experience intense itching of the anus, Shubin says, but the worms only come out at night and are thus rarely seen (except by eagle-eyed kids like mine). So unless your kid reports itching or pays attention to what's on his or her toilet paper at night, you may not know anything is going wrong.

This is why pinworms are rarely treated and also why they often spread. 

"As an illness goes, it's pretty harmless. It doesn't cause any major damage," Shubin says.  

So what's the big deal? Well, for starters, there could be worms in your child's intestines. And the itchy butt is not entirely pleasant. Plus there's the fact that pinworms are highly contagious. If a child has them, Shubin says the entire famly has to be treated, just in case. 

After my daughter's first, second, third, and fourth infestation (yes, really), we spent two weeks washing all of her bedding, clothing, washcloths, and towels in hot water each day, in addition to treating her and treating us. We also made the tough decision to call the school to alert them to an infestation -- although nothing came of it -- and to alert all of her friends' parents. 

Treatment is over the counter with an anti-parasitic that results in mild stomach discomfort and has to be repeated two weeks after the first treatment (yes, for the whole family) to make sure it hits everyone. We all took it. Twice. We did it all, and yet it kept happening ... for a while. 

Shubin says prescription-strength medications may do a better job (although insurance companies often decline to pay for them because there are over-the-counter options). But the other problem was, we didn't know where the pinworms were coming from. We had no way of alerting other parents of kids in her class, and the school declined to send out a note. We did notify the parents of her closest friends, however, after it happened more than once.

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It wasn't exactly fun to call parents to say "Hi, my kid has a worm, and yours might too," but if their kids were getting my kid sick over and over, they had to know. If only to stop the endless cycle of laundry in my house. 

We're finally past it. I think. But if your child's bottom is itching, I can't say it loud enough: Check it! Shubin says you can put a piece of tape on there at night to catch the worms (yeah, it's gross, but it works). The CDC recommends doing this three nights in a row, if you want to truly catch the culprit. 

If it proves to be true, don't second-guess it. Take the medicine. The most common side effect is mild stomach discomfort, which I experienced and Shubin affirms. Otherwise, it's smooth sailing, and the worms will disappear ... well, unless the other families in your 'hood opt out on treatment.

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