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Pinworms—Child Care and Schools

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What are pinworms?

Small, white, threadlike worms (0.25-0.5" long) that live in the large intestine

What are the signs or symptoms?

  • Most people have no signs or symptoms.

  • Itching and irritation around the anal or vaginal area.

What are the incubation and contagious periods?

  • Incubation period: 1 to 2 months or longer from the time of ingesting the pinworm egg until an adult worm migrates to the anal area

  • Contagious period: As long as the female worms are discharging eggs to the skin around the anus

How are they spread?

  • Fecal-oral route: Contact with feces of children who are infected. This generally involves an infected child contaminating his own fingers and then touching an object that another child touches. The child who touched the contaminated surface then puts her fingers into her own mouth or another person's mouth.

  • By sharing toys, bedding, clothing, toilet seats, or baths. The eggs are light and float in the air.

  • Pinworm eggs remain infective for 2 to 3 weeks in indoor environments.

  • Infestation with pinworms commonly clusters within families.

How do you control them?

  • Use good hand-hygiene technique at all the times listed in Chapter 2.

  • Keep the child's fingernails short.

  • Treatment with oral medication once or repeated in 2 weeks may be necessary for the whole family and the group of children who share a common environment.

What are the roles of the teacher/caregiver and the family?

  • Report the infection to the staff member designated by the child care program or school for decision-making and action related to care of ill children. That person, in turn, alerts possibly exposed family and staff members to watch for symptoms.

  • Suspect pinworms if a child has intense itching around the anal or vaginal area.

  • Refer the person with the infection to a health professional for treatment recommendations.

  • Bathe the child in the morning to remove a large proportion of eggs that are laid at night.

  • Avoid shaking bedding or underwear to prevent spreading ova through the air.

  • Wash children's hands directly after using the toilet and before hands are involved with putting something into their mouths.

  • Wash toys frequently.

  • Clean and sanitize surfaces used for eating, toileting, hand hygiene, food preparation, and diapering.

Exclude from group setting?

No.

Comments

  • Pinworms are not dangerous.

  • Pinworms are relatively common among preschool and school-aged children and easily shared within these groups.

  • In the past, pinworms were found in 5% to 15% of the US population, but prevalence has since decreased.

Adapted from Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide.

Any websites, brand names, products, or manufacturers are mentioned for informational and identification purposes only and do not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.