Module 7 Worms
Introduction 1a Intestinal worms, also known as parasitic worms, are one of the main types of intestinal parasites. Common types of intestinal worms include: flatworms, which include tapeworms and flukes Hookworm infestations can cause these additional symptoms as well3: Itchy rash where the larvae penetrated the skin Anaemia Fatigue Tapeworm infestations can cause3: How infestation occurs 1b One way to become infected with intestinal worms is eating undercooked meat from an infected animal, such as a cow, pig, or fish. Other possible causes leading to intestinal worm infection include: Nausea, diarrhea and abdominal pain Lack of appetite and weight loss General weakness Anaemia Neurological problems such as seizures consumption of contaminated water consumption of contaminated soil contact with contaminated faeces poor sanitation poor hygiene Roundworms are typically transmitted through contact with contaminated soil and faeces. Preventing infestation 1c To prevent intestinal worms, regularly wash your hands with soap and hot water before and after using the toilet and before preparing or eating foods. You should also practice food safety: Symptoms of roundworm infestation Most people have no symptoms. However, the following symptoms can occur2: arly-phase symptoms Starts 4 16 after swallowing the eggs and include: Fever Dry cough Shortness of breath Wheezing Late-phase symptoms Starts 6 weeks after ingestion and symptoms associated with mature worms include: Passing worms in your faeces Mild stomach pain Nausea and vomiting Diarrhea (may also notice blood in stool) Avoid raw fish and meat Thoroughly cook meat to temperatures of at least 62.8 C for whole cuts of meat and 71 C for ground meat and poultry Let cooked meat rest for three minutes before carving or consuming Freeze fish or meat to 20 C for at least 24 hours Wash, peel, or cook all raw fruits and vegetables Wash or reheat any food that falls on the floor If you re visiting developing countries, cook fruits and vegetables with boiled or purified water before eating, and avoid contact with soil that may be contaminated with human faeces. 30 31
Case Study 1 Mavis, 32, Mom Recommendation Inform Mavis that she and her family may have a hookworm infestation and that deworming is required as a precaution. After this initial treatment, it is recommended that Mavis deworm every six months4. Mavis has come to your pharmacy to ask for advice. She tells you that her children have been suffering from mild nausea, stomach pain and diarrhea. All of this happened over a period of. Ask the following questions: Does she have pets? Have her children eaten any uncooked or unwashed food? Do her children have a rash on the soles of their feet? Are her children taking any medication? Do her children walk around outside with bare feet often? Mavis confirms that her children don t have an itchy rash on the soles of their feet but she does. You establish that Mavis and her family may have contracted a hookworm infestation. What s it for? 1. Kills all common types of intestinal worms 2. Worms are disintegrated so there is no passing of dead worms 3. Convenient single and multi-dose tablet and suspension options 4. It contains the pharmaceutically favoured Mebendazole Polymorph C the most effective form of Mebendazole5 5. Pleasant banana and chocolate flavoured suspensions. As stipulated in Section 22A subsection 4 and 5 of the Medicines and Related Substances Act 101 of 1965, product recommendations can only be made by Pharmacists and Pharmacist Assistants acting under the personal supervision of a pharmacist (S1 S2). Any customer seeking medical advice from a Front Shop Assistant should be referred to the Pharmacist on duty. 32 33
Case Study 1 Continued: What s inside? Worm Infestation SINGL DOS MULTI DOS Whipworm/ Hookworm/ Large Roundworm/ Pinworm Adults & Tapeworm Adults & Threadworm Adults Threadworm Product 10 ml SD 500 mg Tablet 30 ml 100 mg Tablet Product 10 ml SD 500 mg Tablet 30 ml 10 ml as a single dose 1 tablet (500 mg) as a single dose (or 25 ml as a single dose) n/a n/a n/a n/a n/a n/a daily for 6 (2 x 3-day dose) 10 ml twice ffective treatment for Whipworms Hookworms Large Roundworms Pinworms Whipworms Hookworms Large Roundworms Pinworms Threadworms Tapeworms (2 x 3-day dose) 100 mg Tablet daily for 6 (2 x 3-day dose) 2 tablets twice D O C T O R R C O M M D N 6 D 34 35
Test Your Knowledge You ve reached the end of the module. You can test your knowledge right away while the info is fresh, or you can complete the full Class Test in one go once you reach the end of this Study Pack. See the back page of the booklet for more details on how to complete and submit your test. Below are the questions from the Class Test that apply to the module you just finished. The full Class Test appears on the Fax Sheet included separately. 1 is not a symptom of hookworm infestation? a xcessive sweating b c d Itchy rash where larvae entered the skin Migraine Sleeplessness 2 3 one of the following statements about is not true? a Kills all types of intestinal worms b Worms are disintegrated c It comes in 2 palatable flavours: Lemon & Lime and Watermelon d It is available in tablet or liquid form one of the following actions will not help prevent infestation? a Avoiding raw fish and meat S1 VRMOX. ach 5 ml suspension contains 100 mg Mebendazole Polymorph C. Reg. No. K/12/206. S1 VRMOX 100 mg tablets. ach tablet contains 100 mg Mebendazole Polymorph C. Reg. No. G/12/105. S1 VRMOX SD. ach bottle (10 ml suspension) contains 500 mg Mebendazole Polymorph C. Reg. No. 34/12/0058. S1 VRMOX 500 mg tablets. ach tablet contains 500 mg Mebendazole Polymorph C. Reg. No. W/12/42. For full prescribing information refer to the package insert approved by the Medicines Regulatory Authority. References 1. What are intestinal worms? Available at https://www.healthline.com/health/intestinal-worms. Accessed on 7 June 2018.2. b c d Regularly wash your hands with soap and hot water nsuring good sanitation Drinking lots of alcoholic beverages when it s hot 2. NHS Choices. Roundworm. Available at www.nhs.uk/conditions/roundworm/symptoms/. Accessed on 5 January 2018. 3. Healthline. Parasitic Worms in Humans: Know the Facts. Available at www.healthline.com/health/worms-in-humans. Accessed on 5 January 2018. 4. World Health Organisation, Soil-transmitted helminth infections, Fact Sheet, Updated May 2015. www.who.int/mediacentre/factsheets/ fs366/en/. Accessed December 2015. 5. Swanepoel, Liebenberg W, Melgardt M de Villiers. Quality evaluation of generic drugs by dissolution test: changing the USP dissolution medium to distinguish between active and non-active mebendazole polymorphs. uropean Journal of Pharmaceutics and Biopharmaceutics 55 (2003) 345-349. 6. Vermox HCP Claims Study. Study completed for Johnson & Johnson (PTY) LTD. Prepared by Kantar South Africa (PTY) LTD. May 2017. 36