Definition of Whipworm

Whipworm: A nematode (roundworm) also called Trichuris trichiura. The third most common round worm of humans.

The worm is found worldwide, with infections more frequent in areas with tropical weather and poor sanitation practices and among children. It is estimated that 800 million people are infected worldwide. Trichuriasis (infection with the human whipworm Trichuris trichiura) occurs in the southern United States.

The adult worms (approximately 4 cm in length) lives in the cecum and ascending colon (the first part of the large intestine). Female worms in the cecum shed between 3,000 and 20,000 eggs per day. The unembryonated eggs are passed with the stool. In the soil they embryonate and become infective in 15 to 30 days. After ingestion (soil-contaminated hands or food), the eggs hatch in the small intestine, and release larvae that mature and establish themselves as adults in the colon. The adult worms are fixed in that location, with the anterior portions threaded into the mucosa (the lining) of the intestine. The females begin to oviposit (lay eggs) 60 to 70 days after infection. The life span of the adults is about 1 year.

The condition is most often asymptomatic (without symptoms). Heavy infections, especially in small children, can cause gastrointestinal problems (abdominal pain, diarrhea, rectal prolapse) and possibly growth retardation.

Microscopic identification of whipworm eggs in feces is evidence of infection. Examination of the rectal mucosa (lining) by proctoscopy (or directly in case of prolapses) can occasionally demonstrate adult worms.

Treatment is with mebendazole as the drug of choice, with albendazole as alternative.