I went to the children’s ward to explain something to them about a completely unrelated matter when the nurse said would you like to see what a little boy has vomited up. She produced a glass bottle and triumphantly produced two ascaris worms [roundworm] both approximately 25cms [10inches] long. I saw the child who was about 2 years old looking very happy and pleased with himself.
It reminded me of a case that I had dealt with not long ago of an acute intestinal obstruction in a 5 year old boy. Fortunately we were suspicious and gave the boy anti worm medicine. This was followed by an enema and you can see the result. A grateful mother was able to take her recovered son home the next day.
The life circle of the worm is complicated but it is spread by either contaminated water or food. On indigestion it spreads from the stomach via the blood stream to the lungs and from there back to the gut were each worm can produce up to 200,000 eggs a day. These eggs are very resistant to chemicals and drying and can survive for ten years in the ground. In the UK we are so fortunate to have good sanitation and for us it is not a problem. Throughout the world it is thought that one billion people may be affected.