Whipworm (Trichuris Trichiura)

What is whipworm?

Whipworm, or Trichuris trichiura, is a type of parasite that infects your intestines. It gets its name from its whip-like shape and appearance. It has a thick section on one end that looks like a whip handle, and a narrow section on the other end that resembles a whip.

A whipworm infection in humans can develop after consuming soil or water contaminated with feces (poop) containing whipworm parasites. If you come into contact with contaminated poop, you can also contract a whipworm infection. The infection occurs most often in children. It’s also more common in hot, humid climates and areas with poor sanitation and hygiene. Most people recover fully with treatment.

How do you know if you have whipworm?

Most people infected with whipworm don’t have any symptoms. If you do have whipworm symptoms, they may range from mild to severe and include:

• Bloody diarrhea
• Painful or frequent pooping
• Abdominal pain
• Nausea and vomiting
• Headaches
• Unexpected weight loss
• Fecal (bowel) incontinence (during sleep)

How do humans get whipworm?

The roundworm Trichuris trichiura causes whipworm infection in humans. It’s a common infection that mostly affects children.

Whipworm eggs pass in the poop of someone already infected with whipworm. The eggs can get into soil when people:

• Poop outside
• Use an unsanitary restroom facility
• Use human feces as fertilizer

You might unknowingly ingest whipworm or their eggs when you touch contaminated dirt and then put your fingers or hands near your mouth. Or you may eat fruits and vegetables that haven’t been peeled, washed or cooked properly.

When you swallow soil contaminated with whipworm eggs, you can become infected. When the eggs reach your small intestine, they hatch and release larvae. When the larvae mature, adult worms stick inside the walls of your large intestine. The female worms typically start to deposit eggs about two months later. The females release about 3,000 to 20,000 eggs per day.

Can humans get whipworm from pets?

In most cases, you won’t contract whipworm from pets like dogs or cats. Whipworms that infect animals are typically different species than those that infect humans. For instance, dogs have Trichuris vulpis, while humans have Trichuris trichiura. These different species are adapted to their respective hosts and generally don’t infect other species. In addition, human whipworm spreads through fecal contamination with human waste, not pet waste.

But, there’s a very small chance. While rare, there have been isolated cases of human infection with canine whipworm. This is likely due to accidental ingestion of large amounts of eggs in heavily contaminated environments.

What are the risk factors for whipworm?

Whipworm can affect anyone, but some people are more likely to contract a whipworm infection. Risk factors for the condition include:

• Living in a hot, humid climate
• Living in a region lacking good hygiene practices and proper sanitation
• Working in an industry where you come into frequent contact with soil that contains manure
• Eating raw vegetables that are grown in soil fertilized with manure

Children have a higher risk of developing a whipworm infection because they may not wash their hands after playing outdoors and then eating.

What are the complications of a whipworm infection?

People with severe infections can experience rectal prolapse (their rectum comes out of their anus). Severe infections can also cause serious health complications in children, including:

• Slow growth
• Severe anemia
• Impaired cognitive development

How is whipworm diagnosed?

A healthcare provider will see if you have whipworms in your stool (poop). They’ll take a stool sample and examine it for whipworm eggs under a microscope.

Your provider may also recommend a complete blood count (CBC) to check for anemia.

How is whipworm treated?

Your healthcare provider will prescribe antiparasitic drugs to rid your body of the whipworms. Whipworm treatment with antiparasitic pills that you take orally (by mouth) lasts one to three days. The most common medications include:

• Mebendazole (Vermox® or Emverm®)
• Albendazole (Albenza®)

Your provider may recommend a follow-up stool test after treatment to ensure the infection is gone.

Do whipworms go away on their own?

No, whipworms typically don’t go away on their own. Whipworms lay eggs that can survive in the environment for a long time. If left untreated, you could continue to re-infect yourself by accidentally ingesting the eggs. Untreated whipworm infections, particularly severe infections, can lead to health complications. If you suspect you have a whipworm infection, it’s important to see a healthcare provider for proper diagnosis and treatment.

Can whipworm infection be prevented?

There are many ways you can significantly reduce your risk of contracting a whipworm infection, including:

• Sanitation. Avoid contact with soil that might be contaminated with poop, especially human poop. This includes avoiding using human poop as fertilizer and pooping outdoors.
• Handwashing. Wash your hands thoroughly with soap and warm water before handling food and after using the toilet. Teach children the importance of proper handwashing, too.
• Food hygiene. Wash, peel or cook all fruits and vegetables, especially those that grow close to the ground. This is particularly important if you’re in an area where human waste might be used as fertilizer.
• Animal control. Confine farm animals like pigs and clean their enclosures regularly. This helps prevent fecal contamination in the environment.
• Safe water. In areas with questionable water quality, boil or purify drinking water.

What is the outlook (prognosis) of someone with a whipworm infection?

The outlook for a whipworm infection is generally very good with proper treatment. Most people who get treatment for whipworm make a full recovery.

When should I see my healthcare provider?

If you’re experiencing symptoms of a whipworm infection, call a healthcare provider for diagnosis and treatment. Early intervention ensures a smooth recovery and avoids potential complications.

What questions should I ask my healthcare provider about whipworm?

Questions you may want to ask your healthcare provider include:

• Are there other parasites that could be causing my symptoms?
• What medication is recommended for my case?
• Do I need to repeat the stool test after treatment?
• How can I prevent re-infection with whipworm?
• Should other members of my household be tested?
• Can whipworm infection cause any long-term complications?
• Is there anything else I can do to manage my symptoms?