Parasitic Infections

About Amebiasis

Amebiasis is an intestinal illness that’s typically transmitted when someone eats or drinks something that’s contaminated with a microscopic parasite called Entamoeba histolytica (E. histolytica). The parasite is an amoeba, a single-celled organism. That’s how the illness got its name — amebiasis.

In many cases, the parasite lives in a person’s large intestine without causing any symptoms. But sometimes, it invades the lining of the large intestine, causing bloody diarrhea, stomach pains, cramping, nausea, loss of appetite, or fever. In rare cases, it can spread into other organs such as the liver, lungs, and brain.

Amebiasis typically occurs in areas where living conditions are crowded and where there is a lack of adequate sanitation. The illness is very prevalent in parts of the developing world, including Africa, Latin America, India, and Southeast Asia. It is rare in the United States, occurring mostly in immigrants, recent travelers to high-risk countries, and people with HIV/AIDS.

Signs and Symptoms

Most kids who get amebiasis have minimal or no symptoms. When children do become ill, they experience abdominal pain that begins gradually, along with frequent loose or watery bowel movements, cramps, nausea, and a loss of appetite. In some cases they develop a fever and, possibly, bloody stools.

For some people, symptoms of amebiasis can begin within days to weeks of swallowing food or water contaminated by amoebas. For other people, symptoms of amebiasis either take months to appear or never appear at all.

Contagiousness

Amebiasis is contagious. Wherever living conditions are unsanitary and hygiene is poor, the chances are higher that the infection will pass from person to person.

Someone carrying amoebas in his or her intestines can pass the infection to others through the stool. When infected stool contaminates food or water supplies, amebiasis can spread quickly to many people at once. This is especially true in developing countries where drinking water may be contaminated.

Amebiasis can also be spread between people through inadequate hand washing, by using the same objects, and by sexual contact.

Prevention

There is no vaccine to prevent amebiasis.

Because amoebas may contaminate food and water, you can help prevent the illness by being cautious about what you eat and drink, especially in developing countries, where a good rule regarding food is to cook it, boil it, peel it, or forget it.

Treatment

If your doctor suspects that your child has amebiasis, you may be asked to collect stool samples. After diagnosis, treatment will usually require consultation with appropriate experts such as those at the Centers for Disease Control and Prevention (CDC) or other infectious disease specialists.

When to Call the Doctor

Call your doctor if your child has signs or symptoms of amebiasis, including:

• diarrhea with blood or mucus
• abdominal pain
• fever
• distended abdomen
• pain or tenderness in the area of the liver (below the ribs on the right side)

This is especially important if you have recently traveled to a part of the world where amebiasis is common. Your child should also be examined if he or she has persistent diarrhea without any other symptoms.

Ascariasis is an intestinal infection caused by a parasitic roundworm. While globally it is the most common human infection caused by worms, ascariasis is rare in the United States. Most cases happen in areas with poor sanitation or crowded living conditions.

Signs and Symptoms

Kids are more likely than adults to develop gastrointestinal symptoms with an ascariasis infection because their smaller intestines are at greater risk for intestinal blockage. The greater the number of worms involved, the more severe the symptoms are likely to be.

Symptoms seen with mild infestation include:

• worms in stool (poop)
• coughing up worms
• loss of appetite
• fever
• wheezing

More severe infestations can cause more serious signs and symptoms, including:

• vomiting
• shortness of breath
• abdominal distention (swelling of the abdomen)
• severe stomach or abdominal pain
• intestinal blockage
• biliary tract blockage (includes the liver and gallbladder)

Description

Ascariasis occurs when worm eggs of the parasite Ascaris lumbricoides (commonly found in soil and human feces) are swallowed. This can happen from contaminated food, drink, or soil. The roundworms range in size from 5.9 to 9.8 inches for adult males and 9.8 to 13.8 inches for adult females. The worms can grow to be as thick as a pencil and can live for 1 to 2 years.

Ascariasis is often found in developing countries with poor sanitary conditions or in areas where human stool is used as fertilizer. After the eggs are swallowed, they pass into the intestines, where they hatch into larvae. The larvae then begin to move through the body.

Once they get through the intestinal wall, the larvae travel from the liver to the lungs through the bloodstream. During this stage, pulmonary symptoms such as coughing (even coughing up worms) may occur. In the lungs, the larvae climb up through the bronchial tubes to the throat, where they are swallowed. The larvae then return to the small intestine where they grow, mature, mate, and lay eggs. The worms reach maturity about 2 months after an egg is ingested.

Adult worms live and remain in the small intestine. A female worm can produce up to 240,000 eggs in a day, which are then discharged into the feces and incubate in the soil for weeks. Children are particularly susceptible to ascariasis because they tend to put things in their mouths, including dirt, and they often have poorer hygiene habits than adults.

Ascariasis is common in warmer or tropical climates, particularly in developing nations, where it can affect large segments of the population. Ascariasis is rare in the United States, due to strict sanitation rules and regulations.

Contagiousness

Ascariasis is not spread directly from one person to another. To become infected, an individual has to consume the worm’s eggs.

Prevention

The most important measure of protection against ascariasis is the safe and sanitary disposal of human waste. People living in areas of the world that use human feces as fertilizer must thoroughly cook all foods or clean them with a proper iodine solution (particularly fruits and vegetables).

Children who are adopted from developing nations are often screened for worms as a precautionary measure. Kids who live in underdeveloped areas of the world may be prescribed a preventive deworming medication.

These practices are recommended for all children:

• Try as much as possible to keep kids from putting things in their mouths.
• Teach kids to wash their hands well and often, especially after using the bathroom and before eating.

Professional Treatment

Doctors usually prescribe antiparasitic medication to be taken orally to kill intestinal roundworms. Sometimes the stool will be re-examined about 3 weeks after treatment to check for eggs and worms. Symptoms usually disappear within 1 week of starting treatment.

Very rarely, surgical removal of the worms may be necessary (particularly in cases of intestinal or liver-related obstruction, or abdominal infection). A child who has ascariasis should be checked for other intestinal parasites, such as pinworm.

Home Treatment

If your child has ascariasis, the medicine prescribed should be given as directed. To prevent reinfection:

• Make sure that your child washes his or her hands often, especially after using the bathroom and before eating.
• Have your pets checked for worms regularly.
• Keep your child’s fingernails short and clean.
• Sterilize any contaminated clothing, pajamas, and bedding.
• Try to find the source of the infection. Additional sanitation measures in or around your home may be necessary.

When to Call the Doctor

If your child has any of the symptoms of ascariasis, contact your doctor right away. Stool samples will be sent to a laboratory to check for eggs and worms to confirm the diagnosis.

Call the doctor if symptoms do not improve with treatment or if new symptoms start.

Not long ago, “sleep tight, don’t let the bedbugs bite” was just a sweet rhyme parents said to their kids when tucking them into bed.

But recent infestations of bedbugs in even the cleanest hotels and homes have people on high alert, checking mattresses and furniture for telltale signs of these irritating, hard-to-control pests.

Bedbug Basics

Bedbugs are small, flat, reddish-brown bugs about the size of an apple seed. They can be found all over the world. Bedbugs hide during the day in or around beds and crevices in chairs, couches, curtains, rugs, dressers, and even in cracks of walls and floors and behind wallpaper.

They come out at night to find food, which in their case means blood. Bedbugs have a special ingredient in their saliva (spit) that keeps blood from clotting while they feed, typically at night in areas where people sleep. After their blood meal, bedbugs don’t stay on a person for long. Instead, they hide nearby, often in clothing or luggage, allowing them to spread when belongings move to another location.

A person does not usually feel the actual bedbug bite. But after a person is bitten, the bite will feel itchy. Bedbug bites look like little red bumps (similar to mosquito bites) and they can sometimes occur in a line on the body.

Travel Tips

Since you’re more likely to encounter bedbugs while traveling than in your home, it’s wise to plan ahead. A number of websites let travelers search for bedbug infestation reports by city (and sometimes by hotel), so do a little research before you leave home.

Once at your destination, do a bedbug check of every room before settling in. You probably won’t see the bedbugs themselves, but certain telltale signs can alert you to their presence. Pull back sheets to look for little spots of blood on mattresses, or remove the sheets and look on and under the mattress, especially around its seams (also check headboards and footboards).

If you find any signs of bedbugs, ask for other rooms and inspect them, too. If you still see signs of bedbugs, find another place to stay.

Once in your room, keep luggage off the floor and beds — use the luggage racks most hotels and motels provide or put suitcases on a table or desk. Hang up clothes whenever possible, and when you get back home, dump dirty clothes right into the washing machine.

Prevention

People are finding bedbugs in their homes more than in years past. The bugs can hitch a ride home when you travel, or even after a trip to your local movie theater.

Be careful when you buy used clothing or furniture from garage sales or thrift stores. Always inspect them for bedbugs. Also, don’t grab a discarded couch or other upholstered furniture off the street corner. They might have bedbugs hiding in the fabric. In fact, that might be why the previous owner got rid of them!

If you or your child have been in a place known to have bedbugs, make sure to wash your clothes with hot water when you return home. If you can’t wash your clothing right away, put it in a sealed plastic bag until you can wash it.

Treatment

If you think someone in your family has been bitten by a bedbug, wash the bites with soap and water. Using calamine lotion, an anti-itch cream, or cool compresses can help with the itching. In some cases, an antihistamine by mouth can ease itching. Bites clear up in 1-2 weeks.

Tell kids not to scratch a bedbug bite because doing so can cause a skin infection, such as impetigo and, rarely, cellulitis. If an infection does happen, a doctor will prescribe antibiotics to treat it.

Tackling Bedbugs

If your home has bedbugs, don’t feel bad. Bedbug infestations are common. These tips can help:

• Keep your home uncluttered so bedbugs won’t have places to hide.
• Change bedsheets once a week and vacuum floors regularly.
• If you find bedbugs, wash all bedding, clothing, stuffed animals, etc., in hot water and dry on a hot setting.
• If your mattresses have bedbugs, buy a mattress cover that’s labeled “anti-allergy” or “anti-dust mites” to help prevent the bugs from getting into your bedding.

You also can contact local pest control companies to ask about ways to exterminate bedbugs with or without pesticides.

Chiggers (also called harvest mites or red mites) are tiny red mites whose bites aren’t painful but do cause intense itching shortly after the bite happens.

Chiggers are smaller than a period at the end of a sentence (most can only be seen with a magnifying glass). These members of the arachnid family are found all over, including in grassy fields, along lakes and streams, and in forests. It’s the baby chiggers (or larvae) that bite people and animals.

About Chigger Bites

Chiggers have tiny claws that allow them to attach tightly to people and animals. Once attached, they pierce the skin and inject their saliva, which contains digestive juices that dissolve skin cells. Chiggers then consume the dissolved cells and fall off after a few days, leaving a red welt on the skin.

These itchy red bumps (which can look like pimples, blisters, or small hives) are typically found around the waist, ankles, or in warm skin folds. They get bigger and itchier over several days, and often appear in groups.

Extreme itching begins within hours of the chigger attaching to the skin. The itch resolves after a few days, and the red bumps heal over 1-2 weeks.

Diagnosis and Treatment

Doctors can diagnose chigger bites just by looking at them and getting a little information about your child’s recent outdoor activities.

No specific medications are designed to treat chigger bites, but calamine lotion, anti-itch cream, and/or cool compresses can help with the itching. Washing bites vigorously with soap and water usually helps to remove any chiggers that are still attached to the skin.

Discourage your child from scratching the bites because this can lead to:

• impetigo, a bacterial infection of the skin, with pus and crusts around the bites
• a larger area of increasing redness, swelling, pain, and warmth, called cellulitis

Keeping fingernails short can help your child resist scratching the bites. Antibiotics may be needed if a skin infection does happen.

When to Call the Doctor

Call if the itchiness doesn’t improve with over-the-counter remedies or if the scratching has led to an infection of the bite (watch for warmth, redness, swelling, tenderness, or pus).

Some boys who have chigger bites on the penis develop an acute hypersensitivity reaction known as “summer penile syndrome,” which causes swelling of the penis, itching, and painful urination. Doctors might prescribe antihistamines and recommend cool compresses to treat this problem.

Protecting Kids From Chiggers

Insect repellents that contain 10%-30% DEET are most effective at preventing chigger bites. When possible, dress kids in long-sleeved shirts and long pants that are tucked in when they’ll be playing outside, especially if they’ll be hiking or playing in fields. Have them take a hot shower after returning indoors and wash their clothes in hot water. Clothes also can be treated with a specific insecticide to help prevent bites.

Chiggers aren’t contagious, so kids don’t need to refrain from activities unless the itching makes them too uncomfortable to participate.

Giardiasis, an illness that affects the digestive tract (stomach and intestines), is caused by a microscopic parasite called Giardia lamblia. The parasite attaches itself to the lining of the small intestines in humans, where it interferes with the body’s absorption of fats and carbohydrates from digested foods.

Giardia is one of the chief causes of diarrhea in the United States, and spreads through contaminated water. It can survive the normal amounts of chlorine used to purify community water supplies, and can live for more than 2 months in cold water. As few as 10 of the microscopic parasites in a glass of water can cause a severe case of giardiasis in a human being who drinks it.

Young kids are more likely to have giardiasis than adults, so some experts think that our bodies gradually develop some form of immunity to the parasite as we get older. But it isn’t unusual for an entire family to have giardiasis, with some family members having diarrhea, some just crampy abdominal pains, and others with few or no symptoms.

Signs and Symptoms

Between 1% and 20% of the U.S. population has giardiasis, and this number may be 20% or higher in developing countries, where giardiasis is a major cause of epidemic childhood diarrhea. More than two thirds of people who are infected may have no signs or symptoms of illness, even though the parasite is living in their intestines.

When the parasite does cause symptoms, the illness usually begins with severe watery diarrhea, without blood or mucus. Giardiasis affects the body’s ability to absorb fats from the diet, so the diarrhea contains unabsorbed fats. That means that the diarrhea floats, is shiny, and smells very bad.

Other symptoms include:

• abdominal cramps
• large amounts of intestinal gas
• an enlarged belly from the gas
• loss of appetite
• nausea and vomiting
• sometimes a low-grade fever

These symptoms may last for 5 to 7 days or longer. If they last longer, a child may lose weight or show other signs of poor nutrition.

Sometimes, after acute (or short-term) symptoms of giardiasis pass, the disease begins a chronic (or more prolonged) phase. Symptoms of chronic giardiasis include:

• periods of intestinal gas
• abdominal pain in the area above the navel (belly button)
• poorly formed, “mushy” bowel movements (poop)

Prevention

Here are some ways to protect your family from giardiasis:

• Drink only from water supplies that have been approved by local health authorities.
• Bring your own water when you go camping or hiking, instead of drinking from sources like mountain streams.
• Wash raw fruits and vegetables well before you eat them.
• Wash your hands well before you cook food for yourself or for your family.
• Encourage your kids to wash their hands after every trip to the bathroom and especially before eating. If someone in your family has giardiasis, wash your hands often as you care for him or her.
• Have your kids wash their hands well after handling anything in “touch tanks” in aquariums, a potential source of giardiasis.
• Have your water checked on a regular basis if it comes from a well.

Also, it’s questionable whether infants and toddlers still in diapers should be sharing public pools. They certainly should not if they’re having diarrhea or loose stools (poop).

Contagiousness

People and animals (mainly dogs and beavers) who have giardiasis can pass the parasite in their stool. The stool can then contaminate public water supplies, community swimming pools, and “natural” water sources like mountain streams. Uncooked foods that have been rinsed in contaminated water may also spread the infection.

In childcare centers or any facility caring for a group of people, giardiasis can easily pass from person to person. At home, an infected family dog with diarrhea may pass the parasite to human family members who take care of the sick animal.

Diagnosis

Doctors confirm the diagnosis of giardiasis by taking stool samples and sending them to the lab to be examined for Giardia parasites. Several samples may be needed before the parasites are found. For that reason the doctor might order a much more sensitive test, the enzyme-linked immunosorbent assay or ELISA test.

Less often, doctors make the diagnosis by looking at the lining of the small intestine with an instrument called an endoscope and taking samples from inside the intestine to be sent to a laboratory. This is done in more extreme cases, when a definite cause for the diarrhea hasn’t been found.

Treatment

Giardiasis is treated with prescription medicines that kill the parasites. Treatment typically takes 5 to 7 days, and the medicine is usually given as a liquid. Some of these medicines may have side effects, so your doctor will tell you what to watch for.

If your child has giardiasis and your doctor has prescribed medication, be sure to give all doses on schedule for as long as your doctor directs. This will help your child recover faster and will kill parasites that might infect others in your family. Again, encourage all family members to wash their hands well and often, especially after using the bathroom and before eating.

A child who has diarrhea from giardiasis may lose too much fluid in the stool and become dehydrated. Make sure the child drinks plenty of fluids but no caffeinated beverages or juice, as they make the body lose water faster.

Ask the doctor before you give your child any nonprescription drugs for cramps or diarrhea because these medicines may mask symptoms and interfere with treatment.

Duration

The incubation period for giardiasis is 1 to 3 weeks after exposure to the parasite. In most cases, treatment with 5 to 7 days of antiparasitic medicine will help kids recover within a week’s time. Medication also shortens the time that they’re contagious. If giardiasis isn’t treated, symptoms can last up to 6 weeks or longer.

When to Call the Doctor

Call the doctor if your child has:

• large amounts of diarrhea, especially if he or she also has a fever and/or abdominal pain
• blood in the diarrhea
• occasional, small episodes of diarrhea that continue for several days, especially if appetite is poor, and your child is either gradually losing weight or isn’t gaining as much as expected

Caring for pets is a great learning experience for kids, teaching them responsibility, gentleness, and respect for other living beings. Like adults, kids can benefit from the companionship, affection, and relationships they share with their pets.

But animals and pets can spread infections to humans, especially kids. So if you’re thinking about buying a pet, or already have one, it’s important to know how to protect your family from infections.

How Pets Spread Infections

Like people, all animals carry germs. Illnesses common among housepets — such as distemper, canine parvovirus, and heartworms — can’t spread to humans.

But pets also carry certain bacteria, viruses, parasites, and fungi that can cause illness if transmitted to humans. Humans get these animal-borne diseases when they’re bitten or scratched or have contact with an animal’s waste, saliva, or dander.

These diseases can affect humans in many ways. They’re of greatest concern to young children, infants, pregnant women, and people whose immune systems have been compromised by illness or disease. Infants and kids younger than 5 years old are at risk because their immune systems are still developing, and some infections that might make an adult just mildly sick can be more serious for them.

Healthy Family, Healthy Pets

But you don’t have to give up your family’s furry friends either. Pets can enrich your family life, and taking a few precautions can protect your kids from getting sick.

Protecting your family from pet-related infections begins before bringing a pet home. For instance, reptiles and amphibians should not be allowed as pets in any household with infants and young children.

Also consider the health and age of your kids before getting a pet. A pet that would require frequent handling is not recommended for any immunocompromised child (such as a child who has HIV, has cancer and is undergoing chemotherapy, or uses prednisone frequently). Kids with eczema should probably avoid aquariums.

Dogs and Cats

Dogs and cats are popular pets but can carry infections such as:

• Campylobacter infection: can be spread by household pets carrying Campylobacter jejuni bacteria, which cause diarrhea, abdominal pain, and fever in people. The bacteria may be in the intestinal tract of infected dogs, cats, hamsters, birds, and certain farm animals. A person can become infected through contact with contaminated water, feces, undercooked meat, or unpasteurized milk.

  More than 2 million cases of campylobacter infection happen each year in the United States, and C. jejuni is now the leading cause of bacterial gastroenteritis. These infections are contagious, especially among members of the same family and kids in childcare or preschools. Infection is treated with antibiotics.

• Cat scratch disease: can happen when a person is bitten or scratched by a cat infected with Bartonella henselae bacteria. Symptoms include swollen and tender lymph nodes, fever, headaches, and tiredness, which usually ease without treatment. However, a doctor may prescribe antibiotics if the infection is severe. Cat scratch disease rarely causes long-term complications.
• Rabies: a serious illness caused by a virus that enters the body through a bite or wound contaminated by the saliva from an infected animal. Animals that may carry the rabies virus include dogs, cats, raccoons, bats, skunks, and foxes. Widespread immunization of dogs and cats has decreased the transmission of rabies in these animals and in people. Human rabies is rare in the United States, and a vaccine is available for treatment following a bite from a potentially rabid animal.
• Rocky Mountain spotted fever (RMSF): spread by ticks infected by the Rickettsia ricketsii bacteria. These ticks are frequently carried by dogs. Symptoms include high fever, chills, muscle aches, and headaches, and a rash that may spread across the wrists, ankles, palms, soles, and trunk of the body. RMSF, which can be treated with antibiotics, is most common in the south central and the mid-south Atlantic regions of the United States.
• Ringworm: also called tinea; a skin infection caused by several types of fungi found in the soil and on the skin of humans and pets. Kids can get ringworm from touching infected animals such as dogs and cats. Ringworm of the skin, or tinea corporis, usually is a dry, scaly round area with a raised red bumpy border and a clear center. When the scalp is affected, the area may be flaky, red, or swollen. Often there are bald patches. Ringworm is treated with antifungal medicines including shampoo, cream, or oral medicine.
• Toxocariasis: an illness caused by the parasitic roundworm Toxocara, which lives in the intestines of dogs and cats. The eggs from the worms are passed in the feces of dogs and cats, often contaminating soil where kids play. When a child ingests the contaminated soil, the eggs hatch in the intestine and the larvae spread to other organs, an infection known as visceral larva migrans. Symptoms include fever, cough or wheezing, enlarged liver, rash, or swollen lymph nodes. Symptoms may clear up on their own or a doctor may prescribe drugs to kill the larvae. When the larvae in the intestine make their way through the bloodstream to the eye, it is known as ocular toxocariasis, or ocular larva migrans, which may lead to a permanent loss of vision.
• Toxoplasmosis: contracted after contact with a parasite found in cat feces. In most healthy people, toxoplasma infection causes no symptoms. When symptoms do happen, they may include swollen glands, tiredness, muscle pain, fever, sore throat, and a rash. In pregnant women, toxoplasmosis can cause miscarriage, premature births, and severe illness and blindness in newborns. Pregnant women should avoid contact with litter boxes. People whose immune systems have been weakened by illnesses such as HIV or cancer are at risk for severe complications from toxoplasmosis infection.
• Dog and cat bites: may become infected and cause serious problems, particularly bites to the face and hands. Cat bites tend to be worse, partly because they are deeper puncture wounds. Significant bites should be washed out thoroughly. Often these bite wounds require treatment in a doctor’s office or emergency room; antibiotics are sometimes necessary.

Birds

Pet birds, even if they are kept in a cage, may transmit these diseases:

• Cryptococcosis: a fungal disease contracted when someone inhales organisms found in bird droppings, especially from pigeons, that can cause pneumonia. People with weakened immune systems from illnesses such as HIV or cancer are at increased risk of contracting this disease and developing serious complications, such as meningitis.
• Psittacosis: also known as parrot fever, a bacterial illness that can happen from contact with infected bird feces or with the dust that builds up in birdcages. Symptoms include coughing, high fever, and headache. It is treated with antibiotics.

Reptiles and Amphibians

Reptiles (including lizards, snakes, and turtles) and amphibians (including frogs, toads, and salamanders) put kids at risk for:

• Salmonellosis: Reptiles and amphibians shed Salmonella in their feces. Touching the reptile’s skin, cage, and other contaminated surfaces can lead to infection. Salmonellosis causes symptoms such as abdominal pain, diarrhea, vomiting, and fever. Young children are at risk for more serious illness, including dehydration, meningitis, and sepsis (blood infection).

Other Animals

Handling and caring for rodents — including hamsters and gerbils — as well as fish can place kids at risk for:

• Lymphocytic choriomeningitis virus (LCMV): People can get LCMV by inhaling particles that come from urine, feces, or saliva from infected rodents, such as mice and hamsters. LCMV infection can cause flu-like symptoms — fever, tiredness, headaches, muscle aches, nausea, and vomiting — and may even lead to meningitis (an inflammation of the membrane that surrounds the brain and spinal cord) and encephalitis (an inflammation of the brain). As with most viruses, there is no specific treatment, but some patients might need to be hospitalized. Like toxoplasmosis, LCM may be passed from an infected pregnant woman to her fetus.
• Mycobacterium marinum: This infection may happen in people exposed to contaminated water in aquariums or pools. Although mycobacterium marinum infections are generally mild and limited to the skin, they can be more severe in people with HIV or weakened immune systems.

Precautions When Adopting or Buying a Pet

If you’re adopting or buying a pet, make sure the breeder, shelter, or store has a good reputation and vaccinates all of its animals. A reputable breeder should belong to a national or local breeding club, such as the American Kennel Club. Contact the Humane Society of the United States or your veterinarian for information about animal shelters in your area.

As soon as you choose a family pet, take it to a local veterinarian for vaccinations and a physical exam. Don’t forget to routinely vaccinate your pet on a schedule recommended by your vet — this will keep your pet healthy and reduce the risk that infections will spread to your kids.

You’ll also want to regularly feed your pet nutritious animal food (ask your vet for suggestions) and provide plenty of fresh water. Avoid feeding your pet raw meat because this can be a source of infection, and do not allow your pet to drink toilet water because infections can be spread through saliva, urine, and feces.

Limit young kids’ contact with outdoor pets that hunt and kill for food because a pet that ingests infected meat may get an infection that can be passed to people.

Safely Caring for Your Pet

Here are some tips to help your family safely care for pets:

• Always wash your hands, especially after touching your pet, handling your pet’s food, or cleaning your pet’s cage, tank, or litter box. Wear gloves when cleaning up after an animal’s waste, and if you have a bird, wear a dust mask over your nose and mouth when cleaning the cage to prevent inhaling urine or fecal particles. Don’t have kids clean cages or litter boxes unless there is supervision or until they know how to do this safely and responsibly (and again, hands should be washed afterward).
• Avoid kissing or touching your pet with your mouth because infections can spread through saliva. Also, don’t share food with your pet.
• Keep your pet’s living area clean and free of waste. If your pet eliminates waste outdoors, pick up waste regularly and don’t allow kids to play in that area.
• Don’t allow pets in areas where food is prepared or handled, and don’t bathe your pet or clean aquariums in the kitchen sink or bathtub. Wash your pet outdoors or talk to your veterinarian about professional pet grooming.
• Avoid strange animals or those that appear sick. Never adopt a wild animal as a pet.

Watch kids carefully around pets. Small children are more likely to catch infections from pets because they crawl around on the floor with the animals, kiss them or share food with them, or put their fingers in the pets’ mouths and then put their dirty fingers in their own mouths. Also, if kids visit a petting zoo, farm, or a friend’s house where there are animals, make sure they know the importance of hand washing.

For your pet’s comfort and for your family’s safety, control flea and tick problems in your pet. Fleas and ticks can carry diseases that may be easily passed to kids. Oral and topical medicines are available for flea and tick control; avoid using flea collars because kids can handle them and become sick from the chemicals they contain. Check your pet regularly for fleas and ticks, as well as bites and scratches that may make them more open to infection. Keep your pet leashed when outdoors and keep it away from animals that look sick or may be unvaccinated.

And, finally, spay or neuter your pet. Spaying and neutering may reduce your pet’s contact with other animals that may be infected, especially if your pet goes outdoors.

About Malaria

Malaria is a common infection in hot, tropical areas but can also occur (very rarely) in temperate climates. A serious illness, malaria can cause mild illness in some and life-threatening illness in others. Malaria can be cured if treated.

It is caused by parasites of the Plasmodium species, which are carried by mosquitoes infected from biting someone who already has the disease. Malaria is then transmitted to other people when infected mosquitoes bite them. Rarely, it is passed from person to person (from mother to child in “congenital malaria,” or through blood transfusion, organ donation, or shared needles).

Worldwide, 300-500 million people are infected with malaria each year. Most cases occur in sub-Saharan Africa, with approximately 2 million people dying there each year. Asia, Latin America, and parts of Europe are also affected by malaria.

Malaria is rare in the United States, with only about 1,300 cases reported each year over the last 10 years. Most of these cases occurred in travelers, military personnel, and immigrants who had become infected by malaria parasites outside the United States.

Signs and Symptoms

Early symptoms of malaria can include irritability and drowsiness, with poor appetite and trouble sleeping. These symptoms are usually followed by chills, then a fever with rapid breathing. The fever may either gradually increase over 1 to 2 days or may rise very suddenly to 105° F (40.6° C) or above. Then, as fever ends and body temperature quickly returns to normal, there’s an intense episode of sweating.

The same pattern of symptoms — chills, fever, sweating — may repeat at intervals of 2 or 3 days, depending on which particular species of malaria parasite is causing the infection.

Because the initial symptoms are not specific and can be mistaken for other illnesses, malaria can be difficult to diagnose. In countries where the disease is seen a lot, it’s not uncommon for doctors to treat people for malaria who have fever of no obvious cause without getting laboratory confirmation.

Additional Symptoms

Other symptoms of malaria include headache, nausea, aches and pains all over the body (especially the back and abdomen), and an abnormally large spleen. Convulsions or loss of consciousness may occur if malaria affects the brain. If it affects the kidneys, the amount of urine produced might be abnormally low. In falciparum malaria, caused by the Plasmodium falciparum parasite, the episode of fever and chills is especially intense, and this variety may be fatal in about 20% of cases.

Once malaria parasites enter the bloodstream, they travel to the liver and multiply. Every few days, thousands of parasites are released from the liver into the blood, where they destroy red blood cells.

The incubation period for malaria is the time between the mosquito bite and the release of parasites from the liver. This varies, depending on which malaria parasite is causing the disease. In general, it can range from 10 days to a month.

With treatment, malaria can usually be cured in about 2 weeks. Without treatment, it can be fatal, especially in children who are poorly nourished.

Prevention

Health authorities try to prevent malaria by using mosquito-control programs aimed at killing mosquitoes that carry the disease. If you travel to an area of the world with a high risk for malaria, you can install window screens, use insect repellents, and place mosquito netting over beds. Insecticide-impregnated bed netting has successfully reduced the number of malarial deaths among African children.

Check with your doctor before visiting any tropical or subtropical area at high risk for malaria. Your doctor can give your family anti-malarial drugs to prevent the disease, which need to be taken prior to travel. Several malaria vaccines are currently being developed and tested across the world, but because the malaria parasite has a complicated life cycle, it is a difficult vaccine to develop.

Diagnosis and Treatment

Doctors diagnose malaria by using special blood tests. A blood sample is sent to the laboratory and checked under a microscope for malaria parasites, which may be seen inside infected red blood cells.

Malaria is treated with anti-malarial drugs, such as chloroquine or quinine, given by mouth, by injection, or intravenously (into the veins). Depending on the type of parasite causing the malaria, a person can be treated as an outpatient over a few days or may require hospitalization with IV medication.

Doctors also watch for signs of dehydration, convulsions, anemia, and other complications that can affect the brain, kidneys, or spleen. The patient may require fluids, blood transfusions, and breathing assistance.

Malaria is a leading cause of death worldwide. It’s important to tell the doctor if there has been any travel to areas where malaria is present.

If diagnosed early and treated, malaria can be cured. However, many people who live in areas where malaria is common get repeated infections and never really recover between episodes of illness.

Pinworm is an intestinal infection caused by tiny parasitic worms. One of the most common roundworm infections, pinworm infections affect millions of people each year, particularly school-age kids.

If your child develops a pinworm infection, try not to worry. Pinworms don’t cause any harm (just itching), and it won’t take long to get rid of them. And people who have pinworms aren’t dirty — kids can get pinworms no matter how often they take a bath.

How Pinworm Infections Spread

Pinworm infections (also known as “seatworm infection,” “threadworm infection,” “enterobiasis,” or “oxyuriasis”) are contagious.

Pinworms get into the body when people ingest the microscopic pinworm eggs. These eggs can be found on contaminated hands and surfaces, such as:

• bed linens
• towels
• clothing (especially underwear and pajamas)
• toilets
• bathroom fixtures
• food
• drinking glasses
• eating utensils
• toys
• kitchen counters
• desks or lunch tables at school
• sandboxes

The eggs pass into the digestive system and hatch in the small intestine. From the small intestine, pinworm larvae continue their journey to the large intestine, where they live as parasites (with their heads attached to the inside wall of the bowel).

About 1 to 2 months later, adult female pinworms travel from the large intestine to the area around the rectum. There, they will lay new pinworm eggs, which trigger itching around the anus.

When someone scratches the itchy area, microscopic pinworm eggs transfer to their fingers. Contaminated fingers can then carry pinworm eggs to the mouth, where they are go back into the body, or stay on various surfaces, where they can live for 2 to 3 weeks.

If you’re wondering if your family pet could give your child a pinworm infection, it can’t. Pinworms don’t come from animals.

Signs and Symptoms

Often, someone can have a pinworm infection without knowing it. When symptoms are present, the most common one is itching around the rectum and restless sleep. The itching is usually worse at night because the worms move to the area around the rectum to lay their eggs. In girls, pinworm infection can spread to the vagina and cause a vaginal discharge. If the itching leads to broken skin, it can also lead to a bacterial skin infection.

If your child has a pinworm infection, you can see worms in the anal region, especially if you look about 2 or 3 hours after your child has fallen asleep. You also might see the worms in the toilet after your child goes to the bathroom. They look like tiny pieces of white thread and are really small — about as long as a staple. You might also see them on your child’s underwear in the morning.

Abdominal pain and nausea are less common symptoms but can happen if there are many pinworms in the intestines.

Diagnosis and Treatment

Your doctor may ask you to help make the diagnosis of pinworm by placing a sticky piece of clear cellophane tape against your child’s rectum. Pinworm eggs will stick to the tape and can be seen under a microscope in a laboratory. The best time to take a sample of eggs using tape is at night or in the morning before a bath (this is when there is the most pinworm activity around the rectum). The doctor also might take some samples from under a child’s fingernails to look for eggs.

If your child has a pinworm infection, the doctor may recommend an antiworm medication, which is given in one dose and repeated in 2 weeks. The doctor may decide to treat the entire family, especially if your child has had a pinworm infection before.

Although medicine takes care of the worm infection, the itching may continue for about a week. So the doctor may also give your child a cream or other medication to help stop the itching.

Regular hand washing and routine household cleaning (including frequent changing of underwear, and washing everyone’s pajamas and bed linens) also will help prevent the spread of pinworm infection within the family.

When to Call the Doctor

Call the doctor if your child complains of itchy skin or always seems to be scratching the anal or vaginal area.

Also ask about whether pinworms could be to blame if your child has trouble sleeping or has begun to wet the bed. (Pinworms can irritate the urethra — the channel through which urine leaves the bladder and exits the body — and lead to bedwetting.)

Prevention

Here are a few ways to prevent pinworm infections in your family:

• Remind kids to wash their hands often, especially after using the toilet, after playing outside, and before eating.
• Make sure your kids shower or bathe every day and change underwear and swimsuits daily.
• Keep kids’ fingernails short and clean.
• Tell kids not to scratch around their bottom or bite their nails.
• Wash your kids’ pajamas every few days.

Remember that pinworms are quite common among kids and aren’t harmful. By taking medication and following some prevention tips, you’ll be rid of the worms in no time.

About Pubic Lice

Pubic lice (often called “crabs” because of their crab-like appearance under a microscope) are six-legged creatures that most commonly infest hair in the pubic area, although they also can infest other body hair. In most cases, pubic lice are transmitted sexually from the pubic hair of one person to another. But lice can be contracted in other ways, too — from infested clothing, towels, and bedding.

Typically, pubic lice can be treated at home. But if someone in the house has them, it’s important to take precautions so that they don’t spread.

Symptoms

Although it’s possible to be infested and have no symptoms, people with pubic lice usually experience itchiness. This can worsen at night when the lice become active and bury their heads inside pubic hair follicles to feed on a person’s blood.

Sometimes, lice bites can also cause the infested area to become inflamed and discolored because of a reaction to the proteins in the saliva of the lice. Constant itching and scratching can cause the area to become raw and lead to a secondary bacterial infection. Scratching also can help the pubic lice to spread.

If the infestation consists of many adult lice, symptoms may be noticeable immediately. But if the infestation initially involves a few lice that then lay eggs, a person may not experience any symptoms for 2 to 4 weeks until the eggs hatch.

In young children, pubic lice may also be a cause of blepharitis (irritation or infection of the eyelids). So, a child’s eyelashes should be examined with a high-powered magnifying glass if lice are suspected.

Contagiousness

Pubic lice can live 1 to 2 days away from a human body. But contrary to what some people may think, they’re rarely transmitted from furniture or toilet seats because the lice that fall from the body are usually injured or dying. Unlike fleas, lice can’t jump from person to person. And they can’t be contracted from animals.

Prevention

Because the lice can sometimes be contracted from bedding and towels used by someone who is infested, it’s important to avoid contact with any item — including clothing — that the person has used.

More commonly, pubic lice infestation is spread through sexual contact, so the best way to prevent it is to abstain from having sexual contact. Sexual contact with more than one partner or with someone who has more than one partner increases the risk of contracting any sexually transmitted disease (STD).

When properly and consistently used, condoms decrease the risk of STDs. However, because condoms don’t cover the area with pubic hair, they are not good protection against pubic lice.

A teen who is being treated for pubic lice also should be tested for other STDs, and should have time alone with the doctor to openly discuss issues like sexual activity. Not all teens will be comfortable talking with parents about these issues. But it’s important to encourage them to talk to a trusted adult who can provide the facts.

Treating Pubic Lice

A teen who might have pubic lice should see a doctor right away. If the doctor diagnoses pubic lice, your child may be prescribed medication or told to buy an over-the-counter medicine that kills the lice and their eggs. The important thing to remember is that the treatment may need to be repeated after 7 to 10 days to kill any lice not eliminated the first time.

Also, dry clean or use very hot water and a hot dryer cycle to wash and dry all affected bedding, towels, or recently worn clothing to properly kill the lice and their eggs. Any sexual partners from the last month should also check for pubic lice immediately. Although condoms help protect against other STDs, a partner could still get pubic lice because the condom does not cover the entire pubic area.

Getting Help

If your teen is thinking of becoming sexually active or already has started having sex, it’s important to discuss it. Make sure your teen knows how STDs can be spread (during anal, oral, or vaginal sex) and that these infections often don’t have symptoms, so a partner might have an STD without knowing it.

It can be difficult to talk about STDs, but just as with any other medical issue, teens need this information to stay safe and healthy. Provide the facts, and let your child know where you stand.

It’s also important that all teens have regular full physical exams — which can include screening for STDs. Your teen may want to see a gynecologist or a specialist in adolescent medicine to talk about sexual health issues. Community health organizations and sexual counseling centers in your local area also may be able to offer some guidance.