Trichuriasis is a major neglected tropical disease caused by Trichuris trichiura, an intestinal parasitic nematode (roundworm) called the whipwormThis parasite tunnels through our gut lining cells in the caecum and large intestine.

Infection with whipworms causes abdominal pain, gut inflammation and Trichuris dysentery syndrome including chronic diarrhoea and anaemia. A heavy infection can cause intestinal obstruction and rectal prolapse. Trichuriasis has been linked to malnutrition and physical and cognitive developmental problems.

A whipworm under the electron microscope. Image by David Goulding.

Who it affects

An estimated 700 million people in the tropics and sub-tropics have trichuriasis. It affects mainly children from low and middle-income countries in Asia, Africa and South America. The disease affects children’s mental and physical development.  This can have chronic socio-economic consequences, limiting agricultural and economic productivity in the affected countries. This is a vicious cycle as poverty and poor sanitation produce ideal conditions for the transmission of the disease.

How it is spread

Adult whipworms live in the caecum, at the top of the large intestine, producing thousands of eggs each day.  The eggs are passed in the faeces and in areas of inadequate toilet sanitation, the eggs contaminate the soil and surrounding environment.  After 15-30 days in the warm and moist environment, a tiny parasitic larva develops inside the egg, causing it to become infective (embryonated).

Infection with whipworms occurs upon ingestion of food or water, or from hands, that are contaminated with whipworm eggs from the environment.  In the caecum, the larvae hatch from the eggs, burrow through the gut lining and develop into adults.  Female worms live for around 1 year and shed between 3,000 and 20,000 eggs per day.

Stopping the disease

To prevent and stop trichuriasis we need to:

    • Treat infected people with drugs like albendozole and mebendazole, although these drugs are not completely effective.
    • Change poor sanitation practices by building toilets, promoting their proper use and safe management of faecal waste.
    • Provide safe water supplies.
    • Education:
      • Sanitation and personal hygiene (e.g handwashing with soap before meals, face washing reduces transmission by contaminated hands).
      • Wash, peel, or cook raw vegetables and fruits before eating.
      • Discourage thumb sucking and nail biting in children.
    • Investigate whipworm infections to better understand the disease and the interactions of the whipworm with our intestinal cells. This knowledge will allow us to develop vaccines and new drugs.