Have you ever seen your little one sometimes get dirt in their mouth while playing outside? Or have you ever thought that you, especially your children, could get sick from your beloved puppy or kitten at home? Today we are going to talk about a worm disease that we, especially our children, can get from such animals, but we have not heard much about it, but it is very important. This is what doctors call `(Visceral Larva Migrans)`.
What is this Visceral Larva Migrans?
Simply put, Visceral Larva Migrans is an infection caused by a parasitic worm that can be transmitted from animals to humans, especially young children. These worms are most commonly found in the intestines of animals such as dogs and cats. Most of the time, this infection does not cause any major symptoms. This means that you or your child may not even know you have it. However, some people may experience symptoms such as stomach aches and weakness. This is when medical treatment is needed.
So what kind of worms cause this disease?
Visceral Larva Migrans is mainly caused by a roundworm called Toxocara. There are several types of Toxocara worms:
- `(Toxocara canis)`: These are the ones found in the intestines of dogs.
- `(Toxocara cati)`: These people live in the intestines of cats.
- `(Ascaris suum)`: This type is transmitted from pigs.
- `(Baylisascaris procyonis)`: These people specifically breed animals called raccoons (there is no need to worry about this as there are no raccoons in Sri Lanka).
In our country, dogs and cats are the main contributors to the spread of this disease.
What is Toxocariasis?
`(Toxocariasis)` is the medical name for the disease caused by the larvae of the `(Toxocara)` worms, that is, the previously mentioned `(Toxocara canis)` worms that come from dogs and `(Toxocara cati)` worms that come from cats. To be precise, `(Toxocara)` is an infection with `(Toxocara)`.
This condition (Toxocariasis) can affect our body in three main ways:
1. Visceral Larva Migrans: This is when the worm larvae travel to our internal organs, such as the liver, lungs, and heart, and damage them.
2. Ocular Larva Migrans: In this, worm larvae enter the eye and cause inflammation inside the eye. Sometimes, this can even lead to loss of vision.
3. Neurotoxocariasis: This is a rare condition. In this case, the worm larvae affect the brain and spinal cord. This can cause severe swelling, seizures, and mental confusion (encephalopathy).
How do these `(Toxocara)` worms spread from animals to us? In a very strange way!
Imagine, `(Toxocara)` worms live in the intestines of the animal they infect, that is, a dog or a cat. There, these worms lay eggs. These eggs come out with the animal's feces. Then, the feces of these animals containing `(Toxocara)` eggs accumulate in the soil, that is, in the ground. In this way , the infected eggs can remain active in the soil for months.
Do you know how we get infected with this `(Toxocara)`? If we accidentally put the soil containing these eggs in our mouths. When young children play outside, they pick up soil and sometimes put it in their mouths. That is when they are most likely to get infected. Also, it can be spread from vegetables and fruits grown in such dirty soil and eaten without washing them properly.
The important thing is that after these `(Toxocara)` eggs enter our body, they do not grow into large worms and start laying eggs in our intestines. Instead, larvae hatch from the eggs. These larvae emerge from our intestines and travel to other tissues in the body. Places like the liver, lungs, eyes, and brain. Eventually, these larvae die there. However, as they travel, they damage our tissues. It is because of this damage that the symptoms appear.
What is the difference between `Visceral larva migrans` and `Cutaneous larva migrans`?
Although the names sound similar, the two conditions are completely different. Visceral larva migrans is caused by the larvae of the previously mentioned roundworms moving into the internal tissues of the body and dying. Cutaneous larva migrans is caused by a different type of worm called hookworms. Cutaneous larva migrans usually causes an itchy, red rash on the skin.
How common is this disease? Are we at risk?
If you look at the statistics in a country like America, about one in ten people have been infected with `(Toxocara)` at some point in their lives. However, many people do not develop any symptoms and do not even know they have had such an infection.
People in developing countries are more likely to be infected with Toxocara, and are also more likely to develop Visceral Larva Migrans.
Our beloved pets, dogs and cats, can also be infected with these worms. Especially those that spend a lot of time outdoors. Studies have found that about 2% of dogs and 5% of cats in the United States have worms in their intestines. So, the situation in our country may be similar or even higher.
Who is most likely to develop `Visceral Larva Migrans`?
- Children under the age of 6 are most likely to be infected with this `(Toxocara)` and develop `(Visceral Larva Migrans`. This is because they are the ones who are most likely to inadvertently ingest soil while playing outside.
- This risk is also higher for people who keep pets like dogs and cats.
- People living in warm climates are also at higher risk of contracting these `(Toxocara)` eggs. The reason is that these eggs can survive longer in infected soil in warm weather. This is very relevant for a country like Sri Lanka.
Why do symptoms appear when `Visceral Larva Migrans` develops?
Visceral Larva Migrans is caused by the larvae of the roundworm (Toxocara). After you are infected, these larvae leave the intestines and travel to the organs in your chest and abdomen. Rarely, these larvae can also travel to your eyes, brain, and spinal cord.
In response to a Toxocara infection, your body produces more immune cells in your blood. This increases blood flow and the influx of immune cells to the affected area, which causes inflammation. The symptoms you experience depend on how strongly your immune system responds to the Toxocara infection.
What are the symptoms of this disease? Does it happen to everyone?
Most people infected with Toxocara do not experience any symptoms. However, if symptoms do occur, they may include:
- Fatigue
- Fever
- An increase in a type of white blood cell called eosinophil in the blood (eosinophilia) - This indicates that there is a parasitic infection or allergy in the body.
- Lymphadenopathy
- Abdominal pain
- Hives / urticaria
- Cough
- Wheezing
- Liver swelling (hepatomegaly)
- Splenomegaly
How does a doctor diagnose this? What tests do they do?
A doctor will diagnose Visceral Larva Migrans by doing a physical exam and blood tests. Be sure to tell your doctor if you have pets or if you think you may have been exposed to contaminated soil.
The main test used to diagnose toxocariasis is a blood test called an enzyme-linked immunosorbent assay (ELISA) . This test looks for antibodies to Toxocara in your blood. It does not confirm whether you currently have a Toxocara infection. Instead, it looks for signs in your blood that your immune system has responded to an infection in the recent past.
The doctor may also recommend other tests to further confirm the diagnosis, such as:
- Complete blood count (CBC): This checks the amount of red blood cells, white blood cells, platelets, and hemoglobin in the blood.
- Imaging tests: For example, an ultrasound, CT scan, or MRI scan may be done to check for swelling.
- Stool sample testing: This looks for evidence of parasites in the stool.
- Biopsy: A small sample of the affected tissue is taken and examined to see if larvae are present (this is done very rarely).
What are the treatments for this? Should I be worried?
The good news is that most people with Visceral Larva Migrans do not need any special treatment. Rest and waiting for the inflammation to subside on its own are usually all that is needed.
However, if you have symptoms, your doctor may recommend things like:
- Reduce swelling with corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs) .
- Antihistamines reduce the body's immune response.
If your doctor finds that you have live larvae in your body, he or she may prescribe antiparasitic medication to kill them. This can help prevent the live larvae from entering your body and causing further damage. This is especially important to prevent damage to your eyes, brain, or spinal cord.
How can you avoid this? What are the prevention methods?
There are a few simple things we can do to protect ourselves from this condition (Visceral Larva Migrans):
- Avoid eating foods grown in soil that may have been contaminated with dog or cat feces.
- Keep a close eye on your children when they are playing outside. Don't let them put dirt in their mouths.
- Wash fruits and vegetables thoroughly before eating.
- Make it a habit to wash your hands thoroughly . Teach your children to wash their hands before eating, after playing outside, and after touching pets.
- Set aside a specific place for your pets to defecate. Bag their poop and dispose of it properly, or keep the litter box clean for cats.
- Take your pets to the vet regularly to check for parasites and give them deworming medication.
What happens if I get this disease? Will it be cured?
Usually, this infection heals on its own without any treatment.
Long-term complications are very rare. If they do occur, they may include:
- Inflammation of the heart muscle (myocarditis)
- Pneumonia
- Scarring of lung tissue (pulmonary fibrosis)
Those with the previously mentioned conditions `Ocular larva migrans` (affecting the eyes) and `Neurotoxocariasis` (affecting the brain and spinal cord) can develop serious complications. For example:
- Blindness
- Swelling of the brain and spinal cord (meningoencephalitis)
How do we take care of ourselves and our children? How can we prevent this from happening again?
If you or your child is diagnosed with Visceral Larva Migrans, it is important to find out how it developed so that you can prevent future infections.
If you have a dog or cat, take them to the vet regularly for checkups and deworming. Ask your vet about routine deworming, especially if your pet is an outdoor pet.
Toxocara eggs can survive in the soil for months. Therefore, cleaning up pet feces as soon as you see them can help prevent infection.
You may be thinking, "Oh, how could my beloved pet be spreading a disease to my family?" But, the truth is, dogs and cats can carry roundworms called ``Visceral Larva Migrans'' in their intestines. If you have pets, be extra careful when cleaning up their poop, and take them to the vet regularly.
So, what are the things we should remember from this story?
We've talked a lot about this worm disease called ``Visceral Larva Migrans'' today. So, the most important thing is that this is a preventable disease.
- We can get these worm eggs from our pets, especially through their feces.
- Young children are at the highest risk, as they may unknowingly put worm eggs in their mouths while playing with soil.
- Cleanliness is the most important thing. Washing hands thoroughly, washing fruits and vegetables before eating, and properly disposing of pet feces are very important.
- Don't forget to deworm your pets on time. Ask your veterinarian for advice on this.
If you take care of these things, you and your family, especially your beloved children, can stay healthy and safe from this worm disease called `(Visceral Larva Migrans)`. There is nothing to fear, awareness and caution are the most important things!
` Worms, zoonotic diseases, children's health, Toxocara, Visceral Lava Migration, soil, pets
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