Whipworm in Humans: Symptoms & Treatment

Whipworm in humans is an infection of the large intestine with Trichuris trichiura, a small worm people catch by swallowing eggs from soil, food or water contaminated with human stool. Light infections usually cause no symptoms, while heavy ones can cause painful, frequent diarrhea with mucus or blood, and a clinician may prescribe an anti-worm medicine such as mebendazole.

The infection is also called trichuriasis, and the CDC notes the name comes from the worm's whip-like shape. This page covers the human whipworm. Whipworms in dogs are a different species, covered further down.

How do humans get whipworm?

The CDC explains that a person with whipworm passes the eggs in their stool. Where human waste reaches the soil, through outdoor defecation, poor sanitation or the use of human waste as fertilizer, the eggs develop over time into a form that can infect people.

You get whipworm by swallowing those infective eggs, for example:

• Eating raw fruits or vegetables grown in contaminated soil that were not washed, peeled or cooked; MedlinePlus notes some outbreaks have been traced to contaminated vegetables
• Putting hands in your mouth after touching contaminated soil, which is why children are infected most often
• Drinking water contaminated with human waste

Whipworm does not spread directly from person to person through touch. Freshly passed eggs are not yet infective; they need time in soil first.

What happens inside the body

Once swallowed, the eggs hatch, and MedlinePlus explains that the worm attaches inside the wall of the large intestine (the colon). Unlike roundworm or hookworm larvae, whipworm larvae do not travel through the lungs, so a cough is not a typical sign. The adult worms live in the colon and lay eggs that pass out in the stool.

Whipworm symptoms in humans

The CDC says people with light infections, meaning only a few worms, usually have no signs or symptoms. MedlinePlus agrees that most people with whipworm don't have symptoms, and that symptoms mainly occur in children.

Heavy infections, which are more common in children, can cause:

• Frequent, painful bowel movements containing a mixture of mucus, water and blood
• Diarrhea that smells worse than usual
• Fecal incontinence during sleep, which MedlinePlus lists in severe infections
• Iron-deficiency anemia, with tiredness, weakness and pale skin

When whipworm becomes serious

The CDC notes that heavy infections can cause rectal prolapse, where the rectum sags and comes out of the anus. In children, ongoing heavy infection can slow growth, cause severe anemia and affect learning and concentration.

Bloody diarrhea always deserves medical attention. MedlinePlus points out that many other infections and illnesses cause similar symptoms, so seek care promptly if you or your child have bloody diarrhea, and urgently for rectal prolapse, signs of dehydration, fainting or severe belly pain.

Who is at risk?

The CDC estimates that whipworm infects hundreds of millions of people worldwide. MedlinePlus says it is found throughout the world, especially in countries with warm, humid climates, and mainly affects children. Infection is linked to poor sanitation, and improved sewage disposal has made it less common.

In the United States, modern sanitation makes whipworm uncommon. Your risk is mainly tied to living in, or traveling to, places where the infection is common. Because whipworm, roundworm and hookworm spread in similar conditions, people can carry more than one at the same time. Our overview of intestinal worms in adults compares them side by side.

What about whipworm from dogs?

Dogs carry their own whipworm species. It is a veterinary problem, treated by a vet, and it is not the human infection this page describes. Dog whipworm is not covered by mebendazole's labeling, and it is not treated through Get It Prescribed. If you are worried about a worm you or your child caught from a pet, see a clinician in person.

How whipworm is diagnosed

The CDC says a healthcare provider can examine a stool sample under a microscope for whipworm eggs, and that this is the only way to know if you have a whipworm infection. MedlinePlus calls this a stool ova and parasites exam. A clinician may also check a blood count for anemia. Because bloody diarrhea has many possible causes, testing matters more than guessing from symptoms. Here is how a stool test for parasites works.

How whipworm is treated

Whipworm is treated with prescription anti-worm medicine chosen by a clinician. MedlinePlus names albendazole as commonly prescribed and notes a different anti-worm medicine may be used. The prescribing information for the brand-name mebendazole chewable tablet lists whipworm, Trichuris trichiura, among its labeled uses, alongside pinworm, roundworm and hookworm. For background on the medicine, see what is mebendazole and how does it work. Its labeling does not cover tapeworms or flukes; see which parasites mebendazole's labeling covers.

If whipworm has caused anemia, a clinician may also recommend treating that. The dose and length of treatment are the prescriber's decision. We don't publish doses or schedules, and you should follow the directions on your own prescription label. Possible side effects are covered in mebendazole side effects.

Preventing whipworm

The CDC recommends:

• Washing your hands after using the toilet and before handling food
• Washing, peeling or cooking raw fruits and vegetables
• Avoiding soil or water that may be contaminated with human waste
• Teaching children to wash their hands, since they are infected most often

Getting whipworm treatment online

If you have been diagnosed with whipworm, or a clinician suspects it based on your history and test results, a licensed provider can review your health assessment through Get It Prescribed and decide whether mebendazole is appropriate. There is a one-time $50 consultation fee, and mebendazole costs $3.50 per capsule; the prescriber decides the quantity. The service is available in all 50 states and the District of Columbia, and some states require a live phone or video visit. How it works shows each step. A prescription is never guaranteed.

The mebendazole dispensed through Get It Prescribed is a compounded preparation made by a licensed compounding pharmacy for an individual patient. Compounded preparations are not FDA-approved, and the FDA does not review them for safety, effectiveness or quality. They are not generics of, or substitutes for, the brand-name product.

See a clinician in person instead if you are pregnant or breastfeeding, are treating a young child, have bloody diarrhea that hasn't been tested, or have signs of rectal prolapse or significant anemia.

Related questions

What are the symptoms of whipworm in humans?

Most people with a light infection have none. Heavy infections, more common in children, can cause frequent, painful bowel movements with mucus, water and blood, diarrhea that smells worse than usual, and anemia. Severe cases can cause rectal prolapse and, in children, slowed growth.

How do you get whipworm?

By swallowing whipworm eggs from soil, food or water contaminated with human stool, for example by eating unwashed raw produce or putting dirty hands in the mouth. The eggs must spend time in soil before they can infect anyone, so whipworm does not spread directly from person to person.

What is the treatment for whipworm in humans?

Prescription anti-worm medicine, such as mebendazole or albendazole, chosen by a clinician. A stool test is the only way to confirm a whipworm infection before treatment.

Can humans get whipworm from dogs?

Dogs have their own whipworm species, which is a veterinary problem treated by a vet. It is not the human whipworm infection described here and is not covered by mebendazole's labeling. See a clinician in person if you are worried about a worm caught from a pet.

Is whipworm serious?

Light infections usually cause no harm. Heavy infections can cause bloody diarrhea, anemia and rectal prolapse, and in children can slow growth and affect learning. Bloody diarrhea has many possible causes, so it should always be checked by a clinician.

Sources

• CDC: About Whipworms — how people get whipworm, symptoms, complications, diagnosis and treatment.
• CDC: About Soil-transmitted Helminths — whipworm, roundworm and hookworm, how they spread and how they are treated.
• MedlinePlus: Whipworm infection — National Library of Medicine overview, including symptoms, testing and outlook.
• MedlinePlus: Mebendazole — consumer drug information from the National Library of Medicine.
• DailyMed: mebendazole chewable tablet prescribing information — labeled uses, including whipworm.
• WHO: Soil-transmitted helminth infections — global background on whipworm and related worms.
• FDA: Compounding and the FDA — Questions and Answers — what compounded preparations are and how they are regulated.