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An adult pinworm generally is 1/4 to 1/2 inch (about 6 to 13 millimeters) in length. The most common symptom of infection is anal itching, particularly at night, as worms migrate to the host's anal area to lay their eggs.

While the infected person sleeps, female pinworms lay thousands of eggs in the folds of skin surrounding the anus. Most people infected with pinworms have no symptoms, but some people experience anal itching and restless sleep.

Accidentally swallowing or breathing in pinworm eggs causes a pinworm infection. The tiny (microscopic) eggs can be carried to your mouth by contaminated food, drink or your fingers. Once swallowed, the eggs hatch in the intestines and mature into adult worms within a few weeks.

Female pinworms move to the anal area to lay their eggs, which often results in anal itching. When you scratch the itchy area, the eggs cling to your fingers and get under your fingernails. The eggs then get transferred to other surfaces, such as toys, bedding or toilet seats. The eggs can also be transferred from contaminated fingers to food, liquids, clothes or other people.

The parasite can travel from the anal area up the vagina to the uterus, fallopian tubes and around the pelvic organs. This can cause problems such as inflammation of the vagina (vaginitis) and inflammation of the inner lining of the uterus (endometritis).

We would like to acknowledge Dr. Debby Herbenick for her contributions to the development of survey items for this study. We would like to thank Dr. Nicole S. Zelin for her participation in drafting and reviewing literature for the manuscript. We would also like to thank Dr. Jennifer Arter & Dr. Sybil Lockhart for their contributions to the pilot qualitative research phase, and preliminary qualitative analysis.

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