Deworming for humans
March 16, 2012 7:21 AM   Subscribe

[Grossness warning] I accidentally ate food that was tainted with a small amount of feces. I am concerned about parasites. How do I take care of the fallout, and what are my best human deworming options? Everything I can find on this topic (information and, annoyingly, worming tablets too) seems to be geared towards deworming dogs, cats, and horses.

I went to a dimly-lit bar, then went to a bathroom to pee. I went back outside, and sat in a circle with other girlfriends. There were crossed feet, causing feet in everyone's faces. I have a supernose and smelled shit, but didn't say anything because I have long since learned to stop commenting about scents, because half the time, I'm the only one who can smell it. I assumed it was at the bottom of someone's shoe. I checked over myself. No smell on me, or anything at the bottom of my shoe.

There was a basket of french fries on my left hand side. I don't remember which hand I used to eat with. Probably both.

I eventually couldn't stand the poo smell and checked over myself. I discovered that the scent was now on my left hand. I went to the bathroom for better lighting. Around hand level, on the left side seam of my jeans, was some semi-dried poop. GROSS. Probably picked up from the bathroom earlier. My hand wasn't covered in poo, but clearly there was some contact because of the smell.

I am going to call a doctor in the morning, but any available information is really, really appreciated. Once-off deworming? Regular deworming every week, for the next x amount of weeks? Anything is useful.
posted by anonymous to Health & Fitness (11 answers total) 1 user marked this as a favorite
Assuming you live in a first-world country, there's almost certainly nothing to worry about. While parasites can indeed be transferred via fecal matter, the source of the fecal matter has to be a carrier. Parasites don't spontaneously generate.

Call a doc if you want, but you're almost certainly fine. People outside Africa, South America, and South Asia are pretty unlikely to have a parasitic infection.
posted by valkyryn at 7:32 AM on March 16, 2012 [6 favorites]

I doubt you will get sick from a tiny bit of poo. Worms are probably the least of your worries, and are usually transmitted from undercooked meat rather than human faeces. Anti-helminth (ie worm) drugs are pretty nasty and I doubt anyone would recommend them prophylactically. A bacterial or viral infection is more likely, but still in the scheme of things unlikely and it would have to be the poo of someone with an infection. The poo of a healthy person shouldn't infect a healthy person if eaten.

If you get sick (diarrhoea, nausea, fever, vomiting) - then is the time to worry. But honestly, the human digestive system is pretty well designed to fight off a little bit of poo.

But it is disgusting, no doubt.
posted by chiquitita at 7:34 AM on March 16, 2012

Unfortunately, unless you have been incredibly careful about what you eat for your entire life, this is not the first time you have eat food with fecal contamination. Assuming you are in a first-world country the chance of you getting any sort of parasite is slim. A viral or bacterial infection is more likely, but even so you probably wont get any infection at all. If you do (once again making an assuption that you are reasonably young and healthy) it is likely to be a self-limited case of gastroenteritis. I suspect the physician you talk to tommorrow will mainly offer reassurance and hold off any treatment unless you develop symptoms.
posted by TedW at 7:35 AM on March 16, 2012 [1 favorite]

Deworming meds are pretty much a nuclear option for your digestive system, they will wipe out any parasites but also almost everything else (good bacteria, etc.) in your system. They should only be prescribed when you have physical evidence of worms in your system.

As valkyryn indicates, its entirely unlikely that whoever's poop got on your jeans had worms in it. At worst you may get some bacterial infection which could cause essentially a nasty case of food poisoning. I wouldn't even take a ciprofloxacin unless a doc insisted o nit.
posted by allkindsoftime at 7:37 AM on March 16, 2012

Yeah worms are one of those things that are pretty easy to test for if you get the sort of worms that you are likely to get in the developed world. I have had First World Worms. Not great, but a pretty basic kid in the country disease where I am from. If you get them, you take medicine for them. The medicine isn't really fun so I'd wait for a diagnosis. There are people who go on these parasite cleansing programs but they are not actually useful. Feces are not something you'd want in your french fries but it's not polonium. Do the regular "go to the doc, see what the doc says" routine and try to put it out of your mind otherwise.
posted by jessamyn at 7:40 AM on March 16, 2012 [3 favorites]

For what it's worth, and please forgive the animal parallels but I feel like it addresses the question, we've always had hunting dogs and we've used Ivermectin (further) to worm them for years.

When I was in high school school science/biology class there was one of those "special interest sections" in our textbook where a few pages are dedicated to a topic in the real world that kinda parallels the material in the book. It was dedicated to how the WHO was airdroping ivermectin into africa (maybe, sort of, kind of, related to this sort of thing) for native peoples to prevent blindness caused by some worm that worked it's way to the eyes. They could simply air drop it in because it was so safe to use and dosages didn't have to be perfect for people to benefit from it.

Don't know how that makes you feel, but just providing data on wormers, animals, humans, etc, etc, etc.
posted by RolandOfEld at 7:44 AM on March 16, 2012

RolandofEid, they do that because worms are endemic to countries in Africa. As already noted, worms are very uncommon in the developed world. Bacterial or viral gastroenteritis due to fecal contamination of foods are common here. But without symptoms, there is no reason to take antibiotics, and in most cases, you don't need antibiotics even if you get symptoms, you just need to stay hydrated.
posted by treehorn+bunny at 7:57 AM on March 16, 2012 [1 favorite]

Jessamyn is correct, worms are not at all uncommon here in the US. Just about every kid who ever played outside in a sandbox or has a pet in the house gets them at least once. There's a pill regimen that will get rid of them if you do get them.
posted by raisingsand at 8:07 AM on March 16, 2012

We really cannot give you a good accounting of your likely risk with at least a rough understanding of your location.

If this is first world poop, really don't worry, you might get sick for a few days. You have had poop in you before, seriously, poop is everywhere. Every quarter I send students out looking for fecal coliforms, bacteria found only in poop that are a great indicator, and they find them EVERYWHERE. Assuming that you are in the first world, when you get sick, the overwhelmingly most likely cause will not be so much the type of bacteria but their location and concentration. You'll have bacteria that were most likely perfectly happy in the colon of whomever shit on your bench, that would likely be just fine in your colon, but not so great in your upper intestines. For example, Escherichia coli depending on the strain and concentration, is great to have in your large (lower) intestine (helps keep the it anoxic, sucking out all of the oxygen, so that other good bacteria won't be hurt by it) but not so great to have growing in your small (upper) intestine where it will have access to sugars (it ferments them into really terrible products including stupid amounts of CO2).

The biggest problem with poop is when lots of people get it in them, which selects for virulence. Essentially, lots of people getting poop in them allows bacteria to develop a strategy where they care less about the longevity of their host than getting as much poop out as possible laden with as many cells as possible. In the absence of modern sanitation and effective quarantine of affected individuals this can lead to epidemics of really terrible shit, which is what we see in many developing countries. What ubiquitous private toilets, the government infrastructure behind them, and near universal health care have done is actively select against terrible pathogens to the point where they become near extinct. What we are left with is the mostly good to borderline bacteria that find bad contexts, zoonotic infections, and small pockets of really stubborn shit like C. difficile in hospital populations. That said, even in a developed country, you don't know where that poop came from and it is still worth checking in with your doctor.

Also, if you happen to be in the former Soviet Caucasuses where it is available, I'd ask your doctor about Intestiphage/Bacte-Intestiphage/ინტესტიფაგი
posted by Blasdelb at 8:31 AM on March 16, 2012 [5 favorites]

You're probably worrying too much. If you're seriously worried, see a doctor, who will most likely tell you to not worry so much and charge you eighty bucks for the privilege.

If you don't want to see a doctor or can't afford to see a doctor, Ivermectin is a nice broad-spectrum dewormer dosed by weight and available OTC at Tractor Supply or your local Agway or feed store. It'll be in the "horse wormer" section of the store, should cost under ten bucks for the generic (look for "1.87% Ivermectin" on the tube). It doesn't taste particularly good but can be swallowed without gagging.

See for the "drug" information for the stuff -- the active ingredient referred to there is the same as what you get in a tube of horse wormer and the horse wormer is substantially cheaper and available without a script. More information here: Dosing is simple -- dial up the horse wormer to reflect your weight (to the nearest 200 lbs, usually the tubes are marked by weight) and chow down. :) It's been given to about 50 million humans, most of them in poorer parts of the world, and doesn't seem to kill them wholesale or anything.

Hope this helps.
posted by which_chick at 7:18 PM on March 16, 2012

I just wanted to come back in this thread, if only for the benefit of those finding it with Google, and note that if you do not have symptoms of helminthic infection DO NOT TAKE DEWORMERS. Ivermectin might be a second best solution if you do not have adequate access to healthcare, but is not intended as a prophylactic.
posted by Blasdelb at 3:11 PM on May 17, 2012

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