Infection is acquired by the ingestion of embryonated eggs from contaminated drinking water and food. The eggs, once ingested, hatch in the small intestine, and the larvae enter the intestinal crypts. The larve migrate to the proximal colon and mature into adult worms. The females begin to oviposit 60 to 70 days after infection and shed between 3,000 and 20,000 eggs per day. Whipworm causes disease by colonic mucosal invasion of the adult worms, resulting in inflammation of the colonic mucosa.

1. The eggs develop into a two-cell stage.

2. The two-cell stage then leads to an advanced cleavage stage.

3. The eggs embryonate.

4. Eggs become infective in 15 to 30 days.

5. Mature adult worms travel in the colon.

6. The adult worms (approximately 4 cm in length) live in the cecum and ascending colon. The life span of the adult worm is approximately 1 year.

• Whipworm infection is acquired by the ingestion of embryonated eggs from contaminated drinking water and food.

• The eggs, once ingested, hatch in the small intestine, and the larvae enter the intestinal crypts.^[1][2]
• The larvae migrate to the proximal colon and mature into adult worms.
• The adult worms live in the cecum and ascending colon and attach themselves to the colonic mucosa with their anterior portions threaded into the mucosa.
• The females begin to oviposit 60 to 70 days after infection and shed between 3,000 and 20,000 eggs per day.
• Whipworm causes disease by colonic mucosal invasion of the adult worms, resulting in inflammation of the colonic mucosa.^[3]

• Whipworm infection leads to a predominantly T helper cell 2 (Th2) type immune response, which is an antibody-based immune response.^[7]

• Whipworm infection induces the production of cytokines (interleukin-4, interleukin-5, interleukin-10, and interleukin-13), parasite-specific immunoglobulin, and IgE.^[8]
• This leads to stimulation and proliferation of mast cells, eosinophils, and basophils, which play effector roles during the infection.

• Whipworm infection may present in combination with Ascaris lumbricoides, Necator americanus, and Entamoeba histolytica infections.^[9]
• Whipworm infection can also exacerbate colitis caused by infection with Campylobacter jejuni.^[10]

• Whipworm infection in humans can lead to rectal prolapse which may be visible grossly.^[11]

• Microscopy of the colonic mucosal biopsy from the affected site will demonstrate infiltration by eosinophils and neutrophils.^[12]
• Hematoxylin and eosin (H&E) stain of an infected colon may show one end of the worm embedded in the hyperemic mucosa and other end freely movable within the lumen.^[13]

• A stool examination for ova and parasites reveals the presence of whipworm eggs.
• The diagnostic characteristics are:^[14]
  • A typical barrel shape
  • Two polar plugs that are unstained
  • Size: 50 to 54 µm by 22 to 23 µm
  • The external layer of the shell of the egg is yellow-brown (in contrast to the clear polar plugs).