I earned both  my Master of Science and Doctor of Philosophy degrees at the University of South Carolina in the late 1960s.  My advisor was Felix H. Lauter, a graduate of Louisiana State University who worked under the legendary Asa Chandler.  Lauter, was awarded a governmental grant of some size to educate pre-school age children in the “low country” (southeastern tip of South Carolina) of  the dangers of becoming infected with intestinal worms.  At the time of his grant, preliminary studies revealed that in the southern counties of South Carolina, rural pre-schoolers were infected with Ascaris and/or Trichuris at the incredible incidence of 73%. 

    I was finishing my degree and was not involved with the grant work but many of my classmates were.  They related sad stories of how the kids would question whether they had worms too.  The kids thought that being parasitized was normal, since they routinely passed ascarids with their daily stool.  (My classmates routinely took periodic doses of piperazine citrate as a prophylaxis since they daily handled contaminated feces).  The grant pursued a novel approach to education of these children, most of whom could not read given their age.  Lauter and his students designed a comic book entitled Carrie Ascaris with a storyline that depicted a cartoon, dragon-like worm that was portrayed as evil and caused sickness.  During this period of time, a unrelated incident occurred that is worth repeating. 

    Though these intestinal worms proved common amongst children in the “low country”, they were also common amongst all segments of the population in the southeastern US.  The janitor on our floor knocked on my office door one day and asked me if he could ask me a question.  He presented me with a Coke bottle which had a 10” Ascaris lumbricoides in it.  After I told him what it was, I asked him where he obtained it.  He replied, “I woke up this morning with it in my mouth”.  Ascaris, which normally inhabits the small intestine, will migrate through digestive tract sphincters during heavy worm burdens.  Some emerge from the anus.  Some may even pass up the common bile duct to the liver.  And…..some will pass through the pyloric sphincter into the stomach, through the cardiac sphincter into the esophagus and ultimately end up in the mouth. 

    That was not the only case of this nature that occurred while I was at the university.  A colleague related the following episode to me.  At a pre-school in a suburb of Columbia, a teacher was supervising kids coloring.  She noticed that no one was paying attention to what she was saying but instead staring at a child sitting near her.  She was horrified to see that this child had an ascarid sticking out of his nose.  When he pulled that worm out, another soon appeared and then another.  The other children were horrified because they thought he was pulling out his “insides”.  The psychological and emotional distress in parasitized children can not be underestimated.