Water Sanitation Health

Water-related Diseases

Ringworm (Tinea)

Ringworm or Tinea is a typically mild disease of the skin, scalp or nails caused by a fungus. Personal hygiene, supported by availability of adequate quantities of water are important preventive measures.

The disease and how it affects people

Ringworm is a contagious skin disease, in which the scalp (tinea capitis), nails (tinea unguium), feet (tinea pedis or “athlete's foot”), or body (tinea corporis) can be affected. Despite its name, ringworm is caused by a fungus.

On the scalp, ringworm begins in the form of a pimple or sore, which then spreads into a ring shape. Hair becomes brittle, breaking easily and falling out, leaving bald spots on the scalp. On the body, ringworm may first appear as red or pink, flat or slightly raised, patches on the skin. The circular sores may be dry or scaly crusted or moist. As the sores become larger, the central area clears, leaving a ring of infected tissue around the clear area. Infection in the nails usually begins at the site of an injured nail and may spread to the other nails. Infected nails become thick, pitted, grooved and abnormal in shape and colour.

Ringworm of the feet and body are more frequent in men than women. Adults are more likely than children to get ringworm of the feet, which occurs more frequently in hot weather.

The cause

Ringworm is caused by various types of fungi known as the dermatophytes. It is spread by direct contact with an infected person or animal (dogs, cats, guinea-pigs, cattle), contact with soil or by indirect contact with items contaminated by the fungus, for example clothing, towels, bedclothes, chairs, and toilet articles handled by people with the infection. The link with water is via poor personal domestic hygiene and shortage of water for cleaning and washing.

Distribution

The various types of ringworm are found worldwide.

Scope of the Problem

Although specific figures are not available, ringworm is a frequent problem in most countries, particularly where personal and domestic hygiene are poor.

Interventions

Key components of prevention are:

  • An adequate supply of water for personal washing and hygiene.
  • Regular and thorough bathing with soap and water, with special attention to drying moist areas.
  • Health education about how its spreading can be prevented.

Where ringworm occurs:

  • The clothing and linen of infected persons should be frequently laundered in hot water to rid them of the fungus.
  • Rashes can be treated with topical anti-fungal lotions or creams. In severe or persistent cases oral anti-fungal medication may be required.

Prepared for World Water Day 2001. Reviewed by staff and experts from the cluster on Communicable Diseases (CDS) and the Water, Sanitation and Health unit (WSH), World Health Organization (WHO).

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