Duffmanj
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Not necessarily, worms can lay dormant for some time without outward signs, or they can be introduced by new fish. Stress can be a factor in outbreaks, as can poor food, poor water, new fish etc. In these cases it may be best to assume that all of the above are a cause and review each. The treatment for worms and internal parasites involves meds which break down in the tank over a fairly short period of time, so providing you follow the correct dosage it should have no detrimental affect on the tank.