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Vita health A-Z

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Parasites-Hookworms

An estimated 576-740 million people in the world are infected with hookworm. Hookworm was once widespread in the United States, particularly in the southeastern region, but improvements in living conditions have greatly reduced hookworm infections. Hookworm, Ascaris, and whipworm are known as soil-transmitted helminths (parasitic worms). Together, they account for a major burden of disease worldwide.
Hookworms live in the small intestine. Hookworm eggs are passed in the feces of an infected person. If the infected person defecates outside (near bushes, in a garden, or field) of if the feces of an infected person are used as fertilizer, eggs are deposited on soil. They can then mature and hatch, releasing larvae (immature worms). The larvae mature into a form that can penetrate the skin of humans. Hookworm infection is mainly acquired by walking barefoot on contaminated soil. One kind of hookworm can also be transmitted through the ingestion of larvae.

Most people infected with hookworms have no symptoms. Some have gastrointestinal symptoms, especially persons who are infected for the first time. The most serious effects of hookworm infection are blood loss leading to anemia, in addition to protein loss. Hookworm infections are treatable with medication prescribed by your health care provider.

Epidemiology & Risk Factors

Hookworm is a soil-transmitted helminth (STH) and is one of the most common roundworm of humans. Infection is caused by the nematode parasites Necator americanus and Ancylostoma duodenale. Hookworm infections often occur in areas where human feces are used as fertilizer or where defecation onto soil happens.

Geographic Distribution

The geographic distributions of the hookworm species that are intestinal parasites in human, Ancylostoma duodenale and Necator americanus, are worldwide in areas with warm, moist climates and are widely overlapping. Necator americanus was widespread in the Southeastern United States until the early 20th century.

Disease

Highly magnified histologic section showing hookworm (Ancylostoma sp) attached to the intestine.
High-intensity hookworm infections occur among both school-age children and adults, unlike the soil-transmitted helminths Ascaris and whipworm. High-intensity infections with these worms are less common among adults. The most serious effects of hookworm infection are the development of anemia and protein deficiency caused by blood loss at the site of the intestinal attachment of the adult worms. When children are continuously infected by many worms, the loss of iron and protein can retard growth and mental development.

Diagnosis

The standard method for diagnosing the presence of hookworm is by identifying hookworm eggs in a stool sample using a microscope. Because eggs may be difficult to find in light infections, a concentration procedure is recommended.

Treatment

Anthelminthic medications (drugs that rid the body of parasitic worms), such as albendazole and mebendazole, are the drugs of choice for treatment of hookworm infections. Infections are generally treated for 1-3 days. The recommended medications are effective and appear to have few side effects. Iron supplements may also be prescribed if the infected person has anemia.

Prevention & Control

The best way to avoid hookworm infection is not to walk barefoot in areas where hookworm is common and where there may be human fecal contamination of the soil. Also, avoid other skin contact with such soil and avoid ingesting it.
Infection can also be prevented by not defecating outdoors and by effective sewage disposal systems.