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Hookworm symptoms, causes, treatment – Hookworm

Hookworm is an intestinal parasite that can affect humans. It has various forms, larvae, and adult, causing skin, lung, and intestine disease.

Hookworm affects nearly 500 million people worldwide; it is an infection that predominates mainly in developing countries. The two most important parasites causing the infection are two, Necator americanus and Ancylostoma duodenale.

Within this article, you will find answers to some of the most common questions about this specific disease. There will be questions like what is a hookworm infection, the life cycle of the hookworm, and many more. There will be a brief explanation of basic concepts for a better understanding of the topic.

By reading this article, you will obtain significant insights about Hookworm infection, its symptoms, its causes, and many more. Therefore, please continue reading this article to get to know hookworm infection disease as a doctor would do.

Is hookworm a virus or bacteria?

None of them, actually Hookworms are parasites that live within the small bowel of humans. They belong to the family of Nematoda, a subtype of the family of the Helminths. Helminth is a general term doctors use for referring to a “worm.” There are two principal hookworm species, Necator americanus and Ancylostoma duodenale.

File:Necator Americanus L3 x1000 12-2007.jpg
Necator Americanus

There are also different forms of this parasite that play a less important role. Among the other forms of these parasites are Ancylostoma braziliense, Ancylostoma ceylonicum, and Ancylostoma caninum.

The last four are parasites that affect cats and dogs mainly, but they can also affect humans. Hookworm alongside Ascaris and Whipworm are known as soil-transmitted helminths. These infections account for a significant burden of disease worldwide. 

Hookworm eggs are passed through the feces of an infected person or animal. The presence of feces in places like gardens, whether it be fertilizer or just stool, is a risk factor for acquiring this disease. The eggs can mature and hatch, releasing larvae that, when mature, can penetrate the human skin. It can happen when humans walk barefoot in places with infected soil.

Of course, the ingestion of larvae can also be a factor that can develop this disease. Most of the people with this infection have no symptoms at all. However, people may develop gastrointestinal symptoms if they are infected for the first time. There are severe cases in which blood loss can lead to severe anemia as a complication.

What is a hookworm infection?

The hookworm parasite causes hookworm infection, and it is a parasitic infection that receives the name of Ancylostomiasis. It is a subtype of helminthiasis or helminth infection as they belong to the family of helminths. It causes the following three clinical entities on humans:

  • Classic hookworm disease: On the classical hookworm disease, the parasitic worm in its adult form invades the small intestine. The following hookworm infestation will cause a gastrointestinal infection in which the adult worms will adhere to the intestinal wall. This will ultimately lead to iron-deficiency anemia and protein malnutrition. The causal agents for this disease are Necator americanus and Ancylostoma duodenale. Also, the Ancylostoma ceylonicum can cause this disease, but it is far less common.
  • Cutaneous larva migrans: This is a type of human hookworm infection that affects only the skin. It causes a serpiginous eruption that mainly affects the feet, legs, buttocks, or abdomen. It is a very common infection for travelers as the beaches’ sand is very commonplace for these hookworm larvae to reside. The usual cause of it is the Ancylostoma braziliense. A type of hookworm whose ultimate hosts are dogs and cats.
  • Eosinophilic enteritis: It is very similar to the classic hookworm disease because it is a gastrointestinal infection as well. The only difference is that there is no blood loss, just abdominal pain by an immune reaction. Its causal agent is the canine hookworm, the Ancylostoma caninum.

What is the life cycle of hookworm?

The life cycle of this parasite is very simple. It begins with the presence of the eggs of hookworm in the human feces of an infected person. A mature female from the Ancylostoma duodenale type can produce about 15,000 eggs and an adult Necator americanus female with approximately 7,500 eggs.

After the deposition on the soil, the eggs can hatch if the feces are under favorable conditions. Favorable conditions include moisture, warmth, and shade; if the sun hits the feces directly, these eggs die. Larvae hatch in 1 to 2 days and become a free-living being in the feces or the soil. These larvae receive the name of rhabditiform larvae. After 5 to 10 days, the rhabditiform larvae become the filariform larvae or the infective larvae. 

In favorable environmental conditions, the infective larvae can survive from three to four weeks on the soil. When these larvae become in contact with the human host, they penetrate the skin and go directly to the blood vessels. After reaching the blood vessels, these larvae go to the heart and later to the lungs. Then, they penetrate the pulmonary alveoli (a very tiny lung structure) and ascend right to the pharynx, where they are swallowed. 

The larvae reach the small intestine, specifically the jejunum, where they reside and later mature into adult hookworms. Adult worms live in the lumen of the small intestine, attaching themselves to the intestinal wall, which results in blood loss by the host. Then the adult worms reproduce and lay eggs that go in the feces to start the cycle all over again.

Do they live forever in my intestines?

The adult worms can be eliminated in 1 to 2 years. It can also take more time to eliminate hookworm’s adult form, up to 5 years. Still, it is essential to know that hookworm does not multiply inside the host; therefore, if parasites die and the person does not contract the infection again, it will clear the infection.

What are the signs and symptoms of hookworm?

Most of the time, the human hookworm infection goes asymptomatic (without symptoms). However, this will depend on the hookworm burden each patient has. It means that if a patient has many hookworms living within its small bowel, the chance of developing symptoms goes up.

Among the most common symptoms that patients develop are the following:

  • Itchiness or a Small Rash: This is usually the first symptom any patient presents. It is caused by an allergic reaction when the larvae penetrated the skin to go into the organism.
  • Diarrhea
  • Abdominal pain or cramping
  • Nausea
  • Fever
  • Blood in the feces
  • Loss of appetite
  • Fatigue (Mainly because of the anemia)
  • Weight loss
  • The affection of the physical and cognitive growth in children

What does hookworm rash look like? 

When it comes to the rash of the cutaneous larva migrans, it also receives the name of creeping eruption. This is a skin affection caused by hookworms, usually the Ancylostoma braziliense.

There is severe itching, blisters, and a red growing, winding rash with a snakelike form. Characteristically, it is a rash that can move from its position up to 1 to 2 centimeters per day, usually appearing in parts of the body exposed continuously or in direct contact with the contaminated soil.

A. duodenale or N. americanus, when entering the body, also cause an itchy skin rash. Still, the cutaneous larva migrans rash is characteristic and different from it.

How do you know if you have the infection?

The most common way to know if you have hookworms is through a laboratory diagnosis. If there is persistent abdominal pain and fatigue, a doctor will rule out infectious diseases like parasitic infections. Therefore, a doctor will ask for a stool sample to run some laboratory tests on it. A group of specialist health workers will process the sample and will look for any incongruence within it. If your case is that you actually have them, they will find hookworm eggs within your feces and let you know that you have hookworms.

Are hookworms visible to the eye?

It depends; almost all of the helminths in their adult phases are visible to the eye. Hookworms are not the exception to the rule. However, hookworms are very small; they usually have a length ranging from 6 to 10 millimeters. It will depend on the type as well. But, humans do not evacuate adult forms of hookworms through the feces. Humans evacuate eggs that will later hatch and become larval hookworms rarely seen on the feces.

What is the treatment for the infection?

This will depend on the patient’s overall health status as it directly correlates with the hookworm burden. Doctors usually prescribe antihelminthics to treat hookworm infections. However, suppose the patient has a high hookworm burden. In that case, there is the probability that this patient may suffer from iron-deficiency anemia and malnutrition. If this is the case, the doctor will prescribe iron supplements with the antihelminthics and an appropriate diet. Among the antihelminthics doctors most commonly use to treat hookworm are the following:

  • Albendazole
  • Mebendazole
  • Pyrantel pamoate

The length of these pharmacological treatments tends to be very short. On the other hand, the treatment for anemia may not be as short. Antihelminthic treatment usually lasts one day, but in some cases may even reach three days depending on the drug as well. 

Can hookworms come out of your skin?

No, hookworms are parasites that live within the small bowel, and the natural way to come out is through the feces. Nonetheless, what does actually happen is that the hookworms come into your skin because that is their way to enter the organism.

How can hookworm infections be prevented?

To prevent and control hookworm infections can be a challenging fact. It is a disease that affects the rural areas of developing countries. Therefore, to avoid these diseases, there should be an improvement in their living conditions, including socioeconomic factors. Among the factors to change are sanitation policies, education, and availability of footwear. Nonetheless, here are some general recommendations to avoid hookworm infection:

  • Do not walk shoeless in areas where hookworm may be present
  • Avoid any skin contact with the soil in the regions that may carry hookworm infection
  • Do not ingest soil.

To prevent these diseases, people should avoid defecating outdoors or using human feces as fertilizers. Currently, some laboratories are working to create a hookworm vaccine. This vaccine is a high priority for health services throughout the world. It may represent a more effective way to protect the people.

Where is hookworm most common?

Hookworm infections have affected the most impoverished people among countries that are in development. It is basically a direct consequence of the lack of policies from these countries. They have it more difficult to access clean water, sanitation services, and proper health education. This will ultimately be a risk factor for developing a hookworm infection.

It is a condition that happens mostly in rural regions like the following:

  • Tropical and Subtropical areas of Asia
  • Sub Saharan Africa
  • Latin America

Do you have symptoms of this infection?

This tool is a Hookworm Symptoms Checker. It gathers the most important signs, symptoms, and risk factors for the infection. Therefore, the tool will tell anybody who uses it the likelihood of their symptoms because of hookworm infection. Using the tool is free and would only take a few minutes.

What do you think?

Written by Dr. Esteban Kosak

Doctor of Medicine - MD Recently Graduated from Medical School and inspired to aid the global population during this situation. I think that we shall no longer be waiting to see a doctor when we feel sick. Several times we feel disease searches in Google drive us to a rabbit hole and come out thinking that we may die of cancer or something very serious, given that symptoms may seem to fit a wide variety of illnesses. Since I recently graduated from medical school. I have all the medical information fresh in my mind. My thorough experience as an expert researcher allows me to very-well known the different diseases and conditions that affect human bodies. Empowered by the United Nations 17 Sustainable Development Goals (SGDs). I think that we all can provide a grain of sand to help humanity. That's why we created Symptoms.Care a place where you can come and screen your symptoms and find what different illnesses can be related to them. Armed with the right information you can instantly, discretely, secure and from the comfort of your home talk with a Doctor that can Evaluate your Symptoms and help you seek the right treatment.


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