Hookworm Disease

What is hookworm disease?

Hookworm is a parasite that infects the intestines. Hookworm larvae (eggs) enter through your skin. Once they reach the intestine, they hatch. As the name implies, hookworms have a hook-like head that attaches to the intestinal walls.

Hookworm, ascariasis, and whipworm are all roundworm infections. These parasitic worms are called soil-transmitted helminths (STH) because the infection spreads through contaminated soil.

What is a parasite?

A parasite is an organism that needs to live on or inside another organism (animal or human). The parasite relies on its host (the creature it lives in or on) to survive.

Hookworms are parasites that live inside the intestines. There, they feed on blood from the intestinal wall, mature and lay eggs.

How common is hookworm disease?

Hookworm disease is widespread in many parts of the world. As many as 740 million people worldwide have hookworm disease.

Who is at risk for hookworm disease?

Hookworm disease affects children and adults. It is most common in warm, humid and tropical locations. It’s especially common in places lacking indoor sanitation.

Is hookworm contagious?

Yes. You can get hookworm by coming in contact with stool from an infected person. Hookworm infections also spread through contact with infected soil.

Can you get hookworm disease from your pets or other animals?

Hookworm infections in dogs, cats and other animals typically come from a different species than the one that infects humans. Animal hookworms can sometimes penetrate a person’s skin, but they don’t mature or lay eggs inside a human host.

Animal hookworms can cause a rash as they move under the skin. This itchy rash, called cutaneous larva migrans, shows up as a thin, raised red line that spreads across the skin.

What causes hookworm disease?

Hookworm larvae pass in the feces (poop) of someone already infected with hookworm disease. If a person with hookworm disease poops outdoors, the larvae enter the soil. Using human feces as fertilizer can also contaminate the soil.

If you walk barefoot on infected soil, the larvae can enter your body through the skin on your feet.

How do hookworms affect me?

After infected larvae enter through your skin, they travel through your body:

• They move through your blood vessels to your heart and then your lungs.
• You cough up the larvae from your lungs and swallow them.
• The larvae follow the digestive tract into the small intestine, where they attach to the walls, grow and mature.
• Fertilized eggs leave your body in your stool to infect another host.
• The whole process can take two to three months. The worms can live in your body for two years or more.

What are the symptoms of hookworm disease?

Many people infected with hookworm disease have no symptoms. Those who do have symptoms may experience mild ones at first. Symptoms progress as the infection gets more severe.

Possible symptoms include :

• Skin rash on the feet where the larvae entered the body.
• Fever.
• Coughing or wheezing.
• Abdominal pain.
• Loss of appetite.
• Diarrhea.
• Weight loss.
• Anemia.

What are the complications of hookworm disease?

Hookworms feed on blood in your intestines. An untreated, severe infection results in blood loss. Blood loss can lead to anemia and protein deficiency. Severe anemia can cause dizziness, fatigue, muscle cramps, shortness of breath and chest pain.

Children infected with hookworms over long periods of time can suffer severe effects from lack of iron and protein. This can slow both their physical and mental development.

How is hookworm disease diagnosed?

If you have symptoms of hookworm disease, your healthcare provider will test a sample of your poop. They analyze the stool sample under a microscope to look for hookworm eggs.

If you have recently traveled to an area where hookworm is common, your provider may recommend blood tests. A complete blood count can show eosinophilia (higher than normal white blood cell count). This sign of hookworm disease can show up weeks before eggs are present in your stool.

How is hookworm disease treated?

If tests show that you have hookworm disease, your provider will prescribe medications that treat the infection. In most cases, you’ll take an anthelmintic medication (medication used to destroy parasitic worms) orally (by mouth) for one to seven days.

Your provider may prescribe these medicines to get rid of parasitic worms:

• Mebendazole (Vermox® or Emverm®).
• Albendazole (Albenza®).

Your provider may also prescribe iron supplements to treat anemia caused by hookworm disease.

How can I prevent hookworm disease?

You should avoid walking barefoot in places where the soil or sand may be infected. In these areas, don’t touch the ground with your bare hands. Sit on a tarp or other barrier instead of sitting on the bare earth.

Take these precautions in regions where people:

• Go to the bathroom outdoors.
• Fertilize gardens or farmland with human feces.

What is the prognosis (outlook) for people with hookworm disease?

Hookworm disease is easily curable with appropriate medication. Most symptoms — including anemia — will go away once the infection clears.

When should I call the doctor?

You should call your healthcare provider if you have:

• A rash on your foot.
• Unexplained weight loss.
• Loss of appetite.
• Fatigue or dizziness.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• Do I need to worry about contracting hookworm disease when traveling out of the country?
• What steps can I take to prevent infection in areas where it’s prevalent?
• How long can hookworms live in the intestines?
• Do I need to be tested for anemia?

A note from Cleveland Clinic

Hookworm disease is a common parasitic infection in many parts of the world. Most people get the parasite by walking barefoot in soil infected with hookworm eggs. Left untreated, it can lead to unpleasant — and sometimes serious — symptoms. A single course of medication that kills the parasites is usually enough to treat the infection.