Hookworm Disease

What is hookworm?

Hookworm is a parasite that infects your intestines. There are two main types of hookworm that infect humans: Ancylostoma duodenale and Necator americanus.

Hookworm larvae (eggs) break through your skin. They travel through your body and hatch once they reach your intestines. As the name implies, hookworms have a hook-like head that attaches to your intestinal walls. These tiny worms can cause a number of health problems, including iron-deficiency anemia, diarrhea and abdominal pain.

Hookworm infection is most common in tropical and subtropical areas, especially if sanitation isn’t as good and people walk barefoot on contaminated soil. In the past, hookworm was a serious problem in the southern United States, but improved sanitation has made it much less common.

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 your intestines. There, they feed on blood from your intestinal wall, mature and lay eggs.

How common are hookworms in humans?

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

How do you tell if you have hookworm?

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

Possible hookworm symptoms include:

• Skin rash on your feet where the larvae entered your body.
• Fever.
• Coughing or wheezing.
• Abdominal pain.
• Loss of appetite.
• Diarrhea.
• Weight loss.
• Iron-deficiency anemia.

How do hookworms infect humans?

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 by breaking through the skin on your feet. 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 your small intestine, where they attach to the walls, grow and mature.
• Fertilized eggs leave your body in your poop to potentially infect another host.
• The whole process can take two to three months. The worms can live in your body for two years or more.

Are hookworms contagious?

Yes. You can get hookworm by coming in contact with poop 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 ones that infect 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 your skin. This itchy rash, called cutaneous larva migrans, shows up as a thin, raised red line that spreads across your skin.

Who is at risk for hookworm disease?

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

How serious is hookworm in humans?

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.
• Chest pain.

Children infected with hookworms over long periods of time can develop 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 (stool). They’ll analyze the stool sample under a microscope to look for hookworm eggs.

If you’ve recently traveled to an area where hookworm is common, your provider may recommend blood tests. A complete blood count (CBC) 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 poop.

How do you get rid of hookworms?

If tests show that you have hookworm disease, your provider will prescribe medications that treat the infection. In most cases, hookworm treatment includes 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 if you have anemia from hookworm disease.

Do hookworms go away on their own?

Hookworms may go away on their own, but it can take many years. During that time, they can cause serious health complications, like malnutrition and anemia. With treatment, you can get rid of hookworms and avoid any possible complications.

How can I prevent hookworm disease?

You can prevent hookworm disease by:

• Wearing shoes when walking on soil that may be contaminated with poop.
• Practicing good hygiene, like washing your hands thoroughly after using the toilet and before eating.
• Disposing of poop properly.
• Not using human feces as fertilizer.

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 see my healthcare provider?

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 healthcare provider?

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?