Hookworm infestation tends to be constantly widespread in varied regions of the world.Įggs are passed in the stool, and under favorable conditions (moisture, warmth, shade), larvae hatch in 1 to 2 days.
In heavy infestations (which may involve more than 500 larvae), the general symptoms include pallor of the skin and mucous membranes, fluid retention in the face and extremities, constipation alternating with diarrhea, abdominal tenderness, increased appetite for bulky or strange substances (e.g., clay), delayed puberty and stunted growth, fatigue, dullness, and apathy. In the intestine, the mature worm sustains its life by bloodsucking, and persistent feeding by many worms over many years results in secondary anemia. In passing through the lungs, the larvae may produce coughing and fever. The symptoms of hookworm disease ordinarily begin with ground itch, an itchy skin irritation caused by the larvae when they penetrate the skin and marked by papules and vesicles that are often located between the toes. The intestinal organisms are reputedly long-lived, with a lifetime that may span some 10 years. They then invade the lymph and blood vessels, reach the lungs, and pass up the respiratory tree to reach the mouth, where they are swallowed and sent to the small intestine there they mature and start a new reproductive cycle. If the fecal matter reaches suitable soil, the eggs are hatched, and the infective, threadlike larvae may penetrate human skin, usually that of the foot, by way of the sweat glands and hair follicles. The adult worm attaches itself to the mucosal tissue lining the small intestine, where the female may produce several thousands eggs a day, which are passed in the feces. americanus has plates in its mouth rather than teeth.īoth species of hookworm have similar life cycles. duodenale, possesses four hooklike teeth in its adult stage, and N. ceylanicum, normally parasitic in dogs, is sometimes found in man in South America and Asia. braziliense, from 8 to 11 millimetres long, is normally parasitic in dogs and cats man, however, is sometimes infected by this species in the southern United States, South America, and Asia. Ancylostoma duodenale, 8 to 13 millimeters long, is found on all continents but is most prevalent in warm regions. Necator americanus, which ranges in size from 5 to 11 millimetres (0.2 to 0.4 inch), is responsible for about 90 percent of human hookworm infections that occur in tropical and subtropical regions of the world. Hookworms deplete the body of nutrients, and a major effect is severe chronic iron-deficiency anemia. It penetrates the skin and migrates during its life cycle through the liver and the lungs, and it attaches to the mucosa of the small intestine where it matures. Hookworm infection begins when the worm is in the larval stage.