Hookworm Infection (Ancylostoma Duodenale): Symptoms, Causes, Diagnosis & Treatment

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Hookworm infection (Ancylostoma duodenale or Necator americanus infection) : Symptoms, Causes, Diagnosis & Treatment

Hookworm infection is an infection of the intestines that can cause an itchy rash, respiratory and gastrointestinal problems, and eventually iron deficiency anemia due to ongoing loss of blood. People can become infected when walking barefoot because hookworm larvae live in the soil and can penetrate the skin. At first, people may have an itchy rash where the larvae penetrate the skin, then fever, coughing, and wheezing or abdominal pain, loss of appetite, and diarrhea.

Severe, chronic infections can cause loss of blood and anemia that is sometimes severe enough to cause fatigue and occasionally heart failure and widespread swelling.

Two species of hookworm cause infection in people:

  • Ancylostoma duodenale
  • Necator americanus

Both species are present in moist, hot areas of Africa, Asia, and the Americas. Ancylostoma duodenale is present in the Middle East, North Africa, and southern Europe. Necator americanus is present mainly in the Americas and Australia.

Doctors diagnose the infection by identifying hookworm eggs in a stool sample. The infection is treated with antiparasitic drugs such as albendazole.

Worldwide, between 576 and 740 million people are infected with hookworms, which are intestinal roundworms. The infection is most common in tropical areas where sanitation is poor. Hookworms thrive in warm, moist places.

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How does Hookworm infection affect your body?

Once larvae enter the body, they move through the bloodstream to the lungs. The larvae pass into the air spaces of the lungs and move up the respiratory tract. They are coughed up into the throat and swallowed. About a week after penetrating the skin, they reach the intestine. Once inside the intestine, the larvae develop into adults. They attach themselves by their mouth to the lining of the upper small intestine, where they feed on blood and produce substances that keep blood from clotting. As a result, blood is lost, and anemia may develop.


What are the Causes of Hookworm infection?

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.

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What are the Risk Factors of Hookworm infection?

Following are the risk factors of hookworm infection :

  • Contact with contaminated soil or sand, especially when walking barefoot
  • Residence or travel in an area with poor sanitation, where human fecal matter may contaminate the soil
  • People who live in warm, tropical, or subtropical areas
  • People exposed to poor sanitation management and hygiene, especially if walking barefoot or with skin-to-soil contact
  • Women who are pregnant and those who are of childbearing age
  • Young children who are exposed to contaminated soil or sandboxes
  • People who have contact with contaminated soil, especially farmers, plumbers, electricians, and exterminators
  • People who sunbathe on contaminated sand
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What are the symptoms of Hookworm infection?

Common symptoms include:

  • Abdominal pain
  • Colic, or cramping and excessive crying in infants
  • Intestinal cramps
  • Nausea
  • Fever
  • Blood in stool
  • Loss of appetite
  • Itchy rashes
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How is Hookworm infection diagnosed?

Common diagnostic methods include –

  • Examination of a stool sample – Hookworm infection diagnosis is made by identifying hookworm eggs in a sample of stool. Stool should be examined within several hours after defecation.
  • Blood tests for anemia and nutritional deficiencies, particularly iron, are also done.
  • Specific diagnosis with PCR (polymerase chain reaction) can be employed to confirm hook worm infection.
  • Rarely, endoscopy is done that would reveal the presence of adult worms in the intestine. This is done for the purpose of identification of the species that has infected the person.
  • Chest X- ray is done to check lung involvement in hookworm infection.
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How to prevent & control Hookworm infection?

Following tips should be followed to prevent hookworm infection –

  • Using sanitary toilet facilities
  • Preventing the skin from directly contacting the soil (for example, by wearing shoes and using a tarp or other barrier when seated on the ground)
  • Treating dogs and cats for hookworm to prevent them from spreading hookworms to people.

Treatment of Hookworm infection – Allopathic treatment 

Common medications used are :

  • Albendazole, mebendazole, or pyrantel pamoate (drugs used to eliminate worms—anthelmintic drugs)
  • For iron deficiency anemia, iron supplements

Treatment of Hookworm infection – Homeopathic treatment 

Following medicines are used for the treatment of hookworm interaction :

  • Cina and Spigelia
  • Cina and Natrum Mur
  • Cina and Abrotanum
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Hookworm infection – Lifestyle Tips

Repeat the stool examination using a concentration technique after 2-3 weeks; positive results indicate the need for retreatment.

The entire course of iron therapy must be completed to replenish iron stores, even after hemoglobin values return to normal.


What are Recommended Exercises for Person with Hookworm infection?

No clinical data is available regarding this. You can continue with your regular exercising schedule.


Hookworm infection & Pregnancy – Things to know

No clinical data is available regarding this.


Common Complications Related to Hookworm infection

Hookworm infection can lead to complications such as :

  • Iron deficiency anemia, caused by loss of blood
  • Nutritional deficiencies
  • Severe protein loss with fluid buildup in the abdomen (ascites)
  • Heart failure and widespread tissue swelling secondary to severe anemia
  • Physical and thought development problems in children due to severe anemia
  • Breathing complications such as wheezing and cough

Other FAQs about Hookworm infection

Q. Is hookworm contagious to humans?

A. 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


Q. How big is a hook worm?

A. N. americanus is generally smaller than A. duodenale with males usually 5 to 9 mm long and females about 1 cm long. Whereas A. duodenale possesses two pairs of teeth, N. americanus possesses a pair of cutting plates in the buccal capsule. Additionally, the hook shape is much more defined in Necator than in Ancylostoma.


Q. What is the life cycle of a hookworm?

A. Life Cycle: Eggs are passed in the stool , and under favorable conditions (moisture, warmth, shade), larvae hatch in 1 to 2 days. The released rhabditiform larvae grow in the feces and/or the soil , and after 5 to 10 days (and two molts) they become filariform (third-stage) larvae that are infective.

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