Hookworms are parasitic worms that infect over 800 million individuals worldwide. Although some people are asymptomatic or have few disorders, these worms can sometimes interfere with children's physical and cognitive development. There are several ways to get the infection, but luckily it is completely treatable. See your doctor immediately if you suspect that you have had hookworms so that treatment can be started.
Steps
Part 1 of 3: Diagnosing Hookworm Infection
Step 1. Assess your exposure in high risk areas
This infection is most prevalent in developing countries in Asia, Sub-Saharan Africa and Latin America. Areas where hygienic conditions are precarious, water is not treated and where there are no aqueduct and wastewater infrastructures are at greater risk. Hookworm larvae live in the soil and move across the surface in search of oxygen and sunlight. If you come into contact with this terrain in high-risk geographic areas, whether with your hands or walking barefoot, you increase the chances of getting infected. Sunbathing on your back can also lead to infection.
These parasites prefer humid and sandy environments
Step 2. Think about how you might have contracted the infection
Basically, there are three possible ways: through skin penetration, by ingestion and, albeit rarely, through breast milk. If you live in or have traveled to a high-risk area, consider whether it has been possible to transmit hookworms through these modalities. Skin penetration infection is quite common on the feet, although it can occur anywhere else on the body.
- You may have contracted the infection by mouth, for example by eating food prepared by an already infected person or through contact with infected feces. In particular, dog and cat owners can catch hookworms while disposing of their pets' manure.
- Soil can also become contaminated by infected feces. Try to remember if you have walked barefoot in places where dogs or cats may have defecated.
Step 3. Pay attention if you have a "serpiginous skin infection"
If you have a type of infection called "larva migrans cutanea", you have certainly developed a truly unforgettable rash. The term "serpiginoso", in fact, derives from the word "snake". The rash gets its name because you can see hookworms moving under the surface of the skin, just like small snakes. The worms migrate an inch or two each day, hence the term "migrans" of the infection.
Step 4. Check for a mild cough or sore throat
Once infected, it finds its way into the bloodstream. When it reaches the lungs, it enters the air sacs around the alveoli causing inflammation, resulting in a moderate cough and sometimes a sore throat, while the larvae continue to move up the airways towards the glottis. Other symptoms of this stage of the infection include:
- Dyspnea;
- Headache,
- Cough with traces of blood.
Step 5. Watch for signs of anemia
As the larvae approach the glottis, they can be ingested and make their way to the small intestine. From here they attack the intestinal walls with their teeth, causing a loss of blood from which they absorb proteins. If you let parasites grow and develop in the intestines, you can end up suffering from malnutrition and anemia. Among the symptoms of anemia you can note:
- Exhaustion;
- Weakness;
- Pallor;
- Tachycardia or arrhythmia;
- Shortness of breath;
- Chest pain;
- Dizziness;
- Cognitive difficulties;
- Cold hands and feet
- Headache.
Step 6. Don't neglect stomach pain
Hookworms migrate to the intestines, so it's not uncommon to experience gastrointestinal pain, especially after meals. Since these parasites repeatedly bite the intestinal walls, the pain resembles a bee sting inside the body. Other gastrointestinal disturbances can be diarrhea, loss of appetite, or even weight loss.
Step 7. Keep in mind that many patients do not experience any symptoms
The severity of these depends, in fact, on the extent of the infestation. If you have 100-500 larvae in your body, your symptoms may be mild or you may not have any at all. An average infestation is around 500 larvae or more, while when it is severe it means you have at least 1000 in your body, if not more.
Step 8. Try to get an early diagnosis
If you live in a particularly high-risk geographic area, ask your doctor for a worm test to be an integral part of your routine medical visits. If you have recently traveled to areas with a high risk of hookworms, visit your doctor upon return. Provide him with all the useful information regarding your trip and let him know if you have come into contact with dogs or cats. Your doctor may have the following tests to diagnose the infection:
- Analysis of a stool sample to check for eggs or parasites
- A chest X-ray looking for larvae in the lungs
- A complete blood count (CBC) and iron to control anemia.
Part 2 of 3: Treating Hookworm Infection
Step 1. Follow anthelmintic treatment as prescribed by your doctor
This class of drugs is capable of attacking intestinal parasites such as hookworms. Different types of worms cause different types of infections; Although there are slight differences in specific diagnoses, treatments are generally similar for all varieties of hookworms:
- Take 100 mg of mebendazole three times a day. The dosage is the same for adults and children.
- Take 400 mg of albendazole if the infestation is more severe. If after two weeks of the laboratory examination there is still the presence of eggs in the stool, you must take a second dose.
- If you have an infection called visceral larva migrans, you should take 400 mg of albendazole twice a day for 5 to 20 days.
- Take 325 mg of ferrous sulfate three times a day for six weeks to treat iron deficiency.
- Take 1000 mg of vitamin C supplement for six weeks.
- Take anti-itch medications, such as diphenhydramine, hydroxyzine, or hydrocortisone creams, if you have serpiginous dermatitis (larva migrans cutanea).
Step 2. Refrain from the urge to scratch itchy rashes under any circumstances
The itchiness is due to parasites found under the surface of the skin. If you keep scratching, these worms can move under your nails, and as a result, you may be ingesting them with food or introducing them into your rectum when you go to the bathroom. Also, scratching increases the risk of bacterial skin infections. It is important to avoid scratching the rashes due to hookworms by all means; try to cover them by wearing long-sleeved clothing or long pants so as not to be tempted to scratch.
Step 3. Avoid hand contact with fecal material
When you go to the bathroom, keep your hands away from the anal area. If the larvae present in the feces reach the hands or come into contact with the skin, the infestation process begins again. To stay safe, you should wear disposable latex gloves until the tests find that you are permanently rid of the parasites.
Step 4. Complete iron therapy if needed
Since hookworms cause blood loss, the infection often leads to iron deficiency anemia. If this is the case, your doctor will recommend a course of iron supplements and dietary changes to bring your levels back to normal. In very rare cases, when the anemia is particularly severe, a blood transfusion, iron injections, or intravenous iron therapy are required. The best food sources to get this mineral from are meat products, especially red meat. Other sources are:
- Fortified bread and cereals;
- Peas, lentils, white, red and baked beans, soybeans, chickpeas;
- Tofu;
- Dried fruits, such as plums, grapes, and apricots
- Dark green leafy vegetables
- Plum juice.
Step 5. Go back to the doctor for follow-up visits as directed
The scheduling of subsequent visits can vary a lot, depending on the doctor's analysis of your specific case. On average, an additional stool examination is required after two weeks. If traces of parasite eggs are still found in that circumstance, your doctor will prescribe a second dose of albendazole. Six weeks after starting treatment, your doctor will recommend that you do another complete blood test (complete blood count). If the laboratory results show that the values have not entered the normal range, you will have to repeat the therapy for another six weeks, after which you will repeat the CBC.
Part 3 of 3: Preventing other Infestations During and After Treatment
Step 1. Wash your hands thoroughly
Make sure you cleanse them after coming into contact with potentially contaminated earth or feces and always before eating. Do a thorough cleaning also under the nails, between the fingers and up to the wrists.
Use hot or very hot water, soap, and scrub them for at least 20 seconds. If you don't know how to quantify the time, you can sing the song "Happy Birthday" twice in a row
Step 2. Always wear shoes when going outdoors
This is especially important if you are in a high-risk location. However, walking barefoot is always a potentially dangerous behavior and exposes you to a possible infection, as the skin can come into contact with the larvae present in the feces of dogs or cats. Even wearing flip-flops or shoes with open toes you risk exposing your skin to this infestation.
Step 3. Contact your vet to get your pets checked and annual worm treatment
Even if your pet has already undergone deworming treatment when you adopted him from a kennel, he may still come into contact with hookworms over time. During this annual checkup, he brings a sample of his stool to the vet so that he can check for parasites. If tests confirm the infestation, the animal should be treated immediately.
Step 4. Never allow your pet to lick you on the mouth
Dogs especially love to show their affection towards their owners by licking their faces, including their mouths. If the animal has recently eaten, smelled, or in any way touched infected feces, the "hookworm caninum" species may transfer to your skin.
Step 5. Be especially careful when handling your four-legged friend's feces
Even if you think you are safe when picking up your dog's or cleaning your cat's litter box, remember that it's always better to be safe than sorry. Use a specific scoop to collect the feces and avoid putting your hands anywhere in the surrounding soil if you are concerned that there may be potentially infected manure.
If you can afford it, consider hiring a specialized company to take care of the removal of animal droppings
Step 6. Monitor the children very carefully
Even for adults it can be difficult to limit a hookworm infestation. You don't have to scratch the rashes, you have to prevent the dog from getting close to your mouth, and you have to constantly pay attention to the threat of further infection through your own feces. For children it is even more difficult and they require more help, to avoid spreading the infection to others or infecting themselves again. You need to monitor them carefully, especially when they approach animals, to make sure they stay away from their mouth. Do not allow your child to play where the soil can be potentially contaminated and, above all, make sure that he does not ingest any earth.
Step 7. Make sure the water and food are clean and sterilized
The drinking water that you wash and cook with must be sterilized. If you are unsure of its purity, you need to boil it and then wait for it to cool before using it. Also make sure that the food is cooked perfectly.
Advice
- Hookworm infestation has very few signs or symptoms; for this reason, more than 70% of patients are not even aware that they are infected.
- Once the eggs have hatched, the larvae of these parasites survive for up to 4 weeks in the soil, in the grass or among the plant material.
- Take all necessary precautions when your child goes to a sandpit in the park; animals often use these environments to defecate.
- Hookworm eggs need a moist environment to hatch. Only allow your pet to defecate in those places that are exposed to sunlight for at least 3 hours a day.
Warnings
- Do not give specific hookworm medications to children under two years of age. Consult your pediatrician to get his or her professional opinion and correct recommendations.
- Be aware that babies, young children, pregnant women, and people who are malnourished are more likely to become infected with these parasites.
